MOTIVATIONAL INTERVIEWING

AS A COUNSELING STYLE
NAOMI C. SANCHEZ,RP,MS PSYCH, Ph.D.
SOURCE: ENHANCING MOTIVATION FOR
CHANGE IN SUBSTANCE ABUSE TREATMENT
(Matrix Intensive Outpatient Program Training)

.
“…THE TONGUE OF THE WISE
BRINGS HEALING.”

PROVERBS 12:18
“…THE TAMED TONGUE SUBDUES THE
ADVERSARY.”

Washington Gladden
 Helping people change

Helping people change involves increasing their

awareness of their need to change and helping them to
start moving through the stages of change.

Start “where the client is”

Positive approaches are more effective than
confrontation – particularly in an outpatient
setting.

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 The Concept of Motivation (1)

“Motivation can be defined as the

probability that a person will enter
into, continue, and adhere to a
specific change strategy”
(Council of
Philosophical Studies, 1981)
Motivation is a key to change
Motivation is multidimensional
Motivation is dynamic and fluctuating
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 The Concept of Motivation (2)

Motivation is influenced by the clinician’s style

Motivation can be modified
The clinician’s task is to elicit and enhance
motivation
“Lack of motivation” is a challenge for
the clinician’s therapeutic skills, not a
fault for which to blame our clients

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 General Motivational Strategies

giving ADVICE
removing BARRIERS
providing CHOICE
decreasing DESIRABILITY
practicing EMPATHY
providing FEEDBACK
clarifying GOALS
active HELPING 8
 The Concept of Ambivalence (2)

Ambivalence is normal
clients usually enter treatment with
fluctuating and conflicting motivations
they “want to change and don’t want to
change”
“working with ambivalence is working
with the heart of the problem”

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OUR INTERPRETATION of Motivation

Clients were considered motivated if they-

 Agreed to participate in a program’s course of

treatment;
 Were compliant with treatment activities; and
 Accepted the label of “alcoholic” or “drug
dependent”
Clients were considered unmotivated if they-

 Resisted a diagnosis; or
 Refused to adhere to a program’s treatment
protocol.
Motivation for change is related
to the level of probability that a
person who uses substances will-

Enter treatment;

Continue in treatment; and

Adhere to a specific change strategy.

Belief inherent in the view of motivation
as dynamic and in motivational approaches
in general is that-

The client ultimately is responsible for

change

This responsibility is shared with the

clinician through a therapeutic
partnership.
The Spirit of Motivational Interviewing
Motivational
Interviewing
• Collaboration

• Evocation

• Autonomy
 Why Enhance Motivation?

Motivation- enhancing approaches are associated

with …..

• Greater participation in treatment;