When people want to change something about their life, they need motivation. With substance abuse counseling, motivation is an important factor that many therapists focus on today. One of the ways they do this is with motivational interviewing. It is important to understand what motivational interviewing for substance abuse is and the benefits of motivational interviewing.
Professor William R. Miller first described MI in the early 1980s. The technique involves changing ambivalent behaviors. There are four principles of MI.
They are showing empathy, developing discrepancy, resistance, and self-efficacy support. Clinicians often use the principles as steps in overlapping order. Therapists meet with patients to conduct short interview-like conversations with this technique.
During the first step, it is important to clarify how therapists utilize empathy. While clinicians verbally express empathy in some other types of therapy, MI focuses on creating an empathetic atmosphere. For instance, a clinician will focus on listening and not judging the patient.
In the second step, which is developing discrepancy, a therapist compares actions to values. For instance, when the actions of a patient do not match the person’s stated values, the professional emphasizes the issue. When patients can see discrepancies between what they want and do, it helps them see how they need to change. The third step, which is resistance, involves the clinician fighting the urge to correct the patient. Correction can often push patients more toward the side of themselves that wants to misuse substances.
A therapist’s role in MI is to focus on the patient’s individual motivations for change. The fourth step involves supporting self-efficacy by supporting the patient’s goals or motivations. Therapists consider patients as the biggest experts on themselves. To facilitate positive changes, they subtly provide encouragement by revering patients’ problem-solving skills and knowledge of self.
MI is often used by therapists for general behavioral therapy and treatment for overcoming substance misuse. In substance abuse treatment, therapists use it in various stages. MI can be useful for prevention, in preparation for more intense treatment, and along with other therapies.
Also, it may be used in multiple structures. For example, it may exist in family therapy, brief interventions, and other therapies. In brief interventions, MI skills can help address problematic situations. Brief interventions are quick and discrete conversations that help patients realize problems.
Clinicians who utilize MI often talk about the “spirit” behind it. When they do, it refers to the environment they create by using the four principles discussed earlier. The spirit of MI creates an environment where patients feel safe, accepted, and respected.
They feel like the therapist is compassionate, does not judge them, and accepts them. Additionally, they feel like there is a functional partnership when the spirit of MI exists. Therapists work hard to create this spirit by developing a way of being that facilitates the four principles. That spirit is essential to create a solid foundation for every MI discussion.
MI is necessary to experience the benefits of the therapy, and there are several potential benefits. When patients and therapists work together to achieve goals, they can fulfill the purpose of this type of therapy. These are some top benefits of motivational interviewing:
For people who are hesitant at first to seek treatment, MI can be especially helpful. It gives people who are unprepared to make changes the tools they need to accomplish their change-related goals.
Motivational interviewing for substance abuse can help people with SUDs who are resistant to change. When a person is addicted to a substance, it can be impossible to stop using it without outside help. Because of chemical changes in their brains, people who are addicted to substances experience uncontrollable urges, poor control, and a lack of judgment. This is true even if they are aware of the negative effects like losing a job or a relationship.
Combined with other therapies, MI can be a powerful part of effecting change. Because a lack of motivation is often a factor that holds people back from overcoming addiction, MI is a valuable tool. MI makes people aware of destructive habits and how they compare to their individual goals. The design of MI helps people overcome the fear of change or ambivalence.
People who go through MI can expect an environment described earlier from the four main principles. The patient-centered atmosphere should be empathetic, and the therapist is mainly a listener and a facilitator. The therapist will encourage the patient to talk about reasons for wanting changes. To help a patient become aware of issues, the therapist reflects on the patient’s own words. Although MI is often a short-term therapy, it is usually combined with other treatments.
MI includes a double-sided process. Initially, the top goal is to raise awareness of the patient’s motivation. After that, the therapist focuses on encouraging the patient to commit to change. Therapists do not just tell people that a behavior or habit needs to change. Instead, they help people explore their own behaviors to identify necessary changes. The reason is that studies show that positive change is more likely when patients recognize and state the need to change.
MI focuses on helping people find the ability to make changes, and that is a necessary element of success. Cognitive behavioral therapy, group therapy, and other interventions are often combined with MI. They have structures that are similar and support the goals of MI.
In a research review of more than 100 studies on MI, results showed favor for MI being effective. According to the findings, MI was effective for 75% of the people who participated in it. In comparison with other evidence-based treatments, it was about as effective. It was far more effective than no treatment. Researchers found that it was most effective when it was used before or with other treatments.
More sessions were positively connected with improved outcomes for patients. However, the researchers’ conclusions about the specific ideal length of treatment were unclear. In most of the cases they studied, there were between one and six sessions.
For people undergoing MI with MET, there were often four to six sessions. Their analysis showed that MI was effective for all ages, genders, and groups. In comparison with other treatments, MI had the most significant benefits for minority populations. The researchers also found that MI can improve treatment retention. Also, it may improve engagement by up to 15%.
Using the principles discussed earlier, there are four important techniques therapists use during MI. They include:
Open-ended questions are useful for helping therapists understand patients’ needs, experiences, and goals. Patients can answer in their own words to provide more qualitative information. Summaries are like paraphrasing. When a therapist summarizes what a patient says, it shows that the therapist is listening. During summaries, therapists may also link different topics or transition into new ones.
Summaries also support reflective listening, which is vital for understanding and good communication. Reflective listening can present an opportunity for a patient to clarify something or add more information. As therapists listen to patients, they offer affirmations at appropriate times. These are often positive statements about the patient’s character or strengths. By acknowledging those and offering affirmations, therapists can help build patients’ self-confidence.
For people with SUDs, it helps to work with therapists who have experience with MI. Experienced therapists know how to effectively create the right atmosphere and maintain the spirit of MI. They also know how to ask the right questions and provide valuable support.
Why is motivational interviewing important? It helps people find the incentive to make the changes necessary to overcome substance misuse or addiction. Many people who struggle with SUDs feel a sense of shame or hopelessness. Those feelings can come from a lack of ample support, unmet mental health needs, or other causes. With professional treatment, people can learn the keys to beating the cycle of addiction.
Free By the Sea in Ocean Park provides comprehensive treatment for people who struggle with substance use. In addition to MI, the therapists use other evidence-based approaches. People can learn how to live fuller lives with the right treatment approach, which is customized for each person’s unique needs. Our team is here to answer questions or discuss the benefits of motivational interviewing. To learn more about motivational interviewing for substance abuse, please contact us.
Dr. Richard Crabbe joined our team in 2019 as our psychiatrist and medical director. He attended the University of Ghana Medical School where he became a Medical Doctor in 1977. From 1978 through 1984, he was a medical officer in the Ghana Navy and provided a variety of services from general medicine to surgeries. He received his Certificate in General Psychology from the American Board of Psychology and Neurology in 2002.