Motivational Interview: What Is This Therapeutic Resource?
Many times we think that the different psychological interventions focused on treating mental health problems simply consist of therapies themselves. However, an interview can also be a psychological technique and be part of a therapy, as we will see.
In this article we will learn about the motivational interview of William Miller and Stephen Rollnick , developed in 1999 and focused on treating addictive behaviors. We will learn about its phases, its principles and the strategies it uses to produce therapeutic change.
Motivational interviewing was developed by W. Miller and S. Rollnick in 1999, and was aimed at treat addictive disorders such as addiction to alcohol or other substances (as well as different addictive behaviors). This interview was originally conceived as a brief therapy approach to address the ambivalence toward change characteristic of this type of patient.
The interview is based on a theoretical base that considers that the motivation for change is not imposed from outside but arises from the patient’s ambivalence.
Furthermore, it is an approach in line with the Transtheoretical Model of Prochascka and DiClemente (which we will see later), also consistent with the findings of contemporary research on the factors that account for the effectiveness of psychotherapy.
For their part, its authors W. Miller and S. Rollnick have always stated that motivational interviewing is an approach with a particular philosophy, and not so much a technique.
Motivational interviewing has been and is applied to patients who have some type of addictive disorder, whether due to abuse or problematic substance use, with the aim of promoting adherence to treatment also of people with mental health problems and chronic health disorders.
In addition, it also helps to adopt healthier lifestyles (physical exercise, balanced diet, safe sexual relations, etc.).
Therapeutic principles
Motivational interviewing is based on a series of principles; are the following:
1. Expression of empathy
The first principle states that therapist empathy is essential ; Thus, the therapist’s acceptance of both the patient’s problems and his addiction itself and his behavior facilitates therapeutic change.
2. Develop the discrepancy
The change appears as a consequence of the discrepancy that the patient perceives between his actions, his thoughts, and what he really wants to achieve in the long term (partial or total abstinence).
3. Accept resistance
The third principle of motivational interviewing maintains that the therapist should not confront the patient about his discrepancies, nor provide him with arguments about the need to change; consider that The therapist must play a more “free or neutral” role in that sense.
4. Self-efficacy support
The fact that the patient really believes that change is possible is motivating for him. The therapist should support that feeling of self-efficacy when it appears.
Phases
The motivational interview is developed in two distinct phases:
1. Building motivation for change
The first phase will be aimed at helping to build real motivation for change, to permanently abandon the drink or drug in question (or reduce consumption, depending on the agreed therapeutic objective).
In this phase, the following techniques are used: the use of open questions, reflections, summaries, recognition, acceptance of resistance and provocation of discrepancy.
2. Strengthening commitment to change
In this phase of the motivational interview, the patient’s commitment developed in the previous phase is strengthened. Here, everything worked so far is recapitulated, and also: goals or objectives are set the different options for change are considered, an action plan is designed and the patient’s commitment is extracted.
Evidence
Motivational interviewing has been shown to be more effective than no treatment for addictions; It is especially useful in enhancing other treatments improving adherence, participation and patient satisfaction.
When is it used?
This type of interview is used in the contemplation stage of a person addicted to some substance; The stage of contemplation is that in which The patient has doubts regarding the change process
The stages through which a person with some type of addiction goes through were proposed in the Transtheoretical Model of Prochaska and Diclemente. Let’s see what they are (in order of appearance over time):
According to Prochaska and Diclemente, people with some type of addiction to some substance go through these phases; Normally they would go in order, but regressions can occur in stages, turns, changes, repetitions, etc. For example, a person could go from maintenance to relapse, from relapse to maintenance, and back to relapse.
