Cognitive-Behavioral Therapy and Motivational Interviewing Leigh Lusignan
CPSY 6728-4 Substance Abuse Counseling
Facilitator: Dr. Natalie Spencer
July 23, 2014
Week 8 Discussion 1
Cognitive Behavioral Therapy (CBT) vs Motivational Interviewing (MI) Today, I will introduce the comparison between Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI). The similarities and differences will be addressed regarding techniques and/or methods. In addition, I will explain how CBT and MI are applied to the case study selected (i.e., Jack) a heterosexual male of 64 years of age whom recently chose to seek therapy regarding his substance abuse of alcohol. Cognitive Behavioral Therapy (CBT)
According to Stevens and Smith (2013) CBT and MI can be applied for substance abuse therapy. There are similarities and differences between the two; however I will provide a rationale for combining these models. Jack’s cognitive impairment is in his decision-making (e.g., drinking although the doctor advises he must quit for his health). I believe CBT would assist Jack in self-efficacy (i.e., Jack’s believe in his ability to succeed in specific situations). The therapeutic relationship is essential as previously mentioned in other posts. CBT will challenge Jack’s life goals and offer him encouragement so he can develop a sense of belonging. Jack will perform self-exploration so that he can recognize that he has been blocking his own growth and denying himself the aspects of self-efficacy (as cited in Miller, 2005). According to Corey (2013), this approach is time-limited which focuses on specific problems (e.g., alcoholism). However, it leads to moderate insight and modification in behavior. The client will explore his feelings, share his feelings, and apply it to his socialization (Corey, 2013). Motivational Interviewing (MI)
Substance use problems such as alcoholism require MI because it is not driven by theory or model; however, it does focus on building client motivation and responsibility regarding change (Stevens & Smith, 2013). The clinician will provide guidance and support while no specific assumptions will be made regarding course of treatment. I would begin my therapy with Jack while respecting his independence. Stevens and Smith (2013) stated, “MI is a humanistic, client centered counseling approach” (p. 191). This brief intervention will elicit behavior change in Jack so he is able to explore and resolve his ambivalence (as cited in Rollnick & Miller, 1995, p. 326; Stevens & Smith, 2013, p. 191). For instance, I would like to explore Jack’s point of view and his emotional reactions (e.., obstacles) as a result of his probable undiagnosed Posttraumatic Stress Disorder (PTSD) and prevailing disorder within military personnel. Betty and the doctor advised Jack that he needs to stop drinking and I would like to elicit Jack’s reasons to decrease his consumption of alcohol. However, Jack must commit to this specific change. Similarities and differences
The similarities between CBT and MI emphasize client activity outside meetings; provide support for self-efficacy, and encourage Jack so he will become more aware of his own potential. Common elements are shared within the therapeutic relationship addressing empathy and collaboration (Stevens & Smith, 2013).
The differences between CBT and MI are in the philosophy. For instance, CBT build skills whereas MI builds motivation. CBT is educative whereas MI is evocative (i.e., bringing strong memories and/or feelings to mind). In CBT Jack solutions will be preselected whereas MI allows the client to pick solutions for himself. CBT is also based on empirical support for group format whereas MI is briefer provide strategies for client resistance (Stevens & Smith, 2013). Nevertheless, I would like to provide a rationale for combining strategies. CBT can provide structure for treatment which can be done in groups and is not effective without Jack...
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