Drug Abuse Therapy - Examining Motivational Interviewing In Drug Abuse Therapy

Motivational interviewing (MI) can be defined as a counseling approach which owes a lot to clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D. What motivational interviewing aims to do is to use intrinsic motivation to modify behavior by developing discrepancy and exploring and resolving ambivalence within the client. Motivational interviewing aims to boost a person's commitment to changing their behavior by focusing on such factors as desire, self-efficacy, need, readiness, and reasons. Motivational interviewing can be tried as a tool for drug abuse therapy and experiments are still continuing with its uses.

In the case of a person involved in drug abuse, motivational interviewing tries to raise the abuser's awareness about the problems it leads to, its consequences, as well as its accompanying risks. Those who are conducting the drug abuse therapy with motivational interviews alternately help abusers visualize a better future, and become more motivated to achieve it. In either case, MI tries to help drug abusers think differently about their behavior and finally to consider what they can achieve through change.

A research conducted for assessing the usefulness of a single session of motivational interviewing in drug abuse therapy suggested that the lone session of the MI technique had virtually no effect on drug use outcomes. Later, however, results of another analysis indicated that that the therapist perhaps prematurely tried for change before the abuser was ready.

In the original study, researchers from University of New Mexico had assigned 152 outpatients and 56 inpatients at random to undergo or stay away from a single session of this method as part of their drug abuse therapy. The scientists who conducted the study assessed drug use at the pretreatment baseline and at 3, 6, 9, and 12 months following study entry. It was observed that that the addition of a single session of motivational interviewing did have no positive effect on abstinence.

By following up this research, a psycholinguist watched videotapes of 84 persons undergoing motivational interviewing, who represented a subset of people from the previous study, and their therapists to analyze the language they used.

For this psycholinguistic study, each session was divided into four parts: motivational interviewing, assessment feedback, additional motivational interviewing, and developing a change plan. The researchers observed that during the parts of motivational interviewing segments, the participants in the study used language that suggested a great commitment to stop drug abuse.

The analysis, however, also revealed that participants began offering “resistance", or used not-so-strong and determined language, when the therapist began to give assessment feedback. A precipitous fall in commitment language was also observed when the therapist pushed for a plan to initiate changes in behavior.

From this, we can conclude that the finding from the first study in which motivational interviewing failed to have a positive impact on drug use behavior was unexpected as earlier assessments had suggested that MI had the capacity to improve treatment retention, adherence, and outcome. The second study indicates it is wiser to change manual-guided motivational interviewing techniques when dealing with drug abusers whose language, particularly during assessment feedback, shows a reduction in their initial zeal to overcome drug abuse.

So a therapist must wait till the affected person is ready, otherwise chances are that the efforts would only undermine the present level of motivation for behavior change.

• Janny Raines
• 23/03/2009, 8:59 AM
• 0 Comments