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As a treatment intervention, motivational interviewing hinges on humanistic psychology principles. The treatment is directive, client-centers, and endeavors to enhance motivation for change via ambivalence resolution, in addition to enhancing the patient’s perceived self-efficacy (Burke, Arkowitz & Menchola, 2003, p. 846).
The essay endeavors to compare the motivational interviewing principles with the group therapy approach and the family and marital therapy as applicable in patients seeking treatment for substance abuse. The essay shall also endeavor to determine the most effective approach out of the three discussed in treating chemical dependency.
Motivational interviewing principles
As a counseling style, motivational interviewing endeavors to establish a verbal context that would allow patients who are chemically dependent to overcome their ambivalence regarding behavioral change. This is in addition to guiding the patient on the necessary steps to take so that the patients can assume a healthier and valued lifestyle (Washton & Zweben, 2008, p. 80).
Motivational interviewing hinges on the premise that a clinician-patient interaction results in resistance to change and motivation, meaning that resistance to change and motivation is not a characteristic of the patient.
Therefore, in motivational interviewing, emphasis is placed on the best way that treatment providers can ensure that they increase commitment to change and reduce ambivalence within the setting of a clinical interaction. In motivational interviewing sessions, use is made of open-ended questions.
This is important so that the patients can be encouraged to discuss their current circumstances (for example, the patient could be asked by the clinician, ‘what brings you in today’). The clinician also attempts to make use of summary statements and reflections in order to enable the patient build up their empathy (Miller, Rollnick & Conforti, 2002). In addition, the clinicians also tend to facilitate ‘in-session’ change talk.
The skills employed in motivational interviewing are structured in such a way that the individual in question ends up playing a collaborative role in the entire treatment process. As such, the patient has the autonomy to decide on the direction that the treatment regimen should take.
Owing to the evocative nature of the treatment interaction, this means that the patient is in a better position to make positive changes in his/her behavior. “Resistance” as evidenced in motivational interviewing is regarded as more of a misalliance in the ensuing client-counselor relationship, as opposed to an inherent addiction symptom (Burke et al, 2003, p. 847).
Moreover, client ambivalence is admittedly seen as more of a natural part of the expected change process. The counselor uses various non-confrontational methods in order to decrease client ‘resistance’. In addition, the counselor is careful not to directly confront statements of resistance from a client and instead, choose to accept them.
Motivational interviewing enables the counselor to “meet the client where they are at”. During the first session, not many patients would be willing to talk about the issue of substance abuse that they are faced with. In motivational interviewing however, the counselor endeavors to help the patient reflect on the various interests that they have in life.
For instance, a patient of substance abuse could be willing to have her 11 year old daughter to regularly attend school and yet she cannot realize that she has a problem with substance abuse. In such a case, the counselor tries to assist the patient work on their parenting issues.
This acts as a starting point for the counselor to delve deep into the issues of substance abuse. Motivational interviewing has successfully found use in the treatment of outpatient and inpatient patients who have been abusing drugs.
Group Therapy Approaches
Group therapy approach has gained popularity as the most common mode of treatment for individuals seeking a remedy for their drug abuse behaviors. According to proponents of the group therapy approaches, this mode of treatment has been found to have far more benefits in comparison with individual therapy.
For example, in group therapy approaches, a single professional is in a position to interact with a number of patients at the same time (Doweiko, 2009, p. 337). In addition, members of a group therapy are better placed to learn from the individual experiences of their colleagues on the issue of substance abuse. As such, the provisional of feedback among the members is also possible.
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Moreover, individual members of the group therapy approach are in a position to provide their fellow patients with behavioral models. This is especially important for the clients who are yet to cultivate trust with their therapist. In group therapy, the clients find that rare opportunity to enhance the various interpersonal deficits that they could be faced with.
In addition, the nature of the therapy group is such that clients are in a position to confront the problems facing them because they can now be able to trace their root causes.
Substance abusers who also suffer from personality disorders would also benefit from group therapy especially if such a therapy makes use of cognitive-behavioral approaches as a way of diagnosing and assisting the clients to handle painful affective states capable of enhancing the client’s urge to abuse drugs.
However, women confronted with problems of substance abuse are somehow intimidated by a group therapy setting, perhaps due to shame-based issues (Doweiko, 2009, p. 337).
Besides, elderly clients may also not feel comfortable with the complex and interactive patterns that the group therapy setting provides. Under these circumstances therefore, the clients could respond more favorably to a client-therapist interactive session, as provided for by motivational interviewing.
Family and marital therapy
This form of therapy has proved useful in drug/alcohol rehabilitation programs. As such, the therapy is now seen as an integral component of substance abuse treatment, except under special circumstances (Doweiko, 2009, p. 337). Although there are various types of family therapy, nonetheless, the most common and widely used from is the family disease approach.
According to this approach, substance abuse is regarded as an illness of the entire family, as opposed to a problem of the individuals faced with a drug problem only. The family disease approach framework enables the family members and the therapist to work together with the sole intention of identifying the crucial role played by the substance abuse within the family setting.
In addition, such a working relationship also makes it possible to correct possible dysfunction al patterns of interaction (for example, communication problems). In a case whereby one partner is embroiled in substance abuse problems, such a marriage is often characterized by unhealthy patterns of communication.
This only acts to enhance the partner’s addiction problem. As such, family and marriage therapy approaches that emphasize more on the need for communications skills training are highly effective in helping the patient to shun their substance abuse behavior, as opposed to other rehabilitative programs that stresses more on an individual.
Out of the three chemical dependence treatments examined by the research paper, motivational interviewing is the most effective. This is because in motivational interviewing techniques, the client takes control of the therapy process because of the collaborative nature of the therapy.
Accordingly, the patient has the autonomy to decide on the direction that they would want the therapy to take. In addition, the counselor assists the patient to address some of the secondary issues that though not directly related to substance abuse, may end up hindering the actual therapy.
Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol, 71(5), 843-861.
Doweiko, H. E. (2009). Concepts of chemical dependency. Boston, Mass: Cengage Learning.
Miller, W. R., Rollnick, S., & Conforti, K. (2002). Motivational Interviewing: Preparing People for Change. 2nd ed. New York, NY: Guilford Press.
Washton, A. M., & Zweben, J. E. (2008). Treating alcohol and drug problems in psychotherapy practice: doing what works. New York: Guilford Press. 2008