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Motivational interviewing is an abuses’ treatment therapy that was developed in early 90s by Bill Miller and Steve Rollnick. It is a counseling method that is used to facilitate health related behavioral changes to overcome substance abuse. Patients undergoing this therapy are helped in exploring their addictions and in making a resolution to change their behaviors to overcome their addictions. The method is strongly based on empathizing with substance abusers by treating them warmly by listening reflectively to their issues without criticism and understanding their predicament. The basis of motivational interviewingis that patients are motivated to change when there are gentle negotiations. The patient is then able to articulate the cost and benefits for his or her addictions. The role of the therapist is to help the patient realize the differences in current behavior and their own strongly held values. Therapist helps the patient see the discrepancies in a desire to be good and their addictive behaviors. This helps them come to the cont, therefore, collusion that by changing their behavior they are reinforcing their own values. The key to motivational interviewing success is to motivate patients to change out of their own will and belief that they can succeed (Khantzian, 2007 ). Patients through their own ability to carry out the required behavioral changes necessary to help them overcome their addiction.
The role of the therapist in motivational interviewing is to help patients raise doubts on the risks inherent in continuing their current behaviors. The traditional drug addiction treatment method was largely confrontational (David, Shawn, Gillian, & Gordon, 2009). Patients or addicted persons were confronted with the evidence of their addictions with the intentions of getting them to admit their problems. Although, there was no evidence to support confrontation as the effective way of getting addicted individuals to admit their problem with drugs (Treasure, 2004). Confrontation was used in traditional therapist as a tool for breaking an addict’s resistance. However, today confronting addicted individuals to get them to admit their problems is rarely employed. The current trend is to emphasize with addicted individuals and let them realize on their own the importance of their changing their behaviors to overcome their addiction.
Treatment of drug addiction works on the premise that an individual must be willing to change their behavior so as to overcome their addiction. The first and one of the most crucial steps in treating addiction is the admission by a substance abuser that he or she is addicted drug abuser. Coming to terms with this reality is recognized as beginning of treatment for addiction regardless of the therapy method being employed (Khantzian, 2007 ). The only difference between the modern method and the tradition ones in this crucial step is how individuals are forced to admit and accept their reality. Most traditional methods used to apply confrontational methods to get addicted individuals to admit their problem. Modern addiction treatment methods, on the other hand, avoid confronting addicts to get them to admit their problems with drugs. For effective treatment of addictions the principle that an addicted individual should be willing to change his or her behavior for them to overcome their addiction, is strongly observed. More appropriately change has to come from within if this adage is not strictly followed the risks of relapses are higher. This implies that forced addiction treatments are rarely effective.
Human beings are known for their tenacity to free will, forcing someone to do something only encourages them to do the opposite. This is true also in treatment of drug addiction, if addicted individuals are forced into admitting their problems with drugs. This forces addicts into more denial and takes away the incentives to make the necessary changes in their lifestyle. Behavioral change cannot be effective if one is not willing to make the necessary, permanent adjustments in their lifestyle. This in turn, curtails the effectiveness of reversing the trends that triggers their cravings and desire to use drugs (Henningfield, Santora, & Bickel, 2007). Confidence is another key that ensures permanent change in behavior. It plays the role of enabling an individual believe in themselves and strengthen their resolve to permanently maintain the adjustment made in their behaviors.
Motivational interviewing addiction treatment method applies these principles. There are four main, central principles that are applied to make motivational interviewing effective. Therapists have to empathies with addicted individuals through reflective listening. This enables them to understand their patient’s deeply held values and their current behaviors hence underlying motives that drive them into their addictions. Patients, on the other hand, are able to break their resistance by having someone listen to them without judging them and so they begin to admit their problem. The therapist is then able to draw the conflicting differences between the held values and the current behaviors. This is to enable the patient see how continuing with their current behaviors conflicts with their own, held values, so that they can conclude on their own the necessity to change their behaviors (Walters & Rotgers, 2011). Once the desire to make changes in their lifestyle is evident, the patient can then be encouraged through support on their ability to make the necessary changes in their behaviors. This helps in building their self esteem and confidence and encourages them to modify their current behavior to overcome their addiction. Throughout all these steps, confrontations are avoided to ensure that the behavioral changes that are made are not reversed to avoid relapses. The disadvantages of using this method include that it can only be applied to help in a few addictive substances. The drawbacks arise from the fact that it was developed without a theoretical framework. The method was developed mainly to address alcoholic addiction and adopted to addictions. This limits the method, in that it had a specified problem in brain in the premature stages of development and the other addictions treatments only came in as second thoughts. Although, the underlying principles of treating addictions are largely the same, addictions can differ in terms of effect on an individual’s health. The method is also most effective with patients in early stages of their addiction.
