Motivational Interviewing

Monday, December 7, 2020 | By Cooper Samp

 A Tool To Change Your Life

We all wish to change attributes about ourselves; whether it is with our relationships, career, or day-to-day. But what keeps us from taking the necessary steps towards these goals? Put simply: motivation. Establishing motivation is the key to our long-term productivity, health, and purpose. It guides our life decisions and our energy levels. When instilled with the right decisions, changing our behaviors is not a matter of “if” but “how.”

Therefore, for individuals who may need help finding this motivations, Motivational INterviewing (MI) can be a great technique to help. This popular psychotherapy (implemented within our program here at Coalition Recovery) helps motivate individuals to self improve their relationships, health, and quality of life. 

In this article, we’ll cover why motivational interviewing is such a revolutionary tool used in addiction treatment and recovery. 

What is Motivational Interviewing?

The intent of Motivational Interviewing is prompting behavior change through person-focused and non-confrontational counseling. Behavioral and Cognitive Psychotherapy defines MI as “a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.” 

Much like many psychotherapies, Motivational Interviewing does not involve any form of judgment or confrontation. There’s no arguing or ultimatums. Much like the name would imply, Motivational Interviewing helps individuals find their motivation to change their behavior; but intrinsically in their own way. The beauty of MI is that it guides individuals through the process of deciding and living their best life on their own terms.

In their book “Motivational Interviewing: Preparing People for Change” (a second edition to the popular Motivational Interviewing: Preparing People to Change Addictive Behavior), psychologists Stephen Rolinick and William R. Miller look further into the applications for Motivational Interviewing outside of its initial intended use towards drugs and alcohol addictions. They have stated the therapy can be utilized within a variety of settings in which people may feel ambivalent about making positive behavioral changes; like mental health, health care, schools, social work, and corrections. 

The therapy has been expanded to provide effective therapy for individuals with thoughts of suicide, eating disorders, gambling, smoking, co-occuring disorders, hoarding, chronic diseases like asthma, cardiovascular conditions, diabetes, and of course substance use disorders. 

How Does Motivational Interviewing Work?

The therapist will utilize a variety of techniques exploring an individual’s readiness to change. He or she will listen in a supportive manner while asking open-ended questions and providing positive affirmations. The goal of the therapist is to acknowledge any struggles or pains and offer positive feedback with empathy to help clarify and set future goals. 

Guiding individuals through this process requires a delicate approach. Therefore, therapists who specialize in Motivational Interviewing have been trained on how to ask the right questions and provide useful feedback at the right times. Without this proper training and experience, MI can be ineffective and may even cause further disruption. For this reason, at Coalition Recovery, we employ therapists who are specialized in one or two particular therapies. This way, they are highly experienced in dealing with these approaches and can offer the best experience of therapy. 

Why Does Motivational Interviewing Work?

Individuals who participate in Motivational Interviewing are able to see how their negative and problematic behaviors contradict their own values, goals, and desired outcomes. Through this, they will be better prepared in making a real commitment in changing their life. 

What is “The Spirit of Motivational Interviewing”?

This refers to the frame of mind of the therapist or clinician. The spirit of the therapy revolves around listening and helping, rather than instructing. The therapist will work with the individual while putting empathy, respect, and compassion at the core of everything. They will work with the patient in a collaborative manner rather than in an authoritative manner. They help individuals express ideas instead of imposing them; forming a supportive and therapeutic relationship. 

What Are the Core Techniques Used in Motivational Interviewing?

Therapists or clinicians will use a variety of methods helping patients consider their readiness for change (contemplation) and exploring their motivations for change:

  • Foster self-efficacy and optimism
  • Embrace resistance
  • Displaying empathy through reflective listening
  • Highlight discrepancies between the patient’s goals and their current behavior

What Does Embrace Resistance Mean?

Also referred to as “roll with resistance,” this technique is a frame of mind of validating an individual’s thoughts and feelings of ambivalence or resistance towards changing rather than arguing, dissuading, or being confrontational. The idea stems from the fact that people are more motivated to change when they are intrinsically inspired to do so, rather than pressured or threatened to do so. 

