Motivational Interviewing

There are various forms of counseling, therapy, and mental health treatment applied to addiction recovery. Depending on an individual’s needs, the types of therapy used may vary and change over time. One of biggest influences in the successfulness of treatment is a person’s motivation. It is commonly said that overcoming addiction requires a person to want to make changes before it will actually stick. In cases where a person lacks the motivation or decisiveness to commit to these changes, motivational interviewing may be helpful.

Motivational interviewing is a short-term, practical approach to treatment that is often used to address addiction, mental health conditions, and the management of physical health conditions. This form of therapy is designed to help motivate clients to change behaviors that prevent them from making healthy choices. It can help prepare an individual for specific forms of therapy, be beneficial for those who become angry or hostile when confronted with the idea of change, and help a person move through various emotional stages to accept the need for change in order to start the recovery process.

The Goal of Motivational Interviewing

Motivational interviewing uses a number of elements to engage clients and encourage them to explore their feelings, thoughts, and motivations. While the therapist provides support and encouragement, ultimately, they allow clients to make their own decisions without feeling pressure from the outside world. This approach may require more time, but allowing clients to arrive to conclusions on their own empowers them to make decisions that are more likely to stick.

There are three main components to how motivational interviewing is conducted. They are:

1. Collaboration
   
   Motivational interviewing focuses on creating a dynamic in which the therapist and client work together on issues, rather than the therapist guiding the client. In this setting, the therapist serves more of a support role rather than a persuasive role, allowing the client to feel a sense of empowerment in their own recovery.
2. Evocation
   
   Rather than outlining goals and strategies to help the client in treatment, motivational interviewing works on creating an internal desire for change. Clients are encouraged to speak openly and frequently about their perceptions without the therapist trying to impose outside observations. This can help reduce feelings of defensiveness in clients and helps them feel motivated to make changes they can maintain for a long period of time.
3. Autonomy
   
   Unlike other forms of therapy, motivational interviewing places the power in the hands of the clients. They are empowered to make their own decisions and accept responsibility for the choices they make. The therapist provides space for clients to work through challenges on their own.

How Motivational Interviewing Works

While motivational interviewing places much of the power in the clients’ hands, therapists do not sit idly by throughout sessions. This ensures that sessions are productive and stay on track. Actions a therapist takes through motivational interviewing include:

1. Being empathetic
   
   The therapist’s primary role in motivational interviewing is to build an understanding of the thoughts, struggles, and ideas clients have. This helps clients become more open with expressing themselves because there is no hesitation due to the influence of judgement or criticism. Instead, a therapist may express empathy by conveying a sense of understanding and compassion.
2. Identifying discrepancies
   
   Although therapists do not actively guide clients to follow particular paths, they can point out to a client when their actions do not align with what they are conveying. Rather than confronting the client about these discrepancies, a therapist will ask questions that can help lead the client to their own conclusions. They can identify the link between substance abuse and barriers to their success or happiness.
3. Accept resistance
   
   Clients will naturally resist some ideas or express reluctance about making changes throughout the process. It is not the therapist’s job to confront resistance head-on. Instead, the therapist works to understand why the client feels a specific way. Even if the client’s thoughts are flawed, the therapist does not actively try to change them and instead helps the client find solutions through open discussion.
4. Strengthen belief in oneself
   
   Many who deal with addiction face numerous challenges including relapse. Sobriety is not easy to achieve and for many, it may take numerous tries before it sticks. Numerous relapses can make it difficult for clients to remain optimistic or confident in their abilities. The therapist can help remind clients of their successes in the past and highlight their strengths. This can help minimize the impact of negative perceptions and embolden clients to keep moving forward.

Motivational Interviewing in Addiction Treatment

A lack of motivation to change can be one of the biggest obstacles to overcome in addiction treatment. If someone is not ready to make the changes necessary to achieve sobriety, their chances of success are diminished. Motivational interviewing is a way to help empower clients and encourage them to make life changes. Reluctance to change may be due to fear of the unknown, a lack of desire to change, or a hesitancy to give up something that produces enjoyable side effects. It is not uncommon to find people grieve the loss of an addiction as they work through recovery, which is why it is important to help clients find the desire within themselves to change rather than forcing them to follow a path they are not ready to travel.

Motivational interviewing is a successful element of dual-diagnosis treatment because it encourages clients to find the motivation within themselves to change and it is not forced upon them. Clients take full responsibility for their journey because they guide the conversations, make the decisions, and ultimately decide what happens next. The therapist’s role in these interactions is to draw information from the client so that over time, they can recognize the need for change on their own.

This approach to therapy used in conjunction with traditional addiction treatment can help clients find the motivation and desire to achieve sobriety. Often, motivational interviewing is one of many forms of therapy used over the course of recovery to help empower clients. While this style of therapy can be difficult to navigate at times, the benefits of it are pronounced and can help clients address other challenges in life.

References
drugabuse.com/treatment-therapy/motivational-interviewing/
americanaddictioncenters.org/therapy-treatment/motivational-interviewing