Motivational Interviewing (MI) is a direct, client-centered style of counseling aimed at provoking the behavior change by helping patients to resolve and explore uncertainty. The concept of MI evolved from the experience in the treatment of alcoholics. The method works by aiding and involving the inherent motivation within the client to change their behavior without arousing resistance to change. Thus, it is more of a goal-oriented and focused method when compared to other non-directive counseling methods. The therapists involved in the process attempt to convince their clients to contemplate on the changes that they can make by increasing the incongruity between their present behavior and their anticipated goals. Resistance is also minimized in the process. MI is based on the stages of change, which assumes that motivation is a concept that can be influenced. The MI technique helps people to change by helping them to realize that their behavior poses a high risk to them. It also allows them to evaluate the impact that the given problems have on their lives so that they could look for the ways of changing their behavior through the development of action plans. This paper seeks to provide a detailed insight on the use of MI in a substance abuse prevention program with adolescents.
When dealing with adolescents, it is common to come across the situations where they raise so many objections to the point where it becomes difficult to deal with them. The situation often arises in trainings, consultations, and treatments. Most people would become frustrated, irritated, or annoyed, and they often have limited choices on the courses of action that they can take to deal with the situation. In such situations, it is important for the counselor to make choices that are based on the underlying principles and philosophy of MI. The different counselors represent the needs of different clients. Therefore, they may implement the needed change at different times. It is normal for people to resist change due to the mixed feelings and thoughts about it. This indecision should be considered as strength. It should be seen as an integral component of a process that the client and the counselor could go through together in solving the problem (Smith, Ureche, Davis, & Walters, 2015). This is the basic concept of MI that helps clients to accept the need to go through change willingly.
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Most of the time, the practitioners tend to resist the fighting reflex exhibited by adolescents in the substance abuse prevention programs by trying to involve themselves in active fixing of the problem. Such acts diminish the probability of their clients ever changing. Motivational interviewing skills help the practitioners to be aware of the behaviors that the adolescents may exhibit so that they might find effective ways of going about them. The right reflex will only come out when the practitioner has that deep desire to help others. That positive motivation is translated into the right actions in dealing with the adolescents. When the client is motivated, he or she finds the reason to change their situation and thereby live a healthier, happier, and more productive life. A client, who is not motivated, finds the reason to resist change and not consider the possibility of ambivalence. The client does not see change as something that is necessary or possible due to the costs that they may have to incur in bringing this change. The adolescent may also find change to be impossible due to their fears, uncertainties, the relationship changes associated with it, the time and money invested, and their need to maintain their status quo (Rosengren, 2009). If the client is not motivated, they find reason to stick with the bad habits.
Most of the time, adolescents tend to insist on having their way, which makes it difficult for a practitioner to come to a compromise when dealing with them. Sometimes, the practitioner ignites their quest to resist even more through their actions and behavior towards them. Some of the specialists’ actions that increase this conflict include cautioning them of the costs of resisting change, telling them how to modify their behavior, and trying to make them see their problem. Such practitioners have not mastered the concept of MI and their actions only fuel the quest for these adolescents to remain resistant to change. MI helps the practitioners to weaken the resistance by influencing their behavior towards adolescents. It also influences their actions towards their adolescent clients by helping them to identify the voids that they need to fix so that they may channel their energy towards them. The practitioners who use MI have the ability to address the issues of substance abuse comprehensively since they know that sometimes, the motivation has to come from the client. That is, they do not need to motivate or instill motivation in their clients. Rather, they have to help them to find the motivation that lies deep within them. The practitioner will direct the adolescents towards the discrepancies (Smith et al., 2015).
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The clinicians need to help clients to identify the things that motivate them and capitalize on them. They direct them toward the voids and help them to find ways of filling them. The practitioner listens for and actively seeks for the information about the client’s aspirations, beliefs, and goals and explores the ways, in which they relate to the present circumstances. This directive element is the trademark of MI and it greatly overhauls the traditional client-centered work. The attitude taken by the practitioner in this context is that of curiosity about the clients and their situations. This information helps the practitioner to convince the adolescent of their mistakes through a subtler way of arguing for change (U.S. Department of Health and Human Services, 2007). Thus, MI enables the practitioners to create the environments, in which the adolescents tell them why and how the change can happen.
