Methods and techniques for treating addiction are contiually evolving. Physicians, clinicians, therapists, and other addiction specialists are constantly looking for the best ways to help their patients beat this devastating disease. Doctors and researchers develop new medications and learn more about the way addiction affects the brain and counselors and psychiatrists come up with new ways to treat patients’ emotional and behavioral issues. One technique developed by psychotherapists, which has been used with promising amounts of success is called motivational interviewing. Along with concurrent treatment methods, this style of therapy can help addicts analyze their own choices and behaviors and find a path to recovery. This therapeutic technique was developed by two clinical psychologists, William R. Miller and Stephen Rollnick, in the 1980s. It evolved out of their experiences working with alcoholics. Miller and Rollnick developed the technique over several years with addicts in mind, although it can be used in a variety of therapy situations. Motivational interviewing is centered on the patient and is very goal-oriented. There are three main concepts behind the therapeutic method:
- Collaboration. In more traditional types of psychotherapy, the professional acts as a sort of antagonist. She confronts the patient with the issues and behaviors that are problematic and challenges the patient to accept her ideas about them. In motivational interviewing, the therapist is more of a collaborator. She and the patient form a partnership and work together, rather than in conflict to get to the heart of the patient’s issues that led to addiction. Of course, this does not mean that the therapist always agrees with the patient. Conflict is possible, but the overall relationship is one of collaboration. Although the therapist does not insist that the patient is wrong and that she is right, productive arguments and discussions are necessary.
- Drawing out. The role of the therapist in motivational interviewing is to draw out the ideas of the patient. Instead of being dictated to by the therapist, the patient is encouraged to think for herself and to come up with ideas about her behaviors and her addiction. This is based on the belief that real change comes from the patient’s own motivation. The role of the therapist is to bring about the desire to make this change, not to force it.
- Autonomy. In motivational interviewing, the therapist is not emphasized as an authority figure, unlike other types of therapy. The patient is expected to be autonomous and to make important decisions and changes with the assistance of, but not on the authority of the therapist. The belief is that the true power for change lies within the patient, not in any outside source. This role for the patient is meant to be empowering and to give him responsibility.
The three concepts of motivational interviewing give the patient the power, the responsibility, and the motivation to take control of her own destiny and to make change. This may make it seem as if the therapist becomes an unnecessary element of the process. The therapist, though, is an important tool in using this technique to overcome addiction. The role of the therapist includes several aspects:
- Empathy. Addicts are often reluctant to participate in therapy because of a fear of being judged, criticized, and misunderstood. In motivational interviewing, the therapist accepts the addict for who he is and rather than judge, expresses empathy and care. With understanding and concern, the therapist creates a safe and non-judgmental atmosphere for change.
- Certainty. Addicts are often ambivalent about change. The role of the therapist in motivational interviewing is to provide a certainty and to help the patient decide what to do next. Together the therapist and patient work through different possibilities and their advantages and disadvantages before coming to a decision.
- Guidance. The pathway to recovery from addiction is a tricky one and it can be difficult to stay on that path and to see the correct direction. The therapist who practices motivational interviewing acts as a guide, helping the patient to come to an understanding of his addiction and his motivations and to get on the right path to recovery.
- Support. Perhaps most importantly, a motivational interviewing therapist is a support for the patient. At the first session, the therapist may have more confidence in the patient than she has in herself. Throughout the process, the therapist supports her quest for change, understanding, and recovery.