Substance use and addiction can change your personality, your priorities, and your values. But, to a greater or lesser degree, those with a substance disorder likely understand that it holds negative consequences for them and their loved ones.
But, even if someone knows that they have a problem and need to make a change, it does not mean that they have the strength or motivation to make that change a reality.
What Is Motivational Interviewing?
Motivational interviewing (MI) is a counseling method and substance use disorder treatment that aims to help patients overcome ambivalence, doubt, or fear of change. MI helps patients build the internal motivation and conviction necessary to change their behavior.
It’s also considered an appropriate and often effective tool for those who are angry or hostile towards change.
Motivational interviewing for substance abuse has been described as a practical, empathetic, and brief intervention that respects the difficulty of making life changes while empowering participants to do just that.
It’s also used to prepare patients for other therapies included in their treatment program, or even as an intervention if cognitive behavioral therapy or other therapies aren’t found to be effective.
Outside of addiction treatment, motivational interviewing is often used to improve self-care related to diabetes, heart disease, and eating disorders, as it can give participants the motivation to make better health choices.
What Are The Limits Of MI?
Motivational interviewing works well when someone is doubting and unsure, but not if a participant is already motivated and ready for the rehabilitation process.
How Motivational Interviewing Works
Motivational interviewing is an evolution of Carl Roger’s person-centered counseling approach, which has two main objectives:
- increase an individual’s motivation
- help an individual commit to change
In a session, a motivational interviewer uses open-ended questions to encourage a participant to talk about why they think they need to make a change. Then the interviewer listens to them before summarizing and restating their thoughts back at them, an approach known as reflective listening.
This process ultimately facilitates a supportive, empathetic conversation that, hopefully, results in meaningful change.
Unlike other therapies, motivational interviewing is typically only conducted over one or two sessions, though it can sometimes be included in longer-term therapies.
Why Motivational Interviewing Is Effective
Researchers and clinicians have found that there are three distinct reasons why so many who struggle with substance use disorders experience a lack of motivation to change their current behavior:
- they do not think that their substance abuse is that serious
- they do not want to give up the pleasure or positive associations they have with drug abuse
- they fear the difficulty of stopping their drug use due to withdrawal symptoms, cravings, and other mental effects
Talking through these fears and reasons a person wants to change, and then hearing that reasoning and those motivations repeated aloud, helps motivational interviewers summarize the issue in their participant’s minds.
This allows patients to gain clarity and a new sense of resolution to move forward with substance abuse treatment.
This self-efficacy is critical, as external pressures from family members, doctors, friends, or other loved ones can often push an individual to withdraw further, isolating themselves and not making an authentic effort to recover. This greatly increases the likelihood of future relapse.
What Makes A Good Motivational Interviewer?
Good motivational interviewers are those with specific aptitudes for care, patience, and psychotherapy. They are licensed as mental health care professionals and have received training in specific motivational interviewing techniques.
Interviewers work to forge a personal connection with participants and help them with authentic support, patience, empathy, and validation of their feelings and doubts, often developing their own therapeutic style and approach over time.
Those who have these qualities, and who receive the training and practice necessary to build meaningful therapeutic relationships, can make a truly profound difference in the lives of those they work with.
Other Treatments Used With Motivational Interviewing
Motivational interviewing is often used before other forms of therapy, especially cognitive behavioral therapy.
Motivational interviewing can also be used to help prepare individuals to begin medical detox, in which the symptoms of drug withdrawal are managed in a controlled and supervised setting. It can also be an intervention when different forms of therapy are ineffective.
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