BIMI Case Study and Instructions
Assignment Instructions:
After reading Brief Integrated Motivational Intervention (BIMI), use the following case study to
complete a BIMI. Use the provided worksheets required to complete a BIMI with a volunteer you find
to roleplay as “Keira”. If you cannot find a volunteer, you can roleplay “Keira” yourself.
You are an addictions counselor working at SUNDANCE RESIDENTIAL MENTAL HEALTH AND ADDICTIONS
RECOVERY CENTRE. You are often asked to meet with clients who enter the facility due to a mental
health crisis. At times some of these clients have substance abuse issues, but they have not entered the
treatment center due to these issues. This is the case with Keira Keys.
KEIRA KEYS is a 27- year - old female who has entered the Sundance Mental Health & Addictions
Recovery Centre. Keira came to the Centre after several days in the hospital after a serious suicide
attempt. This was Keira’s 3rd attempt at suicide in the past 2 years.
Keira has been at the Sundance Recovery Centre for 2 weeks now and has been actively participating in
therapy. Keira has disclosed to her therapist that prior to being hospitalized she had been drinking hard
and using cocaine a lot more than usual. Keira has also indicated to her therapist that she is feeling very
tired of her life. She has lost many of her old friends due to her lifestyle and while still in contact with
her family, they are threatening to disown her.
The therapist had some details to pass on to you regarding some background information on Keira as
well as some information about Keira’s substance use.
Keira lived in a very chaotic home with her parents and 3 siblings. Keira was the oldest and was expected
to help look after her siblings from a very young age, while both her parents worked. Keira did not have
a good relationship with her parents as she felt like she was their babysitter, not their daughter. Keira’s
mom was very critical of Keira and her father was typically very quiet and would often go spend his free
time in the garage ‘fixing things’. Keira learned later that her father went to the garage to drink. Keira
never considered her father an alcoholic as he never appeared drunk and went to work every day. At
the age of 17 Keira developed a relationship with a boy from school. Her new boyfriend expected Keira
to spend time with him and so Keira began to rebel against her babysitting duties. Her parents weren’t
happy and Keira left home before her 18th birthday. She lived with her boyfriend’s family for a few
months until that relationship ended. Since that time, Keira has been struggling to support herself, but
she does have her own basement apartment. She works in bars as a waitress and her tips, which is
around $60.00 per night, help to keep her afloat. Due to her work environment, Keira stays for drinks
with her peers after the bar closes every night. Keira has anywhere from 3 to 6 drinks depending on
when the manager closes up. Keira never has to pay for drinks at the bar as the manager lets them drink
for free. A year ago, she went to a party with a friend from work and she tried cocaine for her first time.
For quite some time, Keira only used cocaine at parties when it was offered to her. However, over the
past 3 months Keira has started buying her own. Keira is finding now that she is using her ‘tip’ money to
buy cocaine, and she has less money for her living expenses. Last month, Keira was not able to make
rent and her landlord threatened to evict her. It was after this news that Keira attempted to take her life
by trying to overdose on alcohol and prescription meds (the therapist does not know where Keira got
these). Lucky for Keira, a friend from work came by Keira’s apartment and found Keira.
The therapist has asked Keira if she would be willing to speak with you about substance use and Keira
has agreed, although is not thrilled with the idea. She states she is willing to have a quick meeting with
you, but she is not willing to go into another type of counseling or therapy session.
BIMI Case Study and Instructions
You see this as a good opportunity to use Brief Integrated Motivational Intervention with Keira and set
up a time to sit down with her.
Below is a short guideline for you to follow. Please ensure you read your book for the complete
information on how to complete a BIMI.
Step 1: Engagement and Brief Assessment (Chapter 2)
Session 1
Purpose: Build relationship and open environment in which substance use can be discussed.
Complete worksheets:
• BIMI Brief Assessment Sheet
• AUDIT and/or SDS
• PHQ-9
• GAD-7
• You are at your first meeting with Keira. During this meeting you are building trust and a
relationship. In a conversational style you must complete the Worksheet: BIMI Brief
Assessment. Depending on Keira’s answers, there will be other questionnaires to complete
with her. You must choose which worksheets to complete. As an example, if Keira is not
misusing alcohol, then you would not complete an AUDIT.
• This first session may be a bit longer than the recommended 15 to 30 minutes due to
the need to complete the questionnaires with your client.
Session 2
Purpose: Provide client with feedback from Session 1. Answer client questions, provide educational
information to take away.
Complete worksheet *(before you meet with Kiera again): BIMI Assessment Feedback-Your Results
• To properly complete this worksheet, you will need to do some research. Be sure that
any research and stats are CANADIAN.
• Be prepared to answer any questions the client may have in relation to their substance
misuse and how it affects their specific mental health issues.
• During this session you will go over the results of the Feedback with your client and
discuss how your client feels about the information you have presented.
Step 2: Making Decisions About Change (Chapter 3)
(Will take more than one session)
Purpose: Help client begin to consider benefits and costs associated with use.
Complete (your choice) Worksheet 1 or 2: What I enjoy about using/What keeps me using?
Complete Worksheet 3: How does my use sometimes affect me?
• Complete Worksheet 1 or 2(these are the same worksheets but in different format):
What I enjoy about Using/ What keeps me using?
• After discussing Worksheet 1/2; move on to Worksheet #3: How does my use
sometimes affect me?
Step 3: Change Plans and Social Support (Chapter 4)
(Will take more than 1 session)
Purpose: Help build client confidence that change is possible. Identify small achievable substance
related or personal goal.
Complete Worksheet 4: Taking steps toward my goals.
BIMI Case Study and Instructions
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Help client identify who is their circle of healthy supports.
Discuss with client their personal goals. Then complete Worksheet 4: Taking steps
toward my goals. You may need to use a larger sheet to complete worksheet 4. Assist your
client in identifying things that might get in the way of success. Then work with your client
to come up with strategies to deal with those possible setbacks should they occur.
Assignment Submission:
Submit into Moodle all the Worksheets that you completed.