Motivational Therapy

Motivational Therapy has become a primary modality for treating addiction over the last fifteen years. It is defined as an aggregate sum of multiple individual cognitive treatment methods to treat addiction.  Motivational Therapy includes the integration of humanistic treatment, enhanced cognitive behavioral therapies, motivational techniques, booster sessions, cognizance of responsibilities and obligations, moral reconation techniques, and other methods.  This is a treatment style that has become very popular as a wholly unique and exemplary rehab style of its own.

Motivational Therapy Defined

Motivational Therapy is also called Motivational Interviewing.  The two names are synonymous for each other and cover the same allotment of treatment therapies for addiction.  Though Motivational Therapy by itself is not a psychology-based treatment, it often gets allotted into psychology-based treatment because of the positive effect that it has on the mind, the spirit, and the thought processes of the individual.  An article about Motivational Therapy and Interviewing in “Psychology Today” defines this treatment method.  Though the treatment is not psychology, most experts of the mind are truly impressed by this therapy method for its efficacy.  The magazine defined Motivational Interviewing as such:

“Motivational interviewing evolved from Carl Roger’s person-centered, or client-centered, approach to counseling and therapy, as a method to help people commit to the difficult process of change. The process is twofold. The first goal is to increase the person’s motivation and the second is for the person to make the commitment to change. As opposed to simply stating a need or desire to change, hearing themselves express a commitment out loud has been shown to help improve a client’s ability to actually make those changes. The role of the therapist is more about listening than intervening. Motivational interviewing is often combined or followed up with other interventions, such as cognitive therapy, support groups such as Alcoholics Anonymous and stress management training.”

The focus of Motivational Therapy and Interviewing is to encourage the participant to develop negative views of substance abuse and addiction.  The therapy further seeks to develop positive views of healthy activities, and to associate reward with those activities instead of associating reward with substance abuse.

Motivational Therapy and Interviewing processes are very focused on the individual and his or her needs and what problems that specific individual needs help with.  Because of that focus, this type of therapy is almost always delivered one on one as opposed to being delivered in a group setting instead like so many other treatment methods are.  Sessions are usually relatively short to begin with, as the therapist will want to ease into therapy and will sort of take things on a gradient.  After a few sessions, session time might climb from a half hour to forty-five minutes and even an hour and more.  Motivational Therapy, like any other approach to addiction treatment, depends greatly on the incentive and the desire for sobriety of the client and the skill level of the therapist.

History of Motivational Therapy

Motivational Therapy and Motivational Interviewing both are the culmination of extensive study and practice of other therapies and treatment methods.  The founders of this therapy found that the one thing most often lacking from other treatments was a very kind, very caring, very light touch care-flow factor.  The founders felt as though most treatment methods for addiction were too intensive and too direct, bordering on the point of being overly confrontational and that, while those treatment methods certainly had their place and their value, the addiction treatment community needed something different added to the battery of addiction recovery solutions.  According to the article:

“Motivational Therapy was brought to public awareness by William Miller in a 1983 article published in Behavioural Psychotherapy. In 1991, Miller and Stephen Rollnick expanded on the fundamental approaches and concepts, while making more detailed descriptions of procedures in the clinical setting. He later defined it as a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with non-directive counseling, Motivational Therapy is more focused and goal-directed. The examination and resolution of ambivalence is its central purpose, and the counselor is intentionally directive in pursuing this goal.”

Since the 1980s, Motivational Therapy, Motivational Interviewing, and all other variations of these programs have really taken off.  In a country that was growing weary of the traditional, punitive, accusatory, and very strict approach to addiction treatment, Motivational Therapy was truly something to be thankful for.  As America began to desire treatment methods that treated addicts as ill people who needed help as opposed to criminals needing punishment, Motivational Therapy became one of the mainstays of American addiction treatment, right up there alongside the greats in therapy including big names such as Cognitive Behavioral Therapy and Moral Reconation Therapy.  It was this sudden growth in popularity in this treatment method that gave way to variations and unique alterations of the therapy to create different types of Motivational Therapies.

