Motivational interview is basically a process in which the psychologist act as a helper for the client. He does not dictate the client about what has to be done instead he shows acceptance for the decision and part of the client. It helps the client to realize the personal goals. As the relationship is democratic style so the client is working with the psychologist rather than under a psychologist. This will power is enhanced in a motivational interview that helps the client to fight away the addiction. Some people initiate and continue change on their own but others require support in order to keep their morale high. This process is very important for the people with low level of readiness as they lack the motivation towards the goal that is not set by themselves.
Basic assumptions are made in the process of motivational interviewing:
- Change can occur under a supportive and empathetic approach.
- The relationship with being democratic and both have equal importance as both bring an equal level of expertise.
- Incongruity can be resolved when a psychologist work with the morals of the client.
- Ambivalence is an important hurdle in the treatment and it is normal.
The first and foremost problem of every drug addict is the unacceptance of the fact that they are an addict. Most of the client think they got it under control. They know what damage it is doing to them and they want to stop but at the same time, they don’t. If the psychologist doesn’t discover this situation he may lose the cooperation between his client and himself that lead to the friction between the goals and hence the psychologist may not be successful in motivation. Most of the time psychologist perceive ambivalence as denial or resistance on the part of the client that acts as a hurdle for the client.
Rules of motivational interview
- Don’t confront or argue with client
- Try to express pure empathy
- Adjust to the resistance and conditions that client express.
- Enhance and support every type of positivity and self-efficacy.
- Detect the divergence between the current behavior and aimed behavior.
Early session’s strategy
Don’t load the client with so much information take it slow. Begin with the experience of the client and let him discover his ambivalence. Let the client discover the reason of the change he wants. Determine the level of readiness in the client, make sure you don’t interpret the wrong level just because you meet him in a specific setting. Any wrong assumption according to the level of clients needs and wants can be harmful.
Open ended questions
The psychologist should let the client talk as much as he can and should not interpret him anywhere this will lead the psychologist to reach the condition and hidden thinking that a client has. The open ended questions should be asked that cannot be answered in one world this will make the client think and talk more helping the psychologist to understand the situation.
The psychologist should not assume that he knows exactly what the client is thinking rather he should ask him about what he is thinking and what does he meant when he said certain words. This strengthen the relationship between the client and the psychologist and the client also let him in. this also helps the client in decreasing the negative thoughts and resistance.
Every time a psychologist start or end a session he must summarize the session. This ensures the continuity and also helps the client to realize that the psychologist has been listening attentively. This also helps the client to move on. The psychologist should make a summary that connects the positive and negative emotions together so that the client also realize about his own thinking.
Affirming everything that client said to make him realize that not only you are listening but also you know what he has been through. Use of gentle words like I understand can help in trust building. Emphasizing on their past experience when they showed strength cab boost their confidence.
Rather than suggesting the solution to the problems and making the client to follow rules in order to reach the goal. The role of a psychologist is not like a leader who pushes people to reach the goal rather he works as an assistant and let them realize how much change they need in their life.
- It is a low-cost process as it only requires few sessions.
- Evidence shows that it increases the self-efficacy and so it helps in changing the life threatening behaviors in people.
- It helps in mobilizing and utilizing the own skills and resources of the client.
- Large and better changings are being observed by brief sessions of motivation interview as compared to other techniques.
- A single session of motivation can be long lasting as compared to other techniques.
Generally, counseling is done for almost every psychological disorder but in addiction recovery, it plays a major role. This differs from the general counseling in a way that it helps and guides the client about the whole program of recovery, addiction, tools and treatments used and make sure that the client has enough energy and information till the very end step.
Goal of therapy
The goal is to maintain the self-restraint of the client from the drugs and also to repair the damage done by the drug already used.
It helps the client to gain the insight of the problem and then associate a rational with it. The client is then encouraged to abstain from drugs and continue doing that.
Reason of the drug problem
The client must realize that he is the one who needs change. The second thing is that psychologist should know the trigger point or the cause that has forced the client to use the drug. He should let the client know that the world is unfair and so is life millions of people are coping with it is the one who has to get used to it and change his coping strategy.
|Several Typical Session Topics or Themes|
|Treatment is conceptualized as occurring in stages. The first stage includes denial and motivation.
The next stage, early abstinence, includes issues of:
Addiction and associated symptoms.
People, places, and things.
· Structure of personal time.
· High-risk situations.
· Social pressures to use.
· Compulsive sexual behavior.
· Post-acute withdrawal symptoms.
· Use of other drugs (other than the primary addiction).
· Self-help participation.
The next stage, maintaining abstinence, includes:
The relapse process and tools for preventing it.
· Relationships in recovery.
· Development of a drug-free lifestyle.
· Shame and guilt.
· Personal inventory.
· Character defects.
· Identification and fulfillment of needs.
· Anger management.
· Relaxation and leisure time.
· Employment and finances.
· Transference of addictive behaviors.
Comparison with other styles
As the time is limited so the best counseling therapy can be short term CBT or counseling based on 12 steps. While many people used the direct confrontation method that can increase the risk of the client getting back onwards the drug. The direct confrontation can be disrespectful towards the client and may damage the progress.
- Ideal treatment includes 4 to 10 days of detoxification and 28 days of complete rehabilitation. The sessions offered may vary on the basis of the problem.
- The follow-up session is long and may differ in different situations like 6 months to almost a year. At first, the follow-up is more frequent i.e. one session every week for 3 months if the client shows improvement the client is promoted to the second level which has one session every other week later one per month and finally one after 3 months.
- The individual session runs from 45 to 50 min followed by 1.5hrs of group therapy.
Importance of self-help
The client should be able to take full responsibility of what he is doing. At the point where he realizes that the problem lies within him, he will take reasonability of his own treatment and this is the step that will finally lead him to cure.
Role of significant others
The role of family and friends is no doubt very important. A combined session with the parents, spouse, siblings, friends, and everyone around them should be arranged. The client should be made realize that he is not alone in this while the family should be made realize that the client is not doing all this on propose instead he want to get rid of this.
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