Motivational interview: what is this therapeutic resource?

Many times we think that the different psychological interventions focused on treating mental health problems simply consist of therapies 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 know the motivational interview of William Miller and Stephen Rollnick, developed in 1999 and focused on treating addictive behaviors. We will know its phases, its principles and the strategies it uses to produce therapeutic change.

• Related article: "The different types of interview and their characteristics"

Motivational interview: characteristics

Motivational interviewing was developed by W. Miller, and S. Rollnick in 1999, and addressed treat addictive disorders such as addiction to alcohol or other substances (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 starts from a theoretical base that

considers that the motivation for change is not imposed from outside, but arises from the patient's ambivalence.

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

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

• You may be interested in: "Addiction: disease or learning disorder?"

To whom?

Motivational interviewing has been applied and is applied to patients who have some type of addictive disorder, either due to abuse or problematic substance use, with the aim of promoting adherence to treatment also of people with mental health problems and chronic health disorders.

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

therapeutic principles

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

1. expression of empathy

The first principle states that therapist empathy is essential; Thus, the therapist's acceptance of both the patient's problem and his addiction itself and his behavior facilitates therapeutic change.

2. Develop 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. accept resistance

The third principle of motivational interviewing maintains that the therapist should not confront the patient in his discrepancies, nor provide arguments about the need to change; considers that The therapist should play a more “free or neutral” role in that sense.

4. Self-efficacy support

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

• You may be interested in: "Albert Bandura's Self-efficacy: do you believe in yourself?"

phases

Motivational interviewing takes place in two distinct phases:

1. Building motivation for change

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

In this phase the following techniques are used: the use of open questions, reflections, summaries, recognition, acceptance of resistance and provocation of discrepancy.

2. Strengthening commitment to change

In this phase of motivational interviewing, the patient's commitment developed in the previous phase is strengthened. Here is a recap of everything worked so far, and also: set goals or objectives, the 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 no treatment for addictions; It is especially useful in potentiating other treatments, 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 some substance; the stage of contemplation is that in which the patient has doubts regarding the change process.

The stages through which a person with some type of addiction passes, were proposed in the Prochaska and Diclemente Transtheoretical Model. Let's see what they are (in order of appearance in time):

• precontemplation: There is no intention to change yet.
• Contemplation: the option to change is considered.
• readiness for action: the person prepares to act.
• Action: the person takes action and leaves the substance.
• Maintenance: the person remains abstinent for at least 6 months.
• Relapse: the person consumes again.
• stadium of completion: the addiction is overcome.

According to Prochaska and Diclemente, people with some kind of addiction to a substance go through these phases; they would normally go in order, but there may be regressions in stadiums, laps, changes, repeats, etc. For example, a person might go from maintenance to relapse, from relapse to maintenance, and back to relapse.