The Types of Motivational Therapy

There have been many offshoots of Motivational Therapy, treatment techniques that have been created in an effort to address something very specific.  For example, there are three variations of Motivational Therapy included below that are used frequently.

Motivational Enhancement Therapy.  Probably the most common variation, this approach focuses on alcoholism, but can be used for drug addiction too.  Motivational Enhancement Therapy was specifically designed in the 1990s to address key addiction crisis issues, and the therapy has not changed much since then.  The Good Therapy describes Motivational Enhancement Therapy (or MET) best, stating that:

“MET was one of three interventions tested in Project MATCH, a 1993 clinical trial of treatment options for those experiencing alcohol addiction, and an initiative of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). MET is based on the principles of motivation and employs techniques associated with Motivational Interviewing, a counseling style developed by William R. Miller and Stephen Rollnick. In MET, the style and techniques of Motivational Interviewing are incorporated into a structured therapeutic approach which involves a comprehensive assessment of an individual's behaviors, as well as systematic feedback based on the findings. Detailed guidelines for MET are provided by the NIAAA.”

Motivational Interviewing.  Though Motivational Interviewing is synonymous with Motivational Therapy, some schools of thought and treatment centers draw a slight distinction.  One article in an educational literature guide on Course Hero hits the nail on the head for Motivational Interviewing:

“As the name implies, the goal of motivational interviewing is to strengthen the motivation to change. We accomplish this by encouraging an accurate appraisal of the costs and benefits of change. Unlike some types of addiction treatment that attempt to coerce people to change, motional interviewing honors and respects ambivalence. Motivational interviewing recognizes there are valid reasons not to change, just as there are valid reasons to change. Through a structured sequence of inquiry, the therapist works directly with a person's ambivalence. Therapists guide therapy participants to make their own decision about whether or not they wish to change. In a sense, MI allows therapy participants to convince themselves of the need to change. This approach avoids the so-called ‘resistance to change.’”

Motivational Therapy vs. Ambivalence.  First of all, all Motivational Therapies address ambivalence, but this approach focuses directly on ambivalence.  Ambivalence can be the death nell of addiction and relapse, unless it is properly addressed through a Motivational Interviewing-type of addiction treatment as opposed to a hard-as-nails and tough approach that simply forces the addict to shut down and refuse to accept help.  An article in the National Center for Biotechnology Information, U.S. National Library of Medicine shows the importance of addressing ambivalence in any kind of motivational approach, especially in Motivational Therapy vs. Ambivalence:

“Individuals with substance abuse disorders are usually aware of the dangers of their substance-using behavior but continue to use substances anyway. They may want to stop using substances, but at the same time they do not want to. They enter treatment programs but claim their problems are not all that serious. These disparate feelings can be characterized as ambivalence, and they are natural, regardless of the client's state of readiness. It is important to understand and accept your client's ambivalence because ambivalence is often the central problem--and lack of motivation can be a manifestation of this ambivalence (Miller and Rollnick, 1991). If you interpret ambivalence as denial or resistance, friction between you and your client tends to occur.”

Motivational Therapy in Addiction Treatment

Motivational Therapy is a very useful treatment method for addressing addiction to drugs and alcohol.  What started off as a controversial treatment method has developed into a very popular platform for addiction treatment.  A study done by the National Institute on Drug Abuse on the efficacy of Motivational Interviewing noted that:

“Findings from the NIDA Clinical Trials Network (CTN) protocol documented that Motivational Interviewing (MI) resulted in higher retention rates during the first 28 days of treatment compared to standard interventions. This Blending Team designed empirically supported treatment products to enhance the MI (Motivational Interviewing) skills of treatment providers and supervisory tools to fortify the supervisor's ability to provide more structured, focused, and effective clinical supervision.  Products were completed in 2006.”

The fact that the National Institute on Drug Abuse (the leading authority and governing body on addiction treatment in this country) gave its full backing and nationwide support in 2006 to a treatment method that had barely been in use for more than a decade shows the efficacy and virility of Motivational Therapies.  Truly, Motivational Therapy and Interviewing are treatment methods that any struggling addict would be interested in working with.