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Motivational Interviewing
Motivational interviewing is a technique concerned with helping people change their lives and it is especially used by clinicians in helping addicts refrain from substance abuse. In this technique, the clinician does not impose directions for the client to follow but rather, seeks to get as much as possible from the client about what he or she would want to change concerning their lives. It is also based on collaborations between the client and therapist as both decide the best way to solve particular problems. It is also based on self-rule of a person rather than imposed authority by a clinician. This technique holds the rationales that communicating with clients makes them feel respected and persuade healthy discussions for behavior modification upon requests rather than commands (Sobell, & Sobell, 2008).
This approach can be quite helpful in outlining stages of change a person maybe in. There are generally four stages of change, ranging from the pre-contemplation stage where clients do not consider changing or thinking about it. The second stage is the contemplation stage where clients start considering changing. The third stage is the preparation phase where individuals realize they need to change and therefore prepare towards it using gradual approaches. The fourth stage is the action stage where clients start making progression and change. The fifth is maintenance where the client is helped in upholding the acquired healthy ways. Through asking evoking questions from the client concerning a given behavior, a clinician is able to identify what stage they are.
This approach is centered on the use of suggestive questions towards seeking what the clients think about changing. For instance, a clinician could ask, do want us to talk about your smoking? If the client is not willing, then one knows he is the pre-contemplation stage and does not consider changing. When they agree to talk about it, the clinician could then ask if they have done anything about it (Sobell, & Sobell, 2008). This would aid the clinician in knowing whether the client has considered changing or is contemplating. Further questions could ask the client what changes they want to make in their life.
There are five principles that help clinicians in the motivational interviewing approach. These are expressing empathy, avoiding argument, supporting self-efficacy, rolling with resistance and developing discrepancy (Bundy, 2004). Expressing empathy aims at creating complete perception of the clients and demonstrating active listening as well as understanding predicaments evidenced by the client. Avoiding arguments is another useful principle since creating opinions counter productivity when clinicians insist on changing some behaviors while the clients fail to approve of the same. Clinicians should support self-efficacy that making the clients to feel capable of making the change themselves. This further encourages the clients in making the changes without much resistance. Handling resistance should be done skillfully to ensure a client does not continue defying orders (Bundy, 2004). Developing discrepancy involves setting goals and presenting consequences of the current clients’ situations.
Bundy (2004) further cites eight steps required for the approach’s efficacy. The first concerns establishing a rapport with the client in order to create a healthy setting for the expression one’s ideas. The second is setting the agenda for the change program factoring the clients’ priorities. The third is assessing the readiness for change through asking questions. The fourth deals with sharpening focus after an identification of what the client requires and focusing on changing one thing at a time. The fifth step is identifying ambivalence, conflicting ideas or issues way that may need clarification towards preventing resistance. The sixth step is bringing forth motivational statements that seek to encourage the clients by rephrasing issues positively and reminding them of what could be the best results. The seventh step deals with handling resistance through reflection. The eighth step is shifting the program’s focus after a certain indicator has been achieved.
Behavior is determined by thoughts and beliefs that a person holds. Adjusting behavior then requires changing a person’s thoughts and beliefs by centering them on achieving set targets. This is the aim of motivational interviewing as it seeks to encourage clients to believe that change is possible. This encourages clients to strive for change with least resistance as opposed to imposed change where clients evidence the loss of autonomy. According to Drugnet (2011), motivational interviewing raises awareness in the first stage of change, helps an individual to better decision making in the second stage, and helps to enhance change during other change stages. With the inclusion of individual involvement in the process, a client is persuaded into moving gradually across the identified stages.
References
Bundy, C. (2004). Changing behavior: Using motivational interviewing techniques. J R Soc Med, 97 (44): 43–47.
Drugnet. (2011). Motivational Interviewing. Retrieved from http://drugnet.bizland.com/intervention/motivati.htm
Sobell, & Sobell. (2008). Motivational Interviewing Strategies and Techniques: Rationales and Examples. Retrieved from http://www.nova.edu/gsc/forms/mi_rationale_techniques.pdf
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