Motivational Interviewing: Activating Meaningful Change

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Drug withdrawal occurs when a person stops using an addictive substance like cocaine, heroin, alcohol, or another drug. The symptoms of drug withdrawal range from mild to severe but rarely result in death. Addiction rehabilitation and treatment services can provide support during this difficult step towards sobriety in the form of medically assisted detoxification, therapeutic support, and prescription medications.

What is Motivational Interviewing Therapy

Motivational interviewing therapy is a counseling approach that is patient-focused and designed to change behavior. Oftentimes, those struggling with addiction grapple with conflicting desires – between wanting a better life and believing they’re not ready for or worth recovery.

Originally developed by William Miller and Stephen Rollnick to treat alcohol addiction, the purpose of MI therapy is to empower one to take responsibility for their own addiction recovery. In MI therapy, a counselor enhances one’s readiness for change by helping them examine and address their hesitancy toward treatment.[1]

Four Evidence-Based Principles of MI Therapy

Express Empathy

Feeling judged is a significant fear of those hesitant about seeking change, so understanding and empathy are key.

Develop Discrepancy

A therapist needs to help paint the picture of how one’s current actions don’t line up with the future they’ve envisioned for themself.

Roll With Resistance

Instead of challenging and opposing ideas, a counselor can try to reframe a patient’s thoughts or offer an alternative interpretation of a situation

Support Self-Efficacy

A patient must believe they can achieve positive change within their own ability, and the counselor must reinforce that confidence.

MI Therapy for Substance Abuse and Addiction

Worldwide, more than 76 million people struggle with alcohol addiction, and another 15 million have uncontrolled drug usage.[2] Research suggests that MI therapy is an effective treatment option for those suffering from substance use disorder (SUD) compared to other active intervention methods.[3]

One study examined the effectiveness of group MI therapy in enhancing recovery efforts among veterans with SUD, finding a significant improvement in treatment session engagement, 12-step program attendance, and alcohol consumption.[4]

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MI Therapy Techniques

During MI therapy, a therapist expresses an understanding of how the patient feels about their challenges and guides them through their own decision-making process. Potential consequences of either changing or remaining the same and the patient’s desires for their future are discussed.

Techniques may include a therapist asking open-ended, thought-provoking questions, affirming the patient, and engaging in reflective listening, specifically through thoughtful summaries of what they hear the patient say.

As fresh motivation begins to take root, the patient may begin using change talk phrases that indicate there has been an internal shift toward their behavior. Change talk is anything that favors a change in behavior or puts change in a positive light with less resistance.

The Motivational Interviewing Process

Although treatment processes vary depending on the individual’s needs, many treatment plans will include some or all of the following.

Initial Assessment And Diagnosis

Before admission, patients will speak with a caring admission specialist to evaluate their condition, current needs, past experiences, and unrelated medical conditions. Based on this assessment, a tailored treatment plan is outlined, and the next step forward will be determined.

Detoxification

Many attending MI therapy struggle with substance use. When this is the case, patients first undergo an uncomfortable but critical detoxification process. Here, you will receive intensive medical support and comfort measures as you rid your body and mind of harmful substances and behaviors.

Inpatient Rehabilitation

Depending on the severity of a patient’s condition and a variety of other factors, inpatient or residential rehab may offer the best chance for lasting recovery. Here, you can relax in a distraction-free environment where no negative influences are preventing you from focusing on healing.

How (and Why) MI Therapy Works

Motivational interviewing therapy is designed to evoke a readiness in the patient to change their life. It is a decision that is ultimately made by them. There is an ever-growing body of data confirming MI therapy as an effective form of treatment.

In one literature review, it was found that two-thirds of 39 MI studies reviewed demonstrated reduced adolescent substance use.[5] A similar analysis of data also found that in 21 independent studies, MI therapy interventions were shown to not only be a successful treatment in adolescent substance use but also appeared to retain their effect over time.[6]

What’s the Best Way to Find MI Therapists?

If you or a loved one are struggling to activate change on your own when faced with substance use disorder, detox is often the first step toward recovery. This will free your body and your mind to focus on recovery and healing.

To locate a detox program near you, contact your physician, reference the Substance Abuse and Mental Health Services Administration (SAMHSA) database, or call a drug addiction help hotline.

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Cost of MI Therapy

The cost of MI therapy varies based on insurance coverage and an individual’s treatment needs. When you speak with a knowledgeable admissions counselor, they will verify insurance coverage and discuss payment options.

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Frequently Asked Questions

01

What are open-ended questions in a motivational interview?

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What are open-ended questions in a motivational interview?
Open-ended questions are those that require an answer other than “yes” or “no”. For example, “Can you help me understand ____?”

What are the 3 key elements of motivational interviewing?
The spirit of MI includes collaboration between the therapist and patient, evocation of the patient’s perceptions of change, and honoring the patient’s autonomy.

When not to use motivational interviewing?
MI therapy is not best suited for patients dealing with trauma, severe depression, and bipolar or schizophrenia disorder.

Sources
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[01]

Hettema, J., et al. (27 April 2005). Motivational Interviewing. Retrieved from Motivational Interviewing | Annual Review of Clinical Psychology (annualreviews.org) on 5 July 2023

[02]

Smedslund, G., et al. (08 April 2011). Motivational Interviewing for substance abuse. Retrieved from Motivational interviewing for substance abuse – Smedslund – 2011 – Campbell Systematic Reviews – Wiley Online Library on 5 July 2023

[03]

Smedslund, G., et al. (08 April 2011). Motivational Interviewing for substance abuse. Retrieved from Motivational interviewing for substance abuse – Smedslund – 2011 – Campbell Systematic Reviews – Wiley Online Library on 5 July 2023

[04]

Santa Ana, E.J., et al. (01 June 2021). Randomized controlled trial of group motivational interviewing for veterans with substance use disorders. Retrieved from Randomized controlled trial of group motivational interviewing for veterans with substance use disorders – ScienceDirect on 5 July 2023

[06]

Jensen, C.D. et al. (2011). Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review. Retrieved from Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: A meta-analytic review. (apa.org) on 5 July 2023

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