Motivational interviewing was first developed in 1983 as a form of counseling. This type of therapy is used to help those addicted to drugs or alcohol begin to understand how their addiction is affecting their life and then create a plan to overcome their dependence issues. In this blog, we will take a look at everything you need to know as it pertains to motivational interviewing for substance abuse.
What Is Motivational Interviewing?
Motivational interviewing is often used in addiction treatment because those who are struggling with substance use can be apprehensive about entering treatment. In fact, the willingness, or lack thereof, to enter treatment is one of the biggest barriers people with addictions face, even as their life falls apart because of substance use.
Motivational interviewing is based on the theory that everyone who struggles with addiction has some understanding that their substance abuse is hurting them and the people who care for them. This method further works on the basis that a patient who is currently going through an addiction also wants to change their behavior and will respond positively to treatment overtures.
A therapist who is specifically trained in motivational interviewing will help the patient overcome their uncertainty or apprehension toward recovery by having in-depth conversations that work on increasing the patient’s own motivation to change. Many people who need treatment for their respective addiction disorders have reasons for why they might not want to break out of their self-destructive cycles.
- They may feel that they are in control of their substance use, that it is not as bad as others are saying it is, that other people have worse problems, or that substance use helps them to stay balanced.
- They may worry that they can’t afford treatment.
- They may be afraid of the guilt or shame of acknowledging an addiction.
Additionally, many people become psychologically dependent on the positive sensations they get from their drug use and are very reluctant to give them up. They may also be afraid of the withdrawal symptoms that come from breaking the physical dependence, so they continue to find some escape in their chemical substances.
How Does Motivational Interviewing Work?
Motivational interviewing has seven key approaches:
- The motivation has to come from the patient, not from anyone else.
- When there is apprehension surrounding treatment, the resolution has to come from the patient, not the therapist.
- Persuasion can’t resolve ambivalence.
- The therapist gets their information from the patient through conversation.
- The therapist is responsible for guiding the patient to recognize and resolve their ambivalence toward treatment.
- The readiness to change will fluctuate, and this is a natural part of the process.
- The patient and the therapist work together as partners.
Motivational interviewing is a straightforward approach to treat substance abuse. It can be completed in a relatively short amount of time. In general, it works in a very specific way.
First off, the therapist will engage the patient and talk about their concerns as well as their goals. This is done to establish a relationship based on trust between the therapist and the patient.
The two will then focus on the patterns and habits that have resulted in the addiction. From there, the therapist will discuss the motivation behind the patient looking to get the help they need.
During this time, the therapist will hammer home that change can occur, as long as the patient is willing to put in the work. Finally, both the therapist and patient will put a plan together to make the necessary changes needed to get clean and sober.
Who Benefits From Motivational Interviewing?
When it comes to motivational interviewing, it has been a successful form of therapy for many different groups of people suffering from addiction.
Those Who Didn’t Find Success With CBT
Motivational interviewing can be particularly beneficial for those who have not found success with cognitive behavioral therapy (CBT). While CBT similarly is based on a patient’s willingness to change their negative thoughts and behaviors, it’s done so in a different way.
In fact, Motivational interviewing can actually be a pre-cursor for cognitive behavioral therapy. It can help get the ball rolling on reflection needed to enact change, which can then lead to CBT treatment.
Additionally, those who need a lot of emotional validation, and those who would benefit from a close relationship with their therapists might react to motivational interviewing better than they would with cognitive behavioral therapy.
Those Who Have Relapsed
Studies have shown that motivational interviewing can be very valuable for those who have relapsed. People who have suffered a set back from a relapse, especially those who have relapsed multiple times, might feel defeated, or even think that treatment doesn’t work for them. Motivational interviewing can help patients navigate through the complexities and the toll of relapse, incentivizing them to rediscover the spark of inspiration to quit.
Most importantly for those suffering from relapse, motivational interviewing removes the guilt they might feel for relapsing or the pressure they might feel to get it right this time. For these patients, motivational interviewing can remove those feelings and allow them to focus on their sobriety.
Those Who Suffer From Alcohol Addiction
There is some belief amongst addiction professionals that the group that can benefit the most from motivational interviewing is those suffering from alcohol addiction. It’s believed that the reason for this is, since alcohol consumption is legal and less stigmatized than drug use, it’s easier to be nonchalant about using it.
Those Who Suffer From Mental Disorders
Because of the success of motivational interviewing with those suffering from alcohol addiction, therapists have begun trying this method out with those suffering from mental health and behavioral disorders. In fact, it has been successfully used to increase motivation for people with eating disorders to recover.
Is Motivational Interviewing For Everyone?
In short, just like all other forms of treatment, motivational interviewing is not for everyone. While it has certainly helped many people develop the motivation and strength to overcome their addictions, patients who have co-occurring mental illness and chronic substance use disorders might need more than what motivational interviewing can offer.
One of the benefits of motivational interviewing is that when a patient becomes fully engaged and fully buys into the treatment, the patient and therapist can get a plan in place in as little as four sessions.
Extreme Mental Health or Addiction Issues
On the flip side, someone who has deep-seated mental health concerns, and whose addiction goes beyond a simple case of motivation, will likely need a significantly more in-depth form of counseling. They will need counseling that probably includes medication in the regimen as well.
It’s also possible that for patients with severe mental illnesses and long-lasting addiction problems, motivation might not even be a possibility or might not be the problem either for that matter. If that’s the case, then motivational interviewing would not be beneficial for them.
An example of this is someone who suffers from a major depressive disorder. They will likely not respond well to motivational interviewing because depression robs people of their ability to motivate themselves.
Similarly, a patient who does not have the mental clarity to conceptualize the pros and cons of their substance abuse, and come up with a plan based on that conceptualization, will likely not be helped by motivational interviewing. Schizophrenia and bipolar disorder are two examples of these kinds of conditions, but there are others as well.
How Do I Know If Motivational Interviewing Is Right For Me?
One of the keys to determining whether or not motivational interviewing will be effective is the therapist. It is critically important that the patient and the therapist form a deep partnership so that the patient feels comfortable opening up to the therapist.
As a result, the therapist has to be good at establishing a trusting relationship with different types of people in a short amount of time. This requires patience and nuance. While these skills are important for anyone who wants to get into counseling, motivational interviewing is a particularly demanding application.
Motivational interviewing is centered around the patient. They have to be willing to share their thoughts and apprehensions when it comes to treatment in order to effectively be able to discuss it and treat it. The therapist’s role is to give the patient tools to work through their apprehension.
In motivational interviewing, it is not the therapist’s responsibility to provide solutions or to push the patient in one direction or the other, but simply talk through their issues with them. This is done by the therapist asking open-ended questions.
Some examples of open-ended questions that a therapist might ask are:
- What do your family members say your problems are?
- What do you enjoy about using drugs or alcohol?
- In what ways does your drug or alcohol use make your life harder? To what degree does this concern you?
- Why did you decide to get help at this point in time?
- What do you think you have to do to get better?
The idea behind these kinds of open-ended questions is to get patients to see the problem for themselves and to put the pieces into place where they can begin to work through the problem.
The therapist’s role is to affirm their choices and offer guidance and advice as to how the work can be done. While not every patient will respond positively to this method, it works for those who are ready and willing to make a change.
Are You Interested in Motivational Interviewing for Substance Abuse?
At Footprints to Recovery, our goal is to help you get the help that you need to live a clean and sober life. We know that not everyone responds the same way to treatment, which is why we offer several different treatment options, including motivational interviewing. Contact us today for more information on motivational interviewing or to learn about our many treatment options.