Motivational Interviewing

Motivational interviewing can be defined as a way for therapy to be client-centered in which providing a direct method to increase motivation to solve problems that lie in the psychological path (Van Wormer & Davis, 2008). This process was created by William Miller and his students at a school in Norway in 1983 (Motivational Interviewing, 2011). Motivational interviewing is focused on a respectful stance with a focus on building a rapport in the initial portions of the counseling relationship (MI, 2011). Motivational Interviewing is composed of three essential parts: 

• First, MI is a particular kind of conversation about change 
• MI is collaborative (person centered, partnership, honors autonomy, not expert-recipient)
• MI is evocative (seeks to call forth the person's own motivation and commitment) (MI, 2011).

It can be said that Motivational Interviewing is based on the spirit on three key elements. This includes collaboration between the client and the therapist, evoking or drawing out the the clients' ideas about change, and    emphasizing the autonomy of the client. (MI, 2011). In doing this, it creates an environment where the client can open up and not feel judged or put back in a corner. By emphasizing the autonomy of the client it creates a situation where they feel like they have control. In overcoming an addiction, a sense of control can go a long way in determining future success. 

There are also four distinct principles that guide Motivational Interviewing:

1. Expressing Empathy

• In expressing empathy, you get to look at the clients' problems through their eyes. By looking at it through this lens, one can get a better understanding of what the client is going through in their day to day struggles.

     2. Support Self-Efficacy

• This is focused on getting the client to come to the realization that they have it in themselves to change for the betterment of their lives. 

     3. Roll with Resistance

• This stresses that there will be resistance with change but you must roll with this. Never falter in your belief in the client and in return they will see the positive impacts that this has in the long run for their overall good to overcome their addiction.

     4. Develop Discrepancy

•  When clients recognize that their current behaviors place them in an internal conflict with their values or interrupt the goals they have set for themselves, they are more likely to notice this and go about change. The counselor must not use strategies that could develop discrepancy between this (MI, 2011).

This shows the battle against and towards change.

All of this shows the complex, yet simple set-up of motivational interviewing. It is a simple technique that can have long-term substantial success. However, how does this compare to the components of the addiction cycle?

This method I believe have a strong impact on the addictions cycle. By holding the person accountable and remaining their autonomy, it can be used for all stages of the addiction cycle. I think it is most useful in the dependence stage. Once the client realizes that their life is worth more than a substance and can see further into the future than just until they get their next fix, the motivational interviewing holds a huge benefit. By having a person tell you that you have to quit, makes little difference because it's not a whole-hearted decision. However, by doing it by investigating and getting deeper into your own internal feelings, than you are changing for the betterment of yourself. As stated previously, I believe this provides the best of the strengths-based approaches to create a change in an individual. However, as is everything, not all treatments are for everybody.

 The fact that this counseling technique uses full autonomy provides, I think, the best option for all users. It has been shown to work with alcoholics and other substance abusers through numerous sources I've looked at. As I look into a future working with at-risk children, this could be extremely useful. By using this technique, I could create an environment in which the client can be open and rational in their pursuit of being clean. This approach allows for the client to come to a conclusion themselves. The duration of which may vary, but the end results remain the same. A clean person is a happy person. I could see myself using this approach if needed. I did a little research on each of the strengths-based approaches and I would say this one by far goes about it the best way. It allows for the client to entrust in somebody, but at the same time make psychological gains in their fight to overcome addiction.

Video I found on Motivational Interviewing (demonstration):

http://www.youtube.com/watch?v=URiKA7CKtfc

References:

http://www.motivationalinterview.org/Documents/1%20A%20MI%20Definition%20Principles%20&%20Approach%20V4%20012911.pdf. Cited as: (MI, 2011)

Van Wormer, K., & Davis, D. R. (2008).  Addiction treatment: A strengths perspective.  Pacific Grove, California:  Brooks/Cole Cengage Learning.