Motivational Interviewing: Eliciting Behavior Change with Autonomy Support
Motivational Interviewing is a client-centered counseling approach initially used treat addictions, although it is now being modified and specialized towards different routes. This strategy uses both clinical experience and principles that have been thoroughly researched over the years to demonstrate scientific efficacy in changing human behavior. The Shoreline Recovery Center in San Diego, California is a promoter of this strategy, which undoubtedly seeks to move the patient away from dangerous behaviors, such as drug addiction.
The real purpose of this approach is to influence patients to consider making changes that will last. For this, it is necessary to find the origin and the root of the ambivalence (resistance about behavior change) in order to solve it, since this is considered the center of all problems.
Although the concept has evolved since 1983, when William Miller proposed it in an article published in the journal Behavioral and Cognitive Psychotherapy, the fundamental concepts and bases remain. Furthermore, the scientific world has been dedicated to confirming the potential of this therapy through multiple studies, all with satisfactory results.
Unlike other more technical therapies, with motivational interviewing we seek a more empathetic and communicative route, based on specific techniques and strategies that allow a different style of approach. However, at the same time, we seek to touch on the key points. As Ken Resnicow and Fiona McMaster (2012) said, “An effective MI practitioner is able to strategically balance the need to ‘comfort the afflicted’ and ‘afflict the comfortable.'”
In this approach, the client (and patient) is the foundation of the therapy, not only because he/she is the main target, but also because he/she does much of the work. The “conscious” change that emerges after the resolution of the ambivalence is thanks to the client. Motivational interviewing therapy does not seek to directly change or “dismantle” or “contradict” any of the client’s premises; it is subtle changes (offered by the therapist) that guide the client to understand and verbally express his/her reasons (negative and positive) for the change.
The Basics of Motivational Interviewing
To achieve the patient-centered approach, it is necessary for the therapist to use special techniques and strategies, which fall somewhere between the formal/directed and the informal. Developing real empathy, changing the style of the interview, and not being so “technical” can be difficult, and not just any therapist can do it.
To properly apply IM, we at Shoreline Recovery Center adhere to the fundamentals of this therapeutic strategy:
- Change is born in the client, not imposed. The key to keeping a behavior going over time is not obligation, either directly or indirectly (through modification, as with behavioral cognitive therapy). Therapies that use another approach have their place; however, motivational interviewing seeks to touch on the intrinsic value and goals of the client in order to generate change that will endure and generate real positive effects on the environment in which the client lives
- Resolving the ambivalence is up to the client, not the therapist. Ambivalence is the conflict between two different actions, which creates a confusion that the client has often not had the opportunity to express. The task of the therapist is to provide support to facilitate the expression of the ambivalence and to guide the client towards an acceptable resolution.
- Subtle and empathetic, never direct. Another key point in motivational interviewing is that one should not look for situations of direct confrontation or persuasion, as in other types of therapy. Although it may seem a more “passive” approach for any client who has been exposed to another type of therapy, the proof is in the outcome. More aggressive strategies may lead the client to express denial or aversion to therapy, which would have a negative effect on his/her life and problem.
- More than a therapeutic relationship, it is a partnership. The key to a good therapist’s success with motivational interviewing is the way he/she maintains the relationship with his/her client. The therapist must respect the client’s autonomy and freedom of choice, no matter what his/her behavior is. It is from this healthy and well-established relationship that true agreements and real understanding come.
- We are all ready at our own pace. Everyone has his/her own time and space; it may take longer for some people. Still, it is not a reason for despair. Both the client and the therapist must be patient and expect the best results, as well as the best performance from each.
At Shoreline Recovery Center, unlike other American addiction centers, therapists are trained in motivational interviewing based on each of these fundamentals. As mentioned above, technique, style, and experience are key to overcoming ambivalence and finding improvement in the client.
Small details in this strategy are what make it work so perfectly. The effects are confirmed and corroborated by science, so it only takes one expert who knows how to apply it properly to observe the long-awaited changes. At Shoreline Recovery Center we understand the importance of your problem, and that’s why we only prepare quality personnel to care for you.
Change is a tough decision that needs support and guidance; let our experts show you the way.
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