Best Way to Evoke Change in Others: Motivational Interviewing

Motivational Interviewing (MI) is a counseling style used to help a client uncover his or her ambivalence toward maladaptive behaviors and to evoke change.

This evidence based interviewing style reminds me of a popular philosophical method that Francis Schaeffer used, "taking the roof off." When you remove the roof off of the house, Shaeffer states that, "each man must stand naked and wounded before the truth of what is."  The reality of one's worldview that which someone lives comes flooding in.  Therefore, the roof must be carefully deconstructed so the house can be reconstructed.  Apply that same concept to behavioral change and you have the crux of Motivational Interviewing.

Initiators of MI in the 80's, Miller and Rollnick (2013), in their book entitled Motivational Interviewing: Helping People Change, stated, "If someone else voices an argument for change, people are likely to respond by expressing a counter-change argument from the other side of their ambivalence.  By continuing to express the arguments against change, people can literally talk themselves out of changing.  Similarly, people can talk themselves into change by continuing to voice prochange arguments" (See source here).

Unless there is a direct intent to harm self or others, it is up to the client to make his own life choices (you can't make someone else's choices for them).  What I love about motivational interviewing is that the counselor explores with the client and helps him expose his own destructive path and the consequences of that path.  Then the counselor can process with the client how to hold himself accountable by using his own values, goals, strengths, and morals.  Typically, people have the resources from within to make better decisions; it's up to the counselor to help pull these out.  If this happends, then the client can take ownership and build confidence in changing her behavior.

As the client uncovers his own values, he may see that drinking excessive amounts of alcohol at work or other maladaptive behaviors might cause his life to come flooding in on him (losing his job, income, house, hobbies, license, ability to support his family, prison, etc.).  Seeing this new reality or truth will help motivate the client to change.

A research journal article reported that MI helps clients change their behavior and that it trumps traditional advice giving in approximately 80% of the cases (See full study here). 

Tony Nichols

 --I find joy in helping other's experience hope and peace in their life. 

Addiction Recovery: Stages of Change

Thinking of Change?

Giving up an addiction is the hardest obstacle in life to do.  The addiction is such a struggle to give up because we like the substance or thing we are addicted to.

I love the way coffee makes me feel in the morning when I drink it.  The smell of it brewing, the taste, and then the tingling feeling in my brain after gulping down the first drink.  I continue to drink coffee because I love it!  Using alcohol, marijuana, consuming excessive amounts of fried chicken, or winning lottery tickets feel good to those who engage in those substances, activities or eat certain foods.  Why would we give up something that feels so good?  This is why it is so hard to quit a substance or behavior that we love, but sometimes it is necessary for our health, financial situation, relationships, etc.  We need to ask what is the cost or risk of continuing the addiction or behavior?  Good thing my coffee addiction doesn't present too many risks!-- That's easy to say with all other addictions too.

Though addiction/behavior-educational material is important through this process, this isn't a treatsie on the dangers of your addiction, but only some ideas to think about if you are wanting to change (i.e. contemplation stage).  Inevitably, it is your choice and your life anyway.  DiClemente and Prochaska's (1983) Stages of Change model shows how an addicted person recovers.

1. Precontemplation (unaware of the problem)
2. Contemplation (becomes aware of the problem and the desired behavior change)
3. Preperation (intends to take action)
4. Action (practices the desired behavior)
5. Maintenance (works to sustain the behavior change)
  
Relapse can occur at any stage (drinking a beer after a year of sobriety or smoking a cigarette after six months of cessation).  A person can also sit on one stage longer than the others.  It may take an individual six months to decide that he is ready to take action after deciding he needs to put the booze down. The diagram above helps one to think about what step he or she is facing next.  Due to excessive stress around the holidays, should a coping skill be developed to sustain the behavior change?  Due to a court hearing one may need to start practicing the desired change to avoid more issues.  What's next?

Which step are you on?  Are you aware there is a problem?  Use the beginning of 2015 to make a change for the better!  

Tony Nichols