The main advantages of this method include irreversible behavior modifications. This means that the method is capable of helping the patients overcome their addictions. Since an addict is convinced that behavior changes align with their held personal value, the risks of relapsing are greatly reduced. It also helps an addict identify the risky situations that should avoided reducing temptations to take drugs again. It also helps the addict build personal confidence and hence improving their personality. Addictions can turn one into unproductive individual, thus by overcoming addiction one can become a productive member of the society again. Motivational interviewing also helps an individual improve his relationships with his or her kin, friends, neighbors and the rest of society.
Theoretical frame work
Treasure (2004) argues that although motivational interview lacks the theoretical framework it is shares similarities with the Trans-theoretical Model. This is because the method was developed as a counseling technique from studies by Bill Miller and Steve Rollnick. However, motivational interview heavily borrows most of its theoretical aspects from the Trans-theoretical Model for academic purposes (Treasure, 2004). But the motivational interview method differs from the theory. Trans-theoretical Model has five change stages that are distinctive these stages are pre-contemplation, contemplation, determination, action and maintenance. Each of these stages of change has given periods of time that the process is expected to take. Treasure (2004), therefore, argues that the method has no theoretical backbone the method, however, does follow the basic principles that guide changes in health behaviour. Especially the extremes that can be found in addicted individuals’ denial to their conditions and their symptoms (Treasure, 2004).
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a therapy method comprising of behavioral learning strategies developed to help patients overcome alcohol addiction relapses. It is mainly developed on the basis of learning theory that addresses maladaptive patterns of behavior. Although, the method was developed to first address alcohol addiction relapses, CBT can also be effective in treatment of cocaine addiction. Patients undergoing addiction rehabilitation learn a number of life skills that are applied to correct their behavioral patterns that are responsible for their substances addiction. Addicted individuals first identify their behavioral patterns responsible for their addiction and then the other patterns that influence relapses into their addiction. The strategies developed in Cognitive Behavioral Therapy are specifically aimed at enhancing self control. These strategies are designed to explore the positive and negative aspects of continued use of drugs. The strategies employ self monitoring of an individual’s behavior that triggers drug cravings. An addicted person learns to identify risky situations that influence the need to use drugs. Once indentified situations that triggers ones’ desire to take drugs are avoided, and coping strategies developed to avoid desire to take drugs. Like the motivation interviewing, Cognitive Behavioral Therapy employs most of the principles of the learning theory. The method is largely dependent of the addicted individuals developing coping strategies that can be employed when an individual is faced with situations that can induce cravings or the desire to take drugs. Coping strategies include identifying situations that are likely to triggers the desire to take drugs. Once such situations are indentified, an individual learns to avoid them. Secondly the behavioral patterns or lifestyles that are seen as responsible for addictions are avoided. This is one of the common strategies employed both by the Cognitive Behavioral Therapy and Motivational interviewing. The two methods are also avoid confrontations therapist are encouraged to avoid conflicts with their clients. Additionally empathy is the key to the success of the two methods. By understanding their clients, therapists are able to share their clients’ points of view in order to pin down the drivers of addiction.
For Cognitive Behavioral Therapy to achieve lasting changes to overcome their addiction, the method works on the basis that they must recognize their dysfunctional behaviors. To achieve this, they must get a deeper understanding of themselves and their world. This means that they must get to know the values that they treasure most, their surrounding environment and the people around them. For self improvements to occur, they must be able to relate these factors with their current behaviors and recognize the changes that are necessary for them to overcome their addictions. Therefore, personal beliefs that drag them down have to be changed in order to achieve lasting positive changes in their life (Reinecke, Freeman, & Kazantzis, 2010). Weakness and strengths should also be indentified to help alter self depreciating perceptions. Cognitive Behavioral Therapy is also guided by some of the common principles in treatment addiction. Addictive behaviors can results from uncontrollable anxieties that when ignored or untreated they influence compulsive behaviors, which turn, into addiction. To mask or temporarily relieves the anxieties individuals engage in substance use which turns into addiction (Walters & Rotgers, 2011). Cognitize therapy requires that the uncontrollable anxieties be indentified and treated as a process of achieving full recovery. In other word, it addresses not only the addiction itself but the causative factors. The other common principle in treatment of addictions is that a person must be willing to change their behaviour patters.
