Motivational Interviewing (MI) in Addiction Treatment

Also known as MI, motivational interviewing is one of the counseling approaches that is commonly used in the management of substance abuse and addiction. In some treatment programs, it is also used to manage co-occurring mental and behavioral health disorders, such as post-traumatic stress disorder and anxiety disorders.

About Motivational Interviewing

As a counseling approach, motivational interviewing was first proposed in 1983 by Professor William Miller, PhD. The technique involves motivating someone who is addicted to drugs and alcohol so that they can change the destructive behaviors that they have been engaging in.

Addiction treatment programs will often use this form of therapy. This is because the lack of motivation to stop abusing drugs and drinking alcohol are among the greatest barriers to long term recovery. You might encounter these barriers even though you have been suffering legal, social, financial, and health consequences as a result of your ongoing substance use and abuse.

The basis of motivational interviewing is that you will be aware - even if it is just in part - of the negative consequences and effects of your substance abuse and addiction. You will also be in a particular stage of readiness with respect to changing your behavior.

While working with MI therapists, you will get the help that you need to get ready for change. This is because you will work through the process of overcoming your fear or ambivalence for change while also increasing your own motivation to effect it.

According to the NSDUH - the National Survey on Drug Use and Health - for 2009, over 23 million Americans needed professional addiction treatment services. If you are among these people, you might lack the motivation needed to change your life.

For instance, you might not think that your drug and alcohol abuse problem is serious. On the other hand, you might not want to give up all the positive and pleasurable sensations that you have come to associate with substance abuse and addiction. Finally, you might fear the consequences that will arise when you stop taking drugs and drinking alcohol - including but not limited to intense cravings and withdrawal symptoms. As an addict, you might even go through the various stages of grief after you give up your favorite substances of abuse.

How It Works

Research studies have shown that motivational interviewing is effective in treating addiction both among voluntary clients as well as among involuntary ones. That said, there are key points to this form of therapy that ought to be maintained across all variations of the techniques that are used. They include but are not limited to:

  • Direct persuasion might not be able to resolve ambivalence or unwilling to change
  • Motivation should come from the client and not from any external sources
  • The client - and not the counselor or therapist - would be responsible for resolving their ambivalence
  • The counselor will elicit information - and quietly so - from the client
  • The counselor will guide the client so that they are able to recognize and eventually resolve their ambivalence
  • The readiness and willingness to change would be a result of interpersonal interaction - and it is not a trait
  • The relationship between the counselor and the client should be similar to a partnership

The important thing to keep in mind is that MI is one of the simple processes that you can complete in a couple of sessions. Typically, the sessions will follow some steps, including the following:

a) Engaging

The counselor will talk to you about your hopes, concerns, and issues. In the process, they will work towards helping you establish a relationship of trust and understanding with them.

b) Focusing

The conversation will be narrowed down to the topic of habits and patterns that you - as the client - would like to change.

c) Evoking

The counselor will elicit your motivation for change. They will attempt to do this by increase your sense and understanding of the importance of change. In the process, your confidence will improve and you will eventually be ready for change.

d) Planning

You will work with your counselor to develop several practical steps that you can use to work through and eventually implement the changes that you desire.

Benefits of Motivational Interviewing

As a model of counseling, motivational interviewing is centered on you the client. This means that the focus would be to figure out what you want - and not just what your therapist thinks would be in your best interests.

To this end, it will require a high level of reflective listening, empathy, and a natural ability to form strong bonds between the client and the counselor in a relatively short time period. Research studies have also shown that this type of therapy is quite effective.

For instance, a research study was conducted on students who were addicted to tobacco. Those who received this time of treatment had 4 times as high a likelihood as those in a control group to cut down or at least attempt to quit.

The primary consideration to keep in mind is that motivational interviewing can help you overcome the internal battle that you have been having about whether you really want to give up drugs and alcohol or not.

Although there are many reasons to quit these substances and seek treatment for your addiction, you may also have other reasons not to especially when you are still struggling with a substance use disorder.

The goal of motivational interviewing, to this end, would be to point out the benefits and drawbacks of quitting your favorite substances of abuse. This will be based on what you feel is most important to you.

After you have overcome your denial and have arrived at a conclusion of these benefits and drawbacks of drug use, your desire for change, how this change looks like, how you and how you would like to implement this change, you will have an easier time to do so.

Finally, motivational interviewing will not make you feel forced to give up drugs and alcohol. Instead, you will work on pursuing a change in your life that you would have chosen on your own.

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