One of the greatest reasons why certain therapies work is that they respect where the client is versus attempting to steer anyone in a particular direction. This is most certainly true of Motivational Interviewing. This is a type of therapy used in drug counseling to facilitate change in someone at his or her pace.
Although someone may want to get sober, he or she usually has a few strong reasons why they may not be ready. For instance, they may fear the absence of drinking or drug use in their life. They may worry about losing their drinking friends and related community. They may wonder how to live life without the coping tool of alcohol. For instance, someone might be heavily dependent on alcohol because they turn to it for emotional support. Losing drinking then might seem intimidating. At the same time, drinking may be presenting significant problems (such as potential loss of employment) which is why they want to quit.
Motivational Interviewing takes this ambivalence into consideration. It does this by using its primary principles in therapy. These principles are:
- Point out discrepancies or inconsistencies between what a person wants to do and what he or she is currently doing.
- Express empathy in order to build a connection and accept a person where he or she is at in their process towards change.
- Amplify ambivalence in order to point out that ambivalence is normal when trying to initiate change. However, if not recognized, ambivalence can stand in the way of moving ahead.
- Roll with resistances when a person gives reasons to not change. It’s clear that he or she is not yet ready to move forward.
Furthermore, a drug counselor or therapist using motivational interviewing with someone might use the following tools with someone in order to be accepting and non-judgmental of the person they may be working with:
- Open-Ended Questions: The therapist uses open-ended questions in order to invite personal story, establish rapport, elicit what is important, provide an opportunity for an individual to hear his or her own struggle regarding drug abuse, and increase understanding.
- Affirmations: Affirming a person’s strengths wherever possible provides validation, encouragement, and support. It increases confidence in his or her ability to create change. One of the many dysfunctional patters of addiction is powerlessness. Affirmations can promote a feeling of inner power and the ability to make change.
- Reflective Statements: These are statements that mirror what a person just said without actually repeating his or her words. For instance, if that person expressed difficulty in making a decision, the therapist might respond with, “It sounds like you’re having trouble making the right choice.” These statements allow the client to hear his or her own struggles and the ambivalence he or she is experiencing. Depending on where an individual is in the process of change and also on the depth of the therapeutic relationship, the use of different types of reflections may vary.
- Summaries: A therapist might provide a summary of the therapeutic discussion to highlight any changes, insights, or shifts that a person experienced during a session. Summaries might also include both sides of ambivalence and communicate empathy towards his or her difficult position.
Anyone trying to make such a change as quitting their addiction will have heavy degree of ambivalence -they may want to quit but, at the same time, they may not want to quit. On top of this ambivalence, some might be hard on themselves for not being able to quit. Some men and women struggling with addiction might have a strong inner critic that pushes them to quit and voices its criticism when recovery isn’t happening.
For this reason and more, having a therapist trained in motivational interviewing – someone who can accept you for who you are and where you are in life – can certainly be a support. At the very least, a therapist can help begin the process of change by talking about it, even if that change takes some time to come into fruition.