Motivational interviewing is a therapeutic technique for helping people make changes in their lives, which has been applied effectively to the treatment of drug and alcohol addiction.
Motivational interviewing is based on three key concepts: collaboration between the therapist and the person with the addiction, rather than confrontation by the therapist; drawing out the individual's ideas, rather than the therapist imposing their ideas; and autonomy of the person with the addiction, rather than the therapist having authority over them.
Teamwork vs Confrontation
Teamwork is formed between the therapist and the client. This collaboration is based on the point of view and experiences of the client, in contrast to some other approaches to addiction treatment. Collaboration has the effect of building rapport, allowing the person with the addiction to develop trust towards the therapist, which can be difficult in a hostile atmosphere.
This does not mean that the therapist automatically agrees with the person with the addiction. The client and their therapist may see things differently, which is why the therapeutic process is focused on mutual understanding.
Drawing Out Rather Than Imposing Ideas
The approach of the therapist drawing out the individual's own ideas, rather than the therapist imposing their opinions, is based on the belief that the motivation, or wish, to change comes from the person with the addiction, not from the therapist. No matter how much the therapist might want the person to change their behavior, it will only happen if that individual also wants to change. It is the therapist's responsibility to "draw out" the person's motivations and skills for change, not direct the client what to do.
Individuality vs. Authority
Unlike other treatment models that emphasize the doctor or the therapist as an authority figure, motivational interviewing identifies that the true power behind making change rests within the person with the addiction. It is up to the individual to follow through on creating change. This is empowering to the individual, but also gives them accountability for their actions.
How Change Happens in Motivational Interviewing
Four guiding principles form the basis of motivational interviewing. Although each person's process of overcoming an addiction will be different, the therapist will hold true to these principles throughout everyone’s process. These principles are vital to establishing trust within the therapeutic relationship.
1. Empathy and Acceptance
People with addictions are often unwilling to go into treatment because they don't believe that the therapist will understand why the addictive behavior means so much to them. Many clients believe they will be judged, some even feeling guilty about their behavior and believing judgment might validate it.
Instead of judging the person with the addiction, the therapist emphasizes with the situation from the client's point of view. Empathy does not mean that the therapist agrees with the person, but that they understand and that the individual's behavior makes sense to them.
2. Helping Clients Come to their Own Conclusions
Motivational interviewing identifies that people with addictions are usually indecisive, and uncertain about whether they want to change. Their addiction has already had consequences for them, which likely have brought them into addiction treatment. Yet they have developed their addiction as a way of coping with life.
Motivational interviewing helps people make up their minds about how to move forward through the stages of change. Without pressuring the client, goals and actions can be created in this trusting, collaborative atmosphere, which is based on the individual's own needs, wishes, goals, values, and strengths.
3. Developing a New Understanding
Motivational interviewing recognizes that change does not always happen easily or just because the individual wants it. It is natural for the person to change their mind many times about whether they want to give up their addiction.
Rather than opposing or criticizing the person with the addiction, the therapist will help the individual to reach a new understanding of themselves. They do this by re-framing and offering diverse interpretations of situations that come up in the change process. All of this is based on the individual's own goals and ideals, which have been explored.
4. Being Supportive
The Florida addiction therapist will always support the person's belief in their own power to make the changes they want. At the onset, the therapist may have more confidence in the individual than they have in themselves, but this changes with ongoing support.