Motivational Interviewing (MI) is a tool that a lot of clinicians use to learn more about their clients and the client’s desire for change. Some of the basic tenants include getting to know the client better through reflective listening, determining what underlies the client’s ambivalence about change, and assessing where the client is at in the Stages of Change model. If you are struggling and want to change something that you do, working with a licensed professional with this technique may help you internally realize your roadblocks to change and how to overcome those obstacles.
Reflective Listening
First, the provider will want to get to know you better. They will be intently listening to you and your struggle with change. For example, if you are struggling with substance use, then they will review with you what underlies that struggle. There are a few different ways they will actively listen to you.
- Simple reflection: State back what was said to you in clear terms.
- Example: You do not want to use anymore.
- Reflection of feeling: State what was said, but add the emotion underlying the experience.
- Example: You do not want to use anymore because it makes you feel sad and guilty.
- Double-sided reflection: Highlight contrast in the situation
- Example: On the one hand you do not want to use anymore, but on the other hand you get these cravings that are hard to resist.
In addition to these three reflections, your MI interventionist will also likely ask you lots of open-ended questions. These are questions that cannot be answered with a “yes” or “no” response. They want to know about you in your entirety, which means you have to open up and share with your provider. After an open-ended question, they may further your response with a comment like “tell me more.” Your provider wants to get to know you and wants to help you. Do not be afraid to open up. They should listen to you.
What Underlies Ambivalence?
Sometimes, we aren’t sure if we want to change. Part of us understands the substance use is bad for our health and has negative implications, but the other part of us just wants a bit of relief. Maybe there’s an entirely separate reason why you feel ambivalent about quitting.
The goal of your provider is to understand the feelings underlying your indifference towards change. With you, they want to weigh the pros and cons of your situation so that you can make the best, most informed decision for yourself. It’s okay to acknowledge that you have feelings towards and against quitting. You should share that openly with your provider.
After understanding why you may sometimes feel ambivalent about change, your provider will help you internally move through the Stages of Change model.
Stages of Change
This model from Motivational Interviewing can help you and your provider determine where you are at in the change process. There are five stages to change: 1) pre-contemplation, 2) contemplation, 3) preparation, 4) action and 5) maintenance.
Pre-Contemplation: This is the stage where you are not sure if you want to change. You may be ambivalent or even resistant to the idea of leaving behind a particular behavior. In this phase, your provider just wants to get to know you better. They want to build rapport with you so that if you ever do want help changing, they can help you along with that process.
Contemplation: This is the stage where you are considering changing. You are weighing the pros and cons of the situation.
Preparation: You have made your decision. You want to change – whether that’s quitting alcohol or losing weight – you are ready for the challenge. This is the stage where you are preparing to make the change. It entails a lot of logistics like setting a quit date and having a support network in place.
Action: You are changing. You are quitting something or modifying your behavior in some way to feel healthier overall with your life. This is the good part.
Maintenance: You have been consistent with your change for quite some time, but you need little reminders to keep it up and congratulate yourself. This may entail celebrating your sobriety with a trip or engaging your support network when you cross another milestone.
Relapse: Sometimes, you may fall back into your old behavior. All the skills you learned in the other five stages of change are still there. A provider can intervene again with Motivational Interviewing if it worked for you the first time. It’s understood that life is messy. It is never too late to get back into another stage of change.
Motivational Interviewing (MI) is a very involved process to help clients decide when, how, and why they may want to change but it takes time. By reflective listening and working to understand ambivalence, a provider can determine where you are at in terms of stages of change. They will help you anywhere you are in the process. At Valiant Living, our men’s-only treatment facility in Denver, Colorado, we help you figure out where you are in terms of Stages of Changes. We will listen to you no matter where you are in terms of your change process. Our expert team of providers is trained in this technique and can help you understand the emotions underlying your ambivalence if it exists. We treat addiction and co-occurring mental illnesses. Motivational Interviewing is a technique that works for both problems. To learn more, you can reach out to us today at (303) 952-5035.
