When it seems like a behavioral health professional is working harder than a patient in a therapy session, it may be time to consider whether that patient may benefit from motivational interviewing (MI).
“Many treatment approaches assume that someone is ready for change, but actually people are often ambivalent about it,” says Jonathan Krejci, PhD, Senior Director of Clinical Development and Performance Improvement at Princeton House. “Motivational interviewing is a style of structuring conversation around change to help someone recognize and articulate their own reasons for change.”
Originally centered around substance abuse treatment, this style of therapy is now considered beneficial for a wide range of clinical problems, particularly when a therapist senses disengagement or resistance. By focusing on strengths rather than deficits, MI reduces defensiveness and instills confidence to provide momentum for change.
“Lasting change is more likely when a patient discovers their own motivations for it,” explains Krejci. “Behavioral health professionals can draw out these motivations with a person-centered, goal-directed approach.”
What is Motivation?
When considering what comprises motivation, Krejci refers to this MI formula for change:
M (Motivation) = I (Importance) + C (Confidence)
Two elements are needed for motivation: Importance assumes that the patient understands the problem and expresses a desire, reason, or need to change. Confidence, which often can be overlooked, means the patient believes that change is not only desirable, but possible, and that he or she has the resources to effect change. When behavioral health providers identify and focus on the area that needs more work for a particular patient, motivation is more likely.
“When done well, motivational interviewing feels more like dancing and less like wrestling,” adds Krejci, who has provided comprehensive MI training for staff throughout Princeton House and across the state, in addition to once serving as an MI consultant for the United Nations. “It can be very empowering for patients, because it helps them recognize that they have the ability to create change rather than someone else solving a problem for them.”
Keeping PACE
Motivational interviewing (MI) is characterized by an attitude or approach to patients and to behavior change that can be summarized by the acronym PACE:
(P) PARTNERSHIPMI is best viewed as collaboration with another person, or a conversation between two people who have different but equally important areas of expertise.
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(A) ACCEPTANCEAcceptance is not the same as approval or agreement; rather, it facilitates change. When patients accept themselves as they are, change is possible.
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(C) COMPASSIONDefined as the ability to actively promote another’s welfare and prioritize their needs, the use of compassion in MI ensures that change principles are applied in the interest of the patient.
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(E) EVOCATIONThe goal is to evoke motivation for change through a strength-based approach and techniques focusing on the patient’s own desires for change in their life.
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For more information about Princeton House services, call 888.437.1610. (Option 1 for inpatient, Option 2 for outpatient admissions.)
Article as seen in the Winter 2019 issue of Princeton House Behavioral Health Today.
