What Is Motivational Interviewing?

What Is Motivational Interviewing?The addictive cycle may seem impossible to stop, but it is not. Popular belief that people need to hit bottom before they get sober is false. The truth is that individuals with less emotional stress and fewer problems sometimes feel more driven to get sober according to Psychology Today. That means that people who take action and seek treatment early before an addiction sinks deep physical and psychological roots are more likely to achieve lasting sobriety.

Psychologists wrestled with the question of how to motivate addicts to change their behavior for years with mixed results. In the early 1990s an approach that was developed several decades earlier began gaining support from recovery experts. Motivational Interviewing proved to be an effective way to help people overcome ambivalence toward change. Today the approach is widely used in recovery centers.

Motivational Interviewing 101

Without clear personal reasons for getting sober, it is almost impossible to stop using permanently. The goal of Motivational Interviewing (MI) is to help addicted individuals see the negative effects of substance abuse and then empower them to become motivated to change.

Recovery experts who use MI accept a person’s level of motivation as a good starting point for change say experts at the Substance Abuse and Mental Health Services Administration. This creates a climate of negotiation not conflict. With that foundation of trust laid, therapists can then use a variety of techniques to help individuals recognize discrepancies between their behavior and personal goals. The MI method is designed to show a person who struggles with substance abuse differences between where they are and where they hope to be.

Several characteristics of Motivational Interviewing include the following:

  • Directive
  • Patient-centered
  • Expresses empathy through reflective listening
  • Avoids arguments and rolls with resistance
  • Encourages individuals to believe that they have the ability to change
  • Communicates respect for and acceptance of people and their feelings
  • Establishes a nonjudgmental, collaborative relationship
  • Casts the therapist in the role of a supportive and knowledgeable consultant
  • Employs complimenting rather than denigrating
  • Employs listening rather than telling
  • Gently persuades with an understanding that change is up to the person
  • Provides support throughout the recovery process

Key techniques include the following:

  • Asking open-ended questions
  • Using affirmations
  • Forming reflective statements
  • Providing summaries

Positive “change talk” is another major goal of MI. Self-advocacy and a belief that people are more likely to change when they themselves discuss it than when someone else (such as a spouse or therapist) talks about it is the core of the concept. When addicted individuals mention or discuss their desires, abilities, reasons, or needs to change behavior and commitment to changing, therapists know that they are beginning to catch a vision for a better future.

Stages of Change

Most psychologists agree that people pass through a series of cognitive and behavioral stages when they change behavior. During the early stages they tend to focus on thinking about whether or not change is something they should consider. In later stages individuals take action to change or maintain changes. To be effective a therapist must identify which stage of the cycle a person is in and then tailor therapeutic interventions appropriately.

People move sequentially through the five stages. Each one is preparation for the next, so hurrying through or skipping stages is likely to result in setbacks warn specialists writing for the Harvard Health Publications newsletter. The five main stages include the following:

  • Pre-contemplation – Avoiding a problem either by not seeing it or refusing to consider change
  • Contemplation – Acknowledging that a problem exists but struggling with ambivalence about the pros and cons of changing
  • Preparation/Determination – Taking steps and getting ready to change
  • Action/Willpower – Making the change and living the new behaviors
  • Maintenance – Integrating and maintaining behaviors into everyday life

Avoiding relapse is another benefit of understanding the stages of change model. As noted in Addiction Today Journal, most people follow problematic paths for years and make multiple attempts to change before achieving success. Gaining insight into that cycle can help individuals monitor their progress and stay alert for signs of relapse.

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