Motivational interviewing: what is this therapeutic resource?

This resource is used in addiction therapy and to improve therapeutic adherence.

We often think that the different psychological interventions aimed at treating mental health problems are simply therapies in 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 William Miller and Stephen Rollnick's motivational interviewing technique, developed in 1999 and developed in 1999.developed in 1999 and focused on treating addictive behaviors. We will know its phases, its principles and the strategies that it uses so that the therapeutic change takes place.

Motivational interviewing: characteristics

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). (as well as different addictive behaviors). This interview was originally conceived as a brief therapy approach to address the ambivalence towards change characteristic of this type of patient.

The interview is based on a theoretical foundation that considers that the motivation for change is not imposed from outsidebut arises from the patient's ambivalence.

Moreover, it is an approach in line with the Transtheoretical Model of Prochascka and DiClemente (which we will see below), with the (which we will see below), which is also congruent with the findings of contemporary research on the factors that account for the effectiveness of psychotherapy.

For their part, authors W. Miller and S. Rollnick have always affirmed that motivational interviewing is an approach with a particular philosophy, and not so much a technique.

Who is it aimed at?

Motivational interviewing has been applied and is applied to patients who have some type of addictive disorder, whether due to substance abuse or problematic substance use, in order to promote adherence to treatment, also for people with mental health also for people with mental health problems and chronic health disorders.

In addition, it also helps to adopt healthier lifestyles (physical exercise, balanced diet, safe sex, etc.).

Therapeutic principles

Motivational interviewing is based on a series of principles; they are the following:

1. Expression of empathy

The first principle states that the therapist's empathy is essential.Thus, the therapist's acceptance of the patient's problems, the addiction itself and the patient's behaviors facilitates therapeutic change.

2. Developing 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. Accepting resistance

The third principle of motivational interviewing holds that the therapist should not confront the patient in his discrepancies, nor provide him with arguments about the need to change; he considers that the therapist should exercise a more "free or neutral" role in this regard. in this regard.

4. Support of self-efficacy

The fact that the patient really believes that it is possible to change is motivating for him. The therapist should support this feeling of self-efficacy when it appears.

Phases

Motivational interviewing takes place in two distinct phases:

1. Building motivation for change 2.

The first phase will be aimed at helping to build real motivation for change, to definitively abandon the drink or drug in question (or reduce consumption, depending on the agreed therapeutic objective). (or reduce consumption, depending on the agreed therapeutic objective).

The following techniques are employed in this phase: the use of open-ended questions, reflections, summaries, acknowledgement, 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 that has been worked on so far is recapitulated and goals or objectives are set: goals or objectives are setThe 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 non-treatment for addictions; is especially useful in the enhancement of other treatments, improving adherence, participation and patient satisfaction.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 a substance; the contemplation stage is the one in which the patient has doubts about the process of change. the patient has doubts in relation to the process of change..

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 in time):

• PrecontemplationThere is still no intention to change.
• ContemplationThe option to change is considered.
• Preparation for actionthe person prepares to act.
• Actionthe person takes action and leaves the substance.
• Maintenancethe person remains abstinent for at least 6 months.
• Relapsethe person starts using again.
• Stage of completionThe addiction is overcome.

According to Prochaska and Diclemente, people with some type of substance addiction go through these stages; normally they would go in order, but there can be regressions in the stages, reversals, shifts, changes, repetitions, and so on. For example, a person might go from maintenance to relapse, from relapse to maintenance, and back to relapse.