As physics teachers tell their students each and every day, an object that is at rest tends to stay at rest, unless something appears to change the equation. Stasis is just part of the universe, and sometimes that’s beneficial. Stasis gives things consistency and predictability, and that might make the world seem like a safer and saner place. But when something terrible is happening in a person’s life, change must happen and it must happen fast.
Families touched by addiction might know this all too well, and they might work hard to influence an addicted person to change. But their efforts might be ignored altogether, or the person might change just a little, for a short period of time, and then return to the status quo when the family is no longer paying attention. Overcoming stasis like this is incredibly difficult, unless Motivational Interviewing (MI) is involved.
Typically, people with addictions are confronted by an outside influence due to their drug use habit. They might face pressure from:
- Law enforcement officials
Psychological Underpinnings of Motivational Interviewing
At one point, they might have even been pressured to change in their addiction counseling sessions. But despite this overwhelming chorus of voices clamoring for change, the person might still believe that life is progressing somewhat normally. The person might be happy, or just unwilling to do anything permanent. The person might listen, but the person might not change that inner dialogue that says change isn’t required.
MI is designed to help people get in touch with their personal, private feelings regarding change. In counseling sessions, they have the opportunity to really explore what would happen if they made a different decision, and what might happen if they did nothing at all.
Anything is Possible
Therapists who use MI hope to allow people to develop a strong and persistent personal need to change, and in so doing, these people might be able to do things with their lives that they just never thought were possible before.
An MI Practitioner’s Role
In many counseling modalities, the mental health professional is a bit like a lecturer or a parent. This is the person who has all of the knowledge and all of the skills, and the person with the addiction is expected to approach this person with respect and even a touch of reverence. MI doesn’t work this way. In an overview of the technique, in the International Journal of Behavioral Nutrition and Physical Activity, experts suggest that a practitioner who uses MI must “… balance the need to ‘comfort the afflicted’ and ‘afflict the comfortable.'” In other words, the counselor might be persistent, but the counselor rarely lectures or provides judgment.
In the early portions of the therapy, the practitioner simply tries to build rapport. The patient might discuss the addiction and the consequences of that addiction, and the counselor might listen sympathetically and provide a few follow-up questions about issues that are unclear. But at no point does the counselor attempt to force the person to change. Instead, the counselor listens.
As the therapy deepens, the counselor might begin to ask more probing questions or otherwise exert gentle pressure to change the way in which the person thinks about the addiction. The Substance Abuse and Mental Health Services Administration (SAMHSA) suggests that common techniques used in Motivational Interviewing sessions include:
- Asking open-ended questions, such as, “What do you want to do next?”
- Using affirmations, such as, “I know that beating an addiction is hard, and many people don’t ever ask for help. I’m proud that you chose to take charge.”
- Sprinkling in reflective statements, which build upon statements patients just made and encourage patients to delve a little deeper.
- Using summary statements, which demonstrate that the clinician has been listening and allow patients to correct anything they think is inaccurate.
Practitioners might also encourage patients to take small steps that add up to a big goal. Someone with a nicotine addiction, for example, might be encouraged to give up just one cigarette a day, and then discuss how that small change made the person feel about the future. The person might then be motivated to give up two cigarettes a day, or even three. These incremental steps can add up to big changes, and they can provide patients with a sense of accomplishment and worth.
How MI Fits In
Since an MI practitioner might not force an addicted person to quit using drugs right now, right away, it can be a little difficult to see how this therapy might fit within the larger field of addiction recovery. Families might even be a little impatient with the idea of MI therapy, as it might seem as though the practitioner is supporting the continued use and abuse of drugs.
It’s important to remember that MI practitioners are trying to encourage addicted people to find their own reasons for quitting, at their own pace. In the early stages of therapy, no changes might take hold at all, but deep inside, the person might be thinking and developing the courage needed to make a small step.
That small step can become a bigger step and a bigger step, and in time, the person might be ready to enter an actual rehab program and quit for good. Motivational Interviewing is a precursor to that work. These sessions might not be all that a person needs in order to recover, but they can lay the groundwork for other therapies the person can, and should, complete.
Efficacy of MI
Even though Motivational Interviewing alone can’t help most people to make a full recovery from a serious addiction, SAMHSA suggests that the technique is considered effective in the fight against substance use and abuse. It should be considered an enhancement of standard techniques, but studies suggest that people who get MI recover from addictions at a rate that’s superior to people who don’t get this kind of therapy.
In addition, according to an analysis performed by the Wall Street Journal, MI has been proven effective in people who have chronic health conditions like diabetes or high blood pressure. MI techniques help these people to understand the dangers they face due to their diseases, and they develop the motivation they need to take care of their health and take charge of all of the little details that can keep them alive. Since some people who have addictions also have physical health problems, MI could be useful in terms of developing a healthier lifestyle.
Who Provides MI?
Since Motivational Interviewing can be useful in addressing a large number of different issues, it’s not surprising that it can be provided by a number of different people, including:
- Social workers
At the moment, there is no specific credential a person must have or a class a person must pass in order to begin using this technique. In fact, almost anyone could take a seminar or read a book on the technique and begin using it on other people. But in addiction treatment programs, therapies like this are provided by counselors who have academic credentials. These aren’t self-taught practitioners; they’re experts.
Community counselors might also provide MI to people who aren’t able to enter a traditional addiction program at the moment. These people might hold medical degrees in mental health, or they might have advanced degrees in social work.
When we provide therapies at Black Bear Lodge, we utilize mental health providers with advanced degrees and decades of experience. These are people who can utilize Motivational Interviewing in an expert way, and they’re able to build upon the successes people might bring with them from MI sessions they may have completed before they came to Black Bear Lodge. This is the kind of expertise that results in the best outcomes for patients, and it’s just part of the transformative recovery experience we can provide at Black Bear Lodge. Please contact us, and our admissions coordinators can tell you more.