Rational Emotional Behavior Therapy
Rational Emotional Behavior Therapy (REBT) is largely dependent on the theory that rational human beings are always willing to live with the goal of attaining some happiness in their lives. It is also assumed that human beings can also have irrational believes and philosophies that curtails their goals of achieving happiness in life. Irrational humans adopt lifestyle and beliefs that prevent them from attaining their purpose and goals in life. These negative beliefs result when negative events are experienced and can be responsible for health problems. Beliefs that are held or life philosophies can cause negative occurrences to reinforce negative emotions and result into regrets, concern or sadness. However, the negative emotions do not always turn into unhealthy life conditions. It all depends on one philosophy and beliefs, which can make a difference in the coping strategies that an individual can adopt. The unhealthy emotions, on the other hand, can lead to guilt, anxiety and depression when one experiences negative occurrences. This unhealthy emotion causes negative situations to become intolerable circumstances and in the process affect the psychological well being of an individual (Aurora, Viorel, & Doina, 2008). This in turn, affects the ability to function normally and can result in addictions as a means of coping.
The main objective of REBT is to replace their negative attitudes with more flexible and positive views. These ways they are able to cope with negative circumstances in their lives. They become more tolerant to frustrating situations at the same time pursuing their goals and purpose in life. Therapists employing this method to help clients overcome their addictions have to emphasize with their clients and adopt a positive outlook towards all their clients’ circumstances. The core principle in this form of therapy is it attempts to help the client identify and acknowledge the problem and the influencing factor. Once the problem is understood, and the irrational belief or philosophy that influenced a negative occurrence to turn into a problem, a rational alternative is developed. The function of the therapist is to help their client challenge their irrational philosophies and belief. Therapist, therefore, become very directive and have to actively dispute the irrational philosophies and belief of their clients. Unlike CBT and motivational inquiry why most of the conclusions are arrived at by the clients, in REBT the clients are pushed to make the conclusion by the therapist.
CBT and motivational interview and their similarities and differences
One of similarity that CBT and motivational interview share are the common principles that guide change in health behavior. This implies that the two methods also shares these similarities with most other health change models. The shared similarities include the extremes that can be found in addicted individuals’ denial to their conditions and their symptoms.secondly the two methods operate on the principle that confrontations should be avoided. The two methods are client based, and the behavarial changes required to overcome addiction have to eliminate from the clients.in addationCBT and motivational interview have their origin in alcohol related addictions and later fashioned to address other forms of substances abuses (Treasure, 2004). Finally, the coping that help address addiction is similar. These strategies, which include identifying situations that are likely to triggers the desire to take drugs, indentified and avoided. Secondly the behavioral patterns or lifestyles that are seen as responsible for addictions are avoided. These common strategies are employed both by the Cognitive Behavioral Therapy and Motivational interviewing. Results from the two methods also largely depend on the therapist since adherence to the steps when apply the methods can differ significantly from one therapist to another. CBT theoretical framework is based on the basis of learning theory that addresses maladaptive patterns of behavior. While motivational interview has no theoretical backbone, this is one their significant difference. CBT is easier to apply and is formulated from simple principles. On the other hand, motivation interview is hard to apply although developed from simple principles (Treasure, 2004).
Motivational interview is applicable to many situations in psychiatry. This is so because it is useful to clients who exhibit resistance to change. It has simple principles that can be very hard to practice in uniformity. This is because the method has no theoretical framework, but it has borrowed some of theoretical aspects of Trans-theoretical Model for academic purposes there are distinctive differences between the two. Trans-theoretical Model operates in five change stages or behaviors that are distinctive. These stages are pre-contemplation, contemplation, determination, action and maintenance. Each of these stages of change has given periods of time that the process is expected to take. It should be noted that motivation interview does follow the basic principles that guide changes in health behaviour.
This implies that it shares similarities with most other health change models. The shared similarities include the extremes that can be found in addicted individuals’ denial to their conditions and their symptoms. CBT was developed as behavarial change strategies to help patients overcome alcohol addiction relapses. It is mainly developed on the basis of learning theory that addresses maladaptive patterns of behavior. Although, the method was developed to first address alcohol addiction relapses, CBT can also be effective in treatment of cocaine addiction. Patients undergoing addiction rehabilitation learn a number of life skills that are applied to correct their behavioral patterns that are responsible for their substances addiction.
Addicted individuals first identify their behavioral patterns responsible for their addiction and then the other patterns that influence relapses into their addiction. The strategies developed in Cognitive Behavioral Therapy are specifically aimed at enhancing self control and enable one to overcome their addictions. Rational Emotional Behavior Therapy depends on the theory that rational human beings are always willing to live with the goal of attaining some happiness in their lives. It is also assumed that human beings can also have irrational believes and philosophies that curtails their goals of achieving happiness in life. For this reason, they adopt lifestyle and beliefs that prevent them from attaining their purpose and goals in life hence addictions. However, all these methods of treating addictions identify an individual’s desire to change behavior as the most important to overcome any kind of addiction.
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