Motivational interviewing is a method of addiction counseling that focuses on the client. This is a goal-oriented addiction treatment which emphasizes results and seeks to help alcoholics clear the hurdle of ambivalence.
The entire motivational interviewing process focuses on the desire to change within the client. This desire is not pushed on them by the counselor. Instead, this desire is developed by establishing rapport with the client and encouraging them to consider the consequences of their addictive behavior. When successful, motivational interviewing helps alcoholics find it within themselves to take life in a new and healthier direction.
Motivational interviewing first came on the scene in the early 1980s. It was originally presented by Professor William R Miller and was further developed by Professor Stephen Rollnick the following decade. Rollnick maintains an online archive of motivational interviewing resources.
In the decades that followed, motivational interviewing has been widely adopted by addiction counselors. It has proven effective in guiding clients out of alcoholism and into more productive life patterns. It is also effective in addressing other forms of addiction and substance abuse.
Underlying the motivational interviewing process is a spirit of collaboration between client and counselor. At all stages of the process, the counselor maintains a spirit of respect. Other methods can be more direct, but motivational interviewing is a non-confrontational means of overcoming alcoholism.
Anyone who has struggled with addiction or alcoholism knows that behavior change is a complex process. This is why it is so important for the therapist to guide the client and remain empathetic at all times. Listening to the client without passing any judgment is critical.
However, empathizing with the behaviors of an alcoholic does not equate to agreeing with them. With this in mind, the counselor strives to set up a disparity between the client’s behavior and the goals or aspirations they have for their life. Meeting these goals requires that the client overcome addiction.
There are four major tenets of motivational interviewing. Any addiction counselor will bring these to bear when using motivational interviewing to work through issues of alcoholism. By incorporating these core principles into the treatment process, counselors can help their clients explore and overcome their own addictive behavior:
* Express empathy: the addiction counselor makes every attempt to see the addiction from the client’s point of view without passing judgment or forcing confrontation.
* Develop discrepancy: the counselor and client work together to explore the gulf between an addictive lifestyle and the life that the client wishes to experience.
* Navigate resistance: at this point, the counselor accepts that the client will be resistant to change; this is viewed as natural rather than as an indicator of deeper, pathological problems.
* Encourage self-efficacy: finally, the counselor chooses to support the client’s right to determine their own future, whether this means embracing change or continuing on their current course.
As mentioned in the four principles, resistance is a key component of any addictive behavior. When a person is forced into alcohol rehab by court mandate, this resistance may be blatant and clearly expressed. However, those who actively seek alcohol rehabilitation still have to overcome ingrained and habitual resistance to change.
It is the therapist’s job to place this resistance in its proper context so that it does not interfere with the treatment. Rather than combating resistance or trying to coerce the client, therapists simply acknowledge this behavior as a natural byproduct of the counseling process.
Above all, the motivational interviewing process embraces the belief that any alcoholic has the power to change on their own. The counselor is able to provide information highlighting the hazards and pitfalls of an addiction lifestyle. However, behavioral changes must come from within the client if relapse is to be averted.
Throughout the motivational interview process, the counselor watches for any signs of readiness to change in their client. This does not come about naturally. Instead, this readiness fluctuates due to the interaction between client and counselor.
When the client is ready, the counselor may suggest some practical measures for digging out of an alcoholic lifestyle. These suggestions will only be embraced if the person suffering from the addiction is exhibiting a genuine readiness to leave that lifestyle behind. Assuming more readiness than actually exists can result in greater resistance. Patience and balance are essential to effective motivational interviewing.
Motivational interviewing may not be the preferred course of treatment for every alcoholic, but its cornerstones of respect and dignity set it apart from other regimens. It is, however, highly effective in treating alcoholics who have the least desire to embrace an alcohol-free life. In many cases, motivational interviewing can be combined with other treatment methods and is an important part of a relapse prevention component of addiction rehabilitation.
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