Motivational Interviewing
Addiction is a disease that can be treated in a number of ways. Many people’s treatment plans will consist of different modalities. An intervention staged by loved ones will often be one of the first things a person will go through in their recovery journey.
Behavioural therapies such as cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) can be used. Some patients may benefit from medications, depending on their condition. Patients whose addiction is rooted in traumatic memories may benefit from Eye Movement Desensitisation and Reprocessing (EMDR) therapy.
But some people are ambivalent about changing. They lack the motivation to change their behaviour regarding substance use or behavioural addiction. For those people, resolving ambivalence regarding their desire to change can help them develop the mindset needed to change for the better.
At Sivana Rehab, our personalised treatment approach integrates multiple types of therapy to help patients make the changes they need to make.
What is Motivational Interviewing?
Motivational Interviewing, or MI, is a counselling style designed to help people resolve their ambivalence about change and find their reasons for change. Mixed feelings or even resistance to changing behaviour can be common in treating substance use disorder, as some people may be reluctant to make the lifestyle adjustments needed to make positive changes.
How Motivational Interviewing Works for Addiction Treatment
MI can be particularly helpful because it can address mixed feelings or a lack of motivation for change, as some people may not want to change their behaviour regarding substance abuse as they may be attached to their substances for a variety of reasons. MI can help people change their mindsets and behaviour.
A core tenet of MI is eliciting change talk, which are statements made by the patient that may indicate a longing to change. The therapist actively listens and amplifies these statements without making the patient feel their words are being used against them.
Another major tenet of MI is sustaining change. Sessions can often involve developing strategies to maintain their motivation, handle their triggers, and build a support network, all of which can be invaluable in preventing a relapse.
4 Skills of MI (OARS)
A therapist using ME needs to have 4 core skills to facilitate productive conversations with the patient. These 4 skills are:
Open Questions
Open-ended questions can help put a patient at ease and encourage them to talk. These questions cannot be answered with a simple yes or no, and they encourage patients to really think about their answers.
Affirmation
Affirmations help build a client’s confidence and self-efficacy. This skill requires a therapist to change the client’s behaviour positively.
Reflective Listening
This skill involves showing the client that they are being heard and understood. It’s also an important skill in encouraging patients to explore their thoughts and feelings more deeply. It also involves paraphrasing what the patients say so they can better understand it.
Summarising
This skill consolidates and reinforces the information shared during the session. It helps reinforce change talk, review what was discussed, highlight important points, and ensure that the therapist and patient are on the same page.
Four Processes of MI
Motivational interviewing involves four processes to help a patient develop a readiness to change. These processes are:
Engaging
By using open-ended questions, withholding judgement, and building trust, the therapist creates a safe space for the patient to feel heard and respected, allowing them space to find their own commitment to change.
Evoking
This process involves helping clients evoke their desire to change by exploring their needs, abilities, reasons, and desires. This process is about evoking change talk from the client and can be done by using open-ended questions that require clients to think about their answers.
Planning
This process is about developing a concrete plan to change once the patient is ready to act on their desire to change. This process is about helping patients develop concrete steps to make their desire to change a reality. This process solidifies a patient’s commitment to change and prepares them to act on it.
Principles of Motivational Interviewing
There are a number of principles that guide MI. These principles are:
Expressing Empathy
A key principle in MI is that the therapist must listen reflectively to the patient to understand their feelings and perspectives without judgement. This helps establish a trusting and collaborative relationship.
Developing Discrepancy
This principle concerns the therapist helping a patient see the gap between their actions and their values and goals. This often involves helping the patient see how their current actions do not help them achieve their aspirations.
Rolling with Resistance
Many patients can become resistant or defensive. Instead of being confrontational, the therapist will roll with the patient’s resistance. They don’t argue with the patient and instead use gentle suggestions to guide the conversation in a more productive direction. This allows patients the space they need to explore why they’re so resistant to changing their behaviour and to discover their own motivation to change.
We Can Treat Substance Use with Motivational Interviewing Skills
A person has to want to change. They can be given all the intense treatment in the world, and if they don’t want to change, they won’t. Most people who are affected by addiction want to change, but some may have mixed feelings about it. Maybe they’re scared of what their life will look like if they don’t have a substance to use as a coping mechanism. Maybe they’re worried they don’t have what it takes to make lasting changes.
But the truth is that anyone can change. Anyone who is affected by addiction can overcome their condition. There’s no such thing as a lost cause at Sivana Rehab. We help those who come to us discover their intrinsic motivation to overcome substance addiction. Contact us now, and we’ll help you on your recovery journey.