What Makes People Resistant to Change?

The first thing we often look at when individuals are resistant to change is mental health conditions. Once we eliminate these we can dive into other scenarios in which individuals are stuck in what is called the contemplation stage of change. These things could include:

  • Lack insight about available resources and/or coping strategies 
  • Feeling unnecessarily pressured by others
  • Fearful about how difficult the change process could be

When considering addiction treatment, therapists will often utilize MI techniques alongside the Stages of Change process to promote elicit behavioral changes. This process provides a framework for determining an individual’s readiness for change and resolving any ambivalence while reinforcing motivation. The five stages of behavioral change are:

  1. Precontemplation stage
  2. Contemplation stage
  3. Preparation stage
  4. Action stage
  5. Maintenance stage

Understanding which stage an individual is in – alongside their resistance or readiness towards change – therapists are better positioned to not only instill motivations but to maintain it as well. 

What are Some Typical Questions Used in Motivational Interviewing?

The most effective questions invite self-reflection and self-direction, such as:

  • What is important to you?
  • How would you go about making this change?
  • What would your life look like if you didn’t have this problem/current behavior?
  • What does change look like for you?
  • How does substance use conflict with your goals?
  • How do these behaviors conflict with your values?
  • Why is it important for you to make this change?

Is MI Used Alongside Other Therapies Methods?

Motivational Interviewing is an effective modality for both individualized counseling and group therapy. MI can also utilize elements of Cognitive Behavioral Therapy, Solution-Focused Therapy,Gestalt Therapy or Mindfulness-Based Cognitive Therapy in conjunction with Motivational Interviewing techniques.

Are There Limitations to Motivational Interviewing?

  • Counselors not equipped to “roll with resistance” by being ill equipped to handle this type of therapy. For this reason, MI can be hard to find a quality therapist
  • This type of therapy might not be best suited for individuals with depression and trauma which is why at Coalition Recovery we utilize a variety of therapists with different specialties like trauma and depression to help bridge this gap
  • The patient needs to have an open mind and be realistic about their own problems. For instance, if they are in denial about their substance abuse, different therapies like MRT might be more effective at first. 
  • Certain facilities with high number of patients and low number of therapist could effect how much time and attention a therapist can give towards individuals. Without proper time and attention, MI might not be as effective. 
  • Like many therapies, MI takes time to show results. For individuals who start with outpatient therapy, the lack of frequency of sessions could delay progress.

Are There Certain Individuals Who May Not Benefit From This Therapy?

For people with mental health disorders such as bipolar disorder, schizophrenia and others, MI should not be the primary clinical approach. Interventions such as psychiatry, medication management and other specific treatments should be explored first. After, elements of MI can be used in conjunction with other interventions depending on the individual patient’s circumstances and needs. Finding the right therapy is often an ongoing process. For instance, at Coalition Recovery, we base your treatment program (therapies, medications, level of care, etc.) based on a variety of factors including your physical and mental health, previous history in treatment, and overall use. 

What Are Some Patient-Centered Counseling Strategies?

Patient-centered counseling guides the individual into identifying their own goals and how they are going to get there without imposing goals. 

The philosophies behind Motivational Interviewing also help develop stronger counselors as well. The ability to “roll with resistance” can help clinicians eliminate the possibility of power struggle situations that might arise in a therapeutic setting. This becomes an important long-term skill to acquire, not just to help patients, but also for self-care as a helping professional. 

Motivational Interviewing At Coalition Recovery

Here at our facility, we have counselors who are adept and experienced in performing this form of therapy. While we utilize this technique mostly for substance use disorders, we love it because it is also multi-functional for a variety of circumstances. Because we are a dual-diagnosis facility (meaning we treat mental health disorders alongside addiction), this multifaceted therapy can be extremely helpful for individuals with co-occurring disorders.

Of course, Motivational Interviewing is just one of the many evidence-based therapies that we offer at Coalition Recovery. 

If you are interested in receiving this form of therapy for a substance use disorder, Coalition Recovery is a great choice! Speak with one of our representatives today to learn more about our therapies and the programs we offer to help get your life and happiness back.

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