Motivational interviewing (MI) is a mental health approach that helps individuals move from indecisiveness to certainty regarding goals. It is an interviewing technique that helps people become motivated to make the changes that they truly desire.
Created over 30 years ago by Stephen Rollnick and William R. Miller, this type of therapy has proven useful to help those with low motivation for change ramp up their desire for transformation. Motivational interviewing can be used to treat various mental health disorders and has been found to be quite helpful in treating addiction.
It’s helpful to know where clients are in terms of stages of change. If they are not motivated to stop addictive behaviour, their chances of stopping are slim. They need some motivation to change behaviour, and MI can help.
While it used to be that confrontation was used in this type of interviewing, today it’s more non-confrontational. The thought behind this is that you don’t need to antagonize people to get them to change.
When you can offer authentic support and provide a safe space for mental and emotional exploration, clients typically feel less pressure to change. The decreased pressure helps them be more open to making the decision to change for the better and doing what’s necessary to make it happen.
There is a process for motivational interviewing that steers the client down a path where they come to realize that they are in control of their lives. They have the choice to take full responsibility for their behaviours and problems that come as a result. The therapist will use various questions to help the client gain some “aha” moments. Then, the therapist will work alongside the client to formulate appropriate goals.
MI is centred on four key processes that help clients clarify their goals and get motivated for working toward achieving them.
The best change occurs when a client feels safe and secure in the therapeutic relationship. By offering empathy, compassion, and trust, a therapist using MI is likely to cultivate a trusting relationship with the client. Such a firm foundation can have a huge impact on therapy.
This type of mutual trust relationship ensures that there isn’t a power struggle going on. A client will feel more like an equal, rather than someone with lesser value due to an addiction or other life problems.
In MI, the acronym OARS is used, which stands for open questions, affirmation, reflection, and summarizing. These qualities offered by a therapist can help clients gain clarity, create goals, and take action toward them.
Not every client who enters counselling will have clarity regarding goals. While they may know that they want to quit drinking or using drugs, they may not be clear as to what path to take to get there. They may also not have clarity regarding other life goals, such as career, relationships, and so on.
They might also not understand the discrepancy between their drug use and their life goals. The MI therapist can help the client identify any ambivalence and pinpoint primary goals to begin working on.
Part of the MI process is to discover and evoke the client’s motivation for change. The therapist will ask direct questions to gauge the level of motivation. Some clients are beyond ready to make serious changes, while others say they are, but after a bit of digging, they realize they aren’t.
Openness and willingness are two key characteristics to create change. Motivational interviewing encourages the therapist to ask open-ended questions so the client can start exploring just how ready and committed they are to change. Having them elaborate oftentimes gives them greater insight into what’s going on under the surface.
Ultimately, the MI therapist desires to see the client want to help create their own unique plan for change based on their motivation to experience transformation. The whole MI process is geared toward clients starting to dig deep into their mindsets to gauge where their motivational level for change is. Once they understand that motivation matters, they’re likely to want to be more proactive in changing what needs to be changed in their lives.
There may be some client resistance to change in the therapeutic process. The therapist’s role will be to approach it from a non-confrontational stance. They can listen with empathy, perhaps asking some open-ended questions that may cause the client to look at things from an alternative view. The therapist can allow the client to have that resistance, seeking other avenues to help them understand the motivation for change better.
Regarding substance abuse, motivation to stop abusing alcohol or drugs is necessary. The reality is that if someone just doesn’t want to stop the addictive behaviour, they’re probably not going to last long on the recovery path.
MI is a helpful technique because it helps the client talk themselves into change. It provides a therapeutic environment where the client is more likely to come to terms with where their motivation level is currently at. The interviewer then evokes from them the internal motivation that’s already there.
The clients are directed to see what their life might look like if they completely stop abusing substances. Being able to envision a healthy, happy life can provide the motivation to perhaps take steps they’ve never taken before.
MI has been found helpful for those struggling with addiction. Being able to recognize their ambivalence is a good start to thinking about what it might take for them to seriously consider stopping substance abuse for good.
If you’re struggling with substance abuse, consider reaching out for help. There are therapists that are trained to provide assistance specifically for those with addiction issues. Motivational interviewing is one technique that may be combined with other therapeutic techniques to assist you in recovering fully from addiction, and going on to enjoy the kind of life you truly desire.