Motivational Interviewing for Addiction

Motivational Interviewing Stages of Change

MI frequently incorporates the stages of change model, also referred to as the transtheoretical model, to comprehend and address a person’s readiness for change.

These are the five stages of change in MI:

• Precontemplation: People aren’t thinking about changing their behavior at the beginning. They might not see the need for change, or they might object to the concept. At this point, MI entails bringing the matter to light and investigating ambivalence to promote reflection.
• Contemplation: Though they may still feel conflicted, people in the contemplation stage are aware that change is necessary. During this stage, MI is concerned with examining the benefits and drawbacks of the change and resolving any issues or obstacles.
• Preparation: People have committed to change at this point and are actively preparing to act. During the preparation and planning phase, MI assists people in creating a detailed change plan, defining clear objectives, and resolving any roadblocks.
• Action: People actively carry out their change plan when they are in the action stage. At this point, MI assists people in overcoming obstacles, staying motivated, and rewarding constructive behavior.
• Maintenance: Sustaining the modifications implemented during the action stage is the goal of the maintenance stage. To maintain these modifications, MI supports people in strengthening their resolve, controlling potential triggers for relapses, and creating long-term success plans.

MI strategies, like affirmations, reflective listening, and open-ended questioning, are used during these phases to encourage cooperative and non-confrontational dialogue. Enhancing intrinsic motivation and giving people the tools they need to make and maintain positive life changes are the objectives.

It’s crucial to remember that people might alternate between these phases and that relapse is often seen as a normal aspect of the process of change. Because MI is adaptive and responsive, therapists can modify their strategy according to the patient’s readiness and current stage of change.

Motivational Interviewing for Substance Abuse and Mental Health Disorders at Clearbrook

Motivational interviewing and substance abuse treatment go hand in hand, and when applying this method to our levels of substance abuse and mental health treatment, there are seven key points of MI that our therapists maintain:

1. Motivation comes from the client, not from outside sources (such as spouses or family members).
2. The client, not the counselor, is responsible for resolving ambivalence or fear of change.
3. Ambivalence cannot be resolved through direct persuasion; the person has to want to change.
4. The counselor quietly elicits information from the client.
5. The counselor guides the patient in recognizing and settling ambivalence.
6. Understanding that readiness to change is a fluctuating result of interpersonal interaction, not a trait.
7. The client-counselor relationship should resemble a partnership.

Motivational interviewing is a simple process usually completed in a few one-on-one sessions. The typical steps of MI sessions are:

• Engaging: Talking to the client about issues, concerns, and hopes and establishing a trusting relationship with them
• Focusing: Focusing the conversation on the patterns and habits the client wants to change
• Evoking: Bringing about client motivation by expressing the importance of change, confidence in their ability to change, and readiness for change
• Planning: Developing a set of practical steps the client can use to implement the desired changes

Common motivational interview questions for substance abuse and mental health disorders used in sessions include:

• Tell me about your concerns or challenges related to your drug or alcohol use.
• What do you like most about the drugs or alcohol you use?
• What are the positives about these substances for you? And what are the negatives?
• What are your worries about your drug or alcohol use?
• Tell me what you have noticed about your drug or alcohol use. How has it changed over time?
• What things have you noticed that concern you that might become problems?
• What have other people told you about your drug use?
• What do you think other people are worried about regarding your drug or alcohol use?
• Tell me what concerns you about your drug or alcohol use. Tell me what it cost you.
• What makes you think that you need to change your drug or alcohol use?
• What do you think would be the consequences if you continue to use drugs or alcohol?
• What might be the positives of giving up drugs or alcohol?
• What might be the negatives of giving up drugs or alcohol?

The last question will help the individual realize what they fear about getting sober. Rather than invalidating clients’ fears about sobriety, we want to identify these concerns and help them realize that the pros of sobriety far outweigh any cons.

MI is a client-centered model of addiction counseling designed to help clients realize and figure out what they want to change instead of focusing on what the counselor would want them to change. Although counselors are there to offer guidance and properly administer this therapeutic approach, the benefits of motivational interviewing therapy include self-awareness, accountability, and dependence, each of which the individual has to want to strive for.