What is Motivational Therapy or Interviewing or MI?
It is a collaborative conversation to strengthen a person’s own motivation for and commitment to change. It was originally developed to treat alcoholism. However, the principles have now been tested in multiple settings and MI (Motivational Interviewing) is now established as an evidence-based practice in the treatment of individuals with various addictions and other mental health issues (i.e. gambling and pornography addictions, eating disorders, obsessive compulsive disorder, and phobias). Lets look at how MI might be used when talking to someone about their desire to stop drinking alcohol.
10 PRINCIPLES OF MOTIVATIONAL THERAPY or INTERVIEWING. Let’s explore this further and take a look at how working with a therapist could help you
1. Ask Open Ended Questions: This typically allows one to become aware of what your goals and target behaviors are. For example, how would you like your life to be five years from now? This allows you to think ahead to the future instead of just thinking about the now.
2. Explore Decisional Balance: Discuss the pros and cons of both changing and continuing to drink. This is where we’d ask you to consider how continuing to drink will affect your family and loved ones? How will it affect your work? What if you were to get arrested for drunk driving? How will that impact you, your life, your loved ones and your happiness?
3. Good things/Not-So-Good Things: This is where we;d ask about the benefits of not drinking. We’d also ask you about the consequences of continuing to drink excessively an what that would do to your life.
4. Ask For Examples: Looking more in-depth at the details can also be helpful. “In what ways?” “Tell me more about that?” “What would that look like?” “When was the last time that happened?”
5. Looking Backwards: What was it like before you were drinking? How were things better? How were they different?
6. Looking Forward: What may happen if the drinking continues the way it is or gets worse. Then try asking “If you were 100% successful stopping drinking, what would be different?”
7. Ask About Worst and Best Outcomes: What are the worst things that may happen if you don’t stop drinking? What are the best things that might happen if you do stop?
8. Use “Change Rulers”: Ask: “On a scale from 1 to 10, with 1 being not at all important and 10 being extremely important, how important is it for you to stop drinking? You could then follow up with “How confident are you that you could stop drinking if you committed to doing it?”
9. Explore Goals and Values: Explore what the person’s guiding values are. What does he or she want in life? How does continuing to drink fit in with that? Does you see continuing to drink helping, interfering, or is it irrelevant?
10. Challenge the person gently: For example, “Perhaps continuing to drink is so important to you that you are not willing to give it up?” You can then point out how difficult it will be to get what you really want for your life (see #9).
Motivational Therapy can be very powerful for individuals that are on the fence about discontinuing behaviors that can be harmful to themselves and their families. The good news is that you are not alone and working with a quality therapist or psychiatrist can help you come up with a treatment plan that feels good to you.
Dr. Nicola Gray