Motivational Interviewing is a client-centered type of therapy designed to enhance motivation to change by resolving and exploring ambivalence. The approach was originally developed by Dr. William Miller and Dr. Stephen Rollnick. Motivational Interviewing, sometimes called Motivational Enhancement Therapy, is based on four principles:
1. Empathy. Empathy guides the clinician and the client relationship, helping the clinician understand where the client is coming from.
2. Developing Discrepancies. This prong of the four principles is based on creating a discrepancy between how the client wants their life to be and how what they are currently doing, for example using drugs and drinking, will negatively effect their plans for the future and what they want.
3. Resistance Rolling. This refers to the attitude of the clinician. Historically, in addiction treatment, and psychotherapy in general, resistance has been thought of a pathologically driven behavior/attitude. In Motivational Interviewing, the clinician is taught to Role with the Resistance of the client. For example, instead of punishing a client for not wanting to change, the clinician simply accepts that resistance to change is a natural occurrence, especially in addiction treatment. Resistance Rolling, or R&R as I call it, helps prevent both clients and clinicians from becoming frustrated with the lack of change as a result of resistance and the resistant behaviors of the clients themselves.
4. Supportive Self-Efficacy. Clinicians using Motivational Enhancement Therapy, or Motivational Interviewing Techniques, will focus on the client’s right to change when they want to and encourage clients that they can change when they desire to do so. Simply put, the choice is left to the client and the client’s Free Will to either choose to change, or choose not to change, is in the client’s hands.
At Northbound, we utilize the Motivational Interviewing approach and have taken it a step further in the Northbound Academy. Using a combination of Educational and Career Goal Counseling, College Classes, and Activities, the client in the Northbound Academy is able to see while they are in treatment, how being sober and changing their lifestyle contributes to their future goals. They also are able to see how their occupational and educational goals have been thwarted and discouraged by alcohol and drugs over the years. The proof is their Grades at the end of the semester. After completing an entire semester in the Northbound Academy, the client’s can physically, and not just hypothetically, see the discrepancy between their grades when they were using drugs and drinking, and what their grades look like when they are sober. We have found this to be a most useful tool in creating motivation to change. The entire Northbound Academy is based on the Motivational Enhancement Approach. Clients are allowed to change when they are ready, given the autonomy and responsibility of going to College Classes on a real College Campus while in treatment, and throughout the Northbound Academy’s program, clients goals are developed so that they have something to look forward to and something to loose. From the moment clients enter the Northbound Academy, the focus is on developing occupational and educational goals related to what they want to do and what they want. Then, as a result of them having a goal (hope) where there may have not been one before, clients are shown specifically how they can reach that goal, which keeps the GOAL from becoming a DREAM. When the Goal is realized and a clear path to that goal can be seen, the client is then shown throughout the semester in the Northbound Academy how their past behavior is not conducive to them accomplishing their Goals.
