Motivational Interviewing

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The Effectiveness of Motivational Interviewing as a Treatment for People with Co-Occurring Disorders

HUS 436 Counseling for Co-Occurring
Assignment: Research Paper

The topic of this research paper is the effectiveness of Motivational Interviewing (MI) with people dealing with co-occurring disorders. To begin, I would like to introduce the concept of Motivational Interviewing.

Motivational interviewing is a collaborative, person--centered form of guiding to elicit and strengthen motivation for change. It is an empathic, supportive counseling style that supports the conditions for change. Practitioners are careful to avoid arguments and confrontation, which tend to increase a person's defensiveness and resistance. Motivational interviewing is a proven and effective way to:

* Engage individuals with co-occurring disorders
* Develop therapeutic relationships
* Determine individualized goals
Motivational interviewing is used for the treatment of many conditions. Specific strategies have been successfully applied to working with individuals with co-occurring disorders include: * Assessing the person's perception of the problem

* Exploring the person's understanding of his or her condition * Examining the person's desire for continued treatment
* Ensuring a person's attendance at initial sessions
* Expanding the person's perceptions for the possibilities of successful change Research shows that motivational interviewing techniques, including counseling, assessment, multiple sessions, and brief interventions, are associated with greater participation in treatment and positive treatment outcomes. (SAMHSA)

Motivational interviewing works with acceptance instead censure to help the person change. Rollnick describes motivational interviewing as empowering and its concepts being very powerful. Motivational interviewing helps practitioners connect with an individual's intrinsic motivation to change by exploring and resolving ambivalence. It also regards ambivalence to change as normal, expected behavior. Motivation for change is created when a person recognizes discrepancies between their behavior and their personal goals. The intent of motivational interviewing is to explore the discrepancies with the goal of reducing ambivalence and identifying the individual's goals and priorities. In other words, motivational interviewing helps the person recognize the difference between where they are and where they hope to be. This approach accepts a person's level of motivation-whatever it is-as the starting point for change. (Miller and Rollnick, 2002).

In the past, traditional treatment methods for drug addiction and alcoholism have been characteristically intense and confrontational. They are designed to break down a client’s denial, defenses, and/or resistance to his or her addictive disorders, as they are perceived by the provider. Admissions criteria to substance abuse treatment programs usually require abstinence from all illicit substances. Potential clients are expected to have some awareness of the problems caused by substance abuse and be motivated to receive treatment.

In contrast, traditional treatment methods for mental illness have been supportive, benign and non-threatening. They are designed to maintain the client's already-fragile defenses. Clients entering the mental health system are generally not seeking treatment for their substance abuse problems. Frequently clients within the mental health system who actively abuse drugs and alcohol are not formally identified. If they are, they do not admit to such substance use. As some attention began to focus on clients with both substance abuse problems and mental illnesses, it quickly became apparent that new methods and interventions were necessary. Working with dual disorder clients who deny substance abuse, who are unmotivated for substance abuse treatment, and who are unable to tolerate intense confrontation, required a new...
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