Most practitioners who deal with adolescents often assume that listening to them is an obvious thing. In practice, other imperatives often interfere with this fundamental process. At such times, the concept of MI becomes so clear. Sometimes, the adolescents approach the practitioners for their expertise unwillingly. Even then, they still remain responsible for bringing about any form of change in their lives. For the practitioners to assist them effectively, they must create an atmosphere, in which the adolescents can safely explore challenges and face difficult realities. This is created when the practitioner becomes empathetic and communicates with that empathy (Wei, Heckman, Gay, & Weeks, 2011). The concept of MI facilitates the client-centered approach, empathetic approach. The clinicians bring out this concept through active listening and a positive attitude that enables them to accept the perspectives and the feelings of the clients. Using MI enables the clinician to understand the adolescents’ point of view and remain truthful in expressing their thoughts to them. It is fine to agree and disagree with the adolescents at times. However, the practitioner should strive to remain respectful and try to understand the client’s viewpoint (Carney & Myers, 2012). This attitude translates into the notion that acceptance facilitates the change under pressure.
Using MI in dealing with adolescents is important since it empowers them. The outcome of any given process is always better when the client is involved. For a change to happen, the clients must actively engage in the whole process. Therefore, the clinicians should therefore support the beliefs of the clients. They should believe that the clients’ have great ideas for solving the problems at hand and that they can enact changes if they want to. The notion of self-efficacy makes the client have a “can-do” attitude. In the absence of this belief, the awareness of these problems triggers a defensive attitude because the clients view change as impossible. MI makes it possible for the clients to believe in their abilities to achieve the desire results (Rosengren, 2009). Most of the time, clients meet adolescents expecting to find some form of discouragement about their failures. Thus, the practitioners must always remain hopeful of the possibility that their clients may change. This can only be achieved if the practitioners understand the basics of MI so that they could motivate them to be hopeful and to communicate better. One way of accomplishing this is by talking about the success of some of their other clients (Carney & Myers, 2012). This enables them to offer their opinions and insights on the issue without arguing with them. The clients will then decide if these views fit them and if they can use them.
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The concept of MI emphasizes on eliciting specific kinds of speech from the clients. This is known as “change talk’. Most of the interventions used in MI are designed to specifically arouse this type of talk and strengthen it when it occurs. This notion is based on the fact that adolescents will most likely apply their genuine contributions for a given session. The strength and trajectory of this talk forecasts the obligation that consequently translates into behavior. The central goal of MI in such instances is to help the adolescents to express their reasons for change. Doing this helps them to strengthen their reasons for change. Having the adolescent, rather than the practitioner, makes the argument for a particular change very crucial when the adolescent is ambivalent. This helps to create a special type of dilemma where the client argues against the practitioner’s arguments. If the dilemma persists for a long time, the adolescents may eventually talk themselves into changing (Breda & Heflinger, 2007). The client becomes an expert of themselves and acts as a reservoir of potential solutions that may be used in other groups of adolescents.
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Motivational Interviewing is a concept that works effectively when dealing with groups, facing issues such as drug abuse and depression, and the adolescents, exhibiting different kinds of disturbing behavior. Most of the time, the practitioners have found reason to label their adolescent clients as stubborn people who resist change in every way. This assumption makes them deal with their clients and their issues by forcefully imparting what they think may help them to change. This does not help much since it cultivates the behavior of resistance, which makes the situation worse. MI helps the practitioners to come up with strategies centered on the clients. It helps them to be empathetic and to instill concepts that would have otherwise been used on them if they found themselves in the same situation. Therefore, this concept is important since it empowers the adolescents and gives them the reason to contribute to the discussion on change. Most of the solutions that they come up with only work because they were involved in making them. This also helps the practitioners to use the information that they gather from the clients in helping similar groups facing similar problems in the future.