Motivational interviewing is a cognitive-behavioral interviewing technique that mental health professionals utilize when working with substance abusers.
It was first written about by Miller in 1983 and later developed by Miller and Rollnick in 1991. It categorizes people into stages of change to further help them in a mental health setting.
One of the main components of motivational interviewing is looking at ambivalence and understanding the ambivalence that usually surrounds making a change. For example, if a woman abuses alcohol, has lost her job due to it, and no longer sees her 20 year old son, and decides she is ready to stop drinking, there will probably still be ambivalence around quitting.
She may feel that she can only relax when she drinks and can forget about all of her problems; however, some of her problems are caused because of her addiction. A therapist using motivational interviewing would explore the ambivalence.
There are basic components and techniques that therapists use during motivational interviewing. One of the least used techniques is giving advice. Many therapists utilizing motivational interviewing do not give advice until they have established a relationship with the client.
They want the client to come to the result on their own, because the person is more likely to make changes. Other components include removing barriers to treatment, helping the person realize that they do have choices, empathizing with the client, giving the client feedback, helping the person clarify goals, giving referrals to necessary services, and showing a caring attitude.
Therapists using motivational interviewing techniques express empathy, try to avoid arguing with a client, encourage positive thinking, challenge the person’s thinking without tackling resistance to change head on, and show the client how his actions are in contrast to his goals.
For example, a man may say that he drinks to relax but has a goal of mending his relationship with his wife who is sick of his drinking. A therapist would help him see how those statements contradict each other. How will he relax if he can’t mend his relationship with his wife? The client determines his goals and the therapist uses motivational interviewing to assist the client in reaching the goals.
For motivational interviewing to be successful, a therapist and client have to form a relationship built on trust and empathy. The therapist must be able to use the relationship in the work. This is a major factor in most theories of talk therapy but is essential in motivational interviewing.
Stages of Change
In motivational interviewing there are five major stages of change. The first is pre-contemplation. A person is in this stage if they have not given thought to making a change in the behavior. The second stage is contemplation and this occurs when someone starts to think about changing.
For example, a woman may go to a therapist and say, “Sometimes I think that I need to stop drinking, but I don’t know. Maybe it isn’t so bad for me.” The third stage is planning and happens when someone makes a plan of how they’re going to change.
For example, a mental health professional and man might work together to write out specific steps to help him quit smoking marijuana. The fourth step is action. A person is in this stage when they start taking steps to change. The fifth step is maintenance and occurs when someone has reached her goal. Many people relapse after they quit drug use and start back at the beginning.
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