An addiction to drugs or alcohol can consume an addict’s life, making it extremely difficult to quit, even when the addict realizes the toll addiction is taking on his life. Making the decision to seek help for drug addiction is an important step toward recovery, but it is only the first of many decisions on this journey. Considering which type of drug rehab to pursue can feel overwhelming: inpatient or outpatient drug rehabilitation, faith-based or secular, twelve step, holistic…the number of options for addiction rehab is staggering. One component of drug rehab is the use of motivational interviewing, a therapeutic technique that has been successfully applied to addiction treatment.
What is Motivational Interviewing?
Motivational interviewing is a tool used in therapy that empowers the patient, as opposed to the therapist, to take control and make changes in his or her life. The therapist works with the patient to identify his or her goals, identify obstacles, and create a plan for change. This approach to drug rehabilitation is based on three principles:
- Collaboration versus confrontation
- Drawing out ideas versus imposing solutions
- Autonomy versus authority
These principles are designed to help the patient bring about change for themselves instead of following a plan decided upon by someone else. The therapist is more like a member of the patient’s team than a coach or a boss. The three principles are implemented in the following manner:
The therapist and patient form a partnership to overcome addiction, as opposed to the therapist acting as an authority figure who confronts the patient about his addiction. The therapy sessions adopt the point of view of the patient, which prevents the patient from feeling defensive. The patient and therapist may not always agree with each other but instead of treating one as right or wrong, they instead work to find common ground. This collaboration results in a relationship based on trust. From there, the patient and therapist can work together to form a plan of action.
Drawing Out Ideas
Instead of the therapist sketching out a treatment program for drug rehabilitation, or telling the patient what to do, the therapist works with the patient to draw out his or her own skills, strengths, and ideas. The therapist can use leading questions to help the patient understand his or her own motivation to change and a plan for recovery tailored to his or her own interests and strengths. In this way, the patient maintains control over his drug rehabilitation.
Rather than emphasizing the therapist as the authority over the addict, motivational interviewing maintains the addict’s autonomy over his addiction and treatment. In doing so, motivational interviewing recognizes that the addict is the only person with the power to change. He or she possesses the ultimate ability to change and bears responsibility for his or her actions.
What Are the Benefits of Motivational Interviewing?
Motivational interviewing has several benefits that can help addicts follow through treatment for their drug addiction. Benefits include:
- A feeling of control over their own situation
- Attitude of acceptance and empathy instead of judgment or criticism
- Recognition of the addict’s needs, goals, and particular strengths
- Supporting the idea that the addict possesses the strength and ability to change
Research indicates that including motivational interviewing early in drug rehab makes it more likely that addicts will stay in treatment.
Case Study: Bruce
An interview with Bruce illustrates the principles of motivational interviewing as a way to treat addiction. Bruce wants to stop using marijuana, or at least cut down on his marijuana usage. In a fifteen minute session, his therapist moves through the principles of motivational interviewing: collaboration with the patient, drawing out his ideas, and maintaining his autonomy over his own addiction and future. The therapist does so by asking Bruce many open-ended questions, summarizing his ideas and mirroring them back to him, and affirming his thoughts.
Collaboration: The therapist maintains a collaborative feel with Bruce throughout the session. She sits across from him in a chair similar to his, so that they are facing each other and are at the same level. By maintaining a similar stance, the therapist conveys that they are working together on his recovery. Were she to sit behind a desk, or have Bruce lie down on a couch while she sat in a chair, the therapist would seem more like an authority taking control of Bruce’s recovery.
Drawing Out: The therapist asks Bruce a series of open-ended questions in order to elucidate his own ideas on how he can cut down or stop using marijuana. She draws out his ideas by following up on their previous session, summarizing his prior stated goals and asking whether he was able to implement them. As a collaborator, she does not pass judgment when he fails to follow through on any of them. Bruce’s previous goals were to:
- Run more frequently
- Get a pet dog
- Avoid spending time with friends who abuse marijuana
- Join a sports group specifically for people in recovery
Bruce had not implemented any of the first three goals. He did attend one meeting of the sober sports league but felt uncomfortable and did not want to go back. To find out why he did not work more on these goals, the therapist asks him what the barriers were to act on his part. To draw out his ideas on how he could make these goals more realistic, the therapist asked Bruce what would be the benefit of each, and what he thought he could do differently to achieve the goals, including changing the goal. His ideas were:
- Prepare for the weather so that he would not be discouraged from running in the rain or cold
- Recognizing that a dog is too much work for him; look for a pet that requires less care
- Focus on rekindling friendships with sober friends
- Join a support group instead of a sports team
The therapist never suggested any specific actions but helped Bruce figure out what he would prefer.
Autonomy: Throughout the session, the therapist made a point not to impose her own ideas or suggestions on Bruce. In this manner, the therapist helps Bruce to solve his own problems by coming up with solutions that work for him. By drawing out ideas that Bruce himself feels he can stick to, he maintains authority over his recovery and is more likely to follow through on the ideas. If the therapist suggested her own alternatives that did not fit in with Bruce’s lifestyle, he would be less likely to persist in his treatment. Instead, he has full ownership of his plan for recovery.
At the end of their session, the therapist reflects back to Bruce his plan for cutting back on marijuana use. She reminds him of the benefits they discussed and asks him to rank his level of motivation on a scale of 1 to 10. In this manner, he leaves the session reminded of his own motivation to change and a specific plan to do so.
If you or someone you love is interested in motivational interviewing as an approach to drug rehab, call our toll-free number today. We can help you to connect with the right person and help you become sober.