Motivational Interviewing and Substance Abuse
History
In the past 50 years, many confrontational psychodynamic approaches became popular and almost the expectation of substance abuse and addiction treatment. There clearly was the proven fact that substance abuse was a symptom of an underlying disorder . Once the disorder was treated, the secondary substance abuse would clear through to its own. As Wiegmann discussed, research has shown that highly confrontational methods often instilled an ever deeper sense of resistance in the client. The percentage of successful outcomes within the field of addiction has been tossed around and range a great deal, however, they have always seemed pretty dismal when compared with the length and cost of many treatment programs. A fresh approach is essential and an approach that is more accessible to those needing it will be highly valuable in the field.
Addiction and Substance Abuse
Based on Miller , addiction could be described within two conditions: behavior that persists even though there is apparent risk or harm to oneself or others and to an outside observer the person demonstrates diminished, but retrievable, capacity for self-regulation of the behavior. Miller also discusses "symptoms" of addiction including giving inordinate priority to the addictive behavior; avoidance of situations where the behavior is inaccessible; and giving a higher priority to the behavior after an amount of abstinence, among others. Miller shows that the issue of addiction is simply competing for motivations. The motivation for the behavior currently outweighs the harm and perceived value of available alternatives to that particular behavior.
So how can an addicted individual escape addiction? Miller argues that there can be quite a sudden shift in how the individual perceives the good qualities and cons of the behavior. This really is often seen as time passes while the suffering directly attached to the addiction increases and the ratio of pros and cons shifts. Through motivational interviewing, Miller shows that therapists and other helping professionals can lend clients another perspective, a reflection image of themselves, to be able to boost the client's conception of the consequences and saliency of the behavior.
Adolescence and Young Adulthood
Within efforts to utilize motivational interviewing within adolescence, motivational interviewing offers several advantages over other treatment options. According to at least one article , motivational enhancement sap evaluation Atlanta and other brief interventions have the best effect sizes among all treatments for alcohol abuse and dependence and evidence similar efficacy rates. Motivational techniques offer an even more flexible continuum of treatment ranging from abstinence to harm reduction within cases when abstinence is not necessary, which can be the case with adolescents with short histories of substance abuse . Adolescents also often result in a treatment setting as a result of a decision made by an authority figure such as their parents or the justice system and concerns are often not shared by the adolescent. They are often characterized by resistance to improve and deficiencies incomprehension of the consequences of the behavior. Motivational techniques provide clinicians having an attractive method to increase rapport and commitment to improve from clients that have been deemed as resistant before .
It's often not required for adolescents to admit to or acknowledge having substance abuse problems in the order in order for them to take advantage of a motivational approach. Motivational techniques also do not depend on diagnostic labels allowing the client to benefit at any level of readiness to change. It can raise awareness throughout the pre-contemplation stage, can help in decision-making during contemplation, can enhance a person's resolution to improve throughout the action and maintenance stages, and after having a relapse, it provides a chance for reassessment .
Within young adulthood, motivational interviewing provides similar advantages over other treatment plans, however, the ability to utilize brief interventions becomes incredibly valuable as of this stage. Teenagers are at a greater risk of the drastic effects of substance abuse because of their distance from home and authority. As Monti and Tevyaw point out, teenagers in the 18 to 25 age groups consistently engage in high rates of risky behavior such as heavy substance abuse and unprotected sex. These individuals are less apt to be confronted with the household because of their distance from their website or by friends as a result of general acceptance of the behavior during this life stage. It's therefore important to utilize brief motivational interventions within areas where teenagers present themselves such as the emergency department, college counseling and health centers, and within employee assistance programs. Motivational interviewing provides a simple, trainable technique that can be utilized in any of these settings in a quick amount of time.
Outcomes
Each study agreed that motivational interviewing provided at the very least a comparably effective choice for substance abuse treatment. Within one study , clients who were placed with counselors practicing motivational interviewing showed higher satisfaction rates using their experience. In another study among heavy drinkers on college campuses, brief interventions of motivational interviewing results in lower self-reported rates of alcohol consumption and lower blood alcohol levels than people who simply received feedback . Students mandated into a campus alcohol program were more prone to seek further assistance using their drinking adhering to a brief motivational intervention than students who simply completed this program in one single study . In a single final study, older adolescents presenting at a crisis department following an alcohol-related event were randomized to at least one session of motivational interviewing versus typical care. At a 6-month follow-up, those who had received the motivational interview showed a dramatically lower rate of drinking and driving, traffic violations, and other alcohol-related problems or injuries .
Conclusion
Motivational interviewing is really a simple, highly trainable, and effective technique that approaches addiction in a unique way. It offers a theoretical framework that falls more in accordance with social work values and ethics than many others. It permits self-determination, respect, and validation of the client's strengths. Emphasis is on giving the client something new. Especially within substance abuse, the client has heard from multiple authorities and trusted family and friends that their behavior must change. The framework also permits brief interventions that may take invest in almost any setting and do not require a specialist therapist to initiate. This allows for more manageable, accessible, and cost-effective treatment.