People with substance use disorders (SUDs) usually realize the need to stop taking drugs, while some usually do not notice they have developed a drug addiction (Petrolienė, 2013). Some also consider the need to change and believe that recovery may not be possible. Motivational interviewing is regarded as an approach to counseling where clients are assisted in overcoming ambivalence while making use of opportunities in recovering from an addiction (Petrolienė, 2013). Motivational interviewing is a technique that enables individuals in developing the motivation to take treatment though it fails to address the major cause of drug abuse, thus considered a compliment to other therapies like cognitive behavioral therapy.
The main idea behind MI is that people do not recognize the bad side of drug abuse. Furthermore, people are always at different levels in terms of readiness to change their behavior (Miller & Rose, 2009). Motivational interviewing has been considered effective for clients that have sought out treatment (Petrolienė, 2013). The spirit of motivational interviewing operates on three main concepts, namely collaboration with the therapist, drawing out the individual’s idea, and autonomy of the person with an addiction problem (Petrolienė, 2013).
Motivational interviewing is considered a simple process that can be accomplished through a few sessions where steps include engaging, focusing, and evoking (Petrolienė, 2013). The therapist has to talk to the drug abuser regarding their issues, concerns, and hopes while developing a relationship of trust (Petrolienė, 2013). The therapist should also narrow the conversation so that it covers habits and patterns that clients prefer then elicit motivation towards adjusting to a new lifestyle free from drug abuse.
The major element of MI is overcoming the internal battle over whether or not an individual wants to quit their addiction (Rollnick & Miller, 1995). It is important to recognize that while there are many reasons for one to stop abusing drugs, people with an addiction also have reasons why they do not want to quit. Thus, MI aims at laying down the pros and cons of quitting by focusing on the way a client feels such that a client should not feel forced to give up something they like (Petrolienė, 2013). MI can be considered beneficial, especially among individuals that did not have good results with cognitive behavioral therapy. For instance, lack of motivation has the potential to make it difficult for an individual to change their thought and behavior patterns.
Therefore, people with an addictive disorder are encouraged to undergo motivational interviewing first before embarking on other options (Miller & Rose, 2009). Furthermore, motivational interviewing is better than CBT, especially for individuals in need of much support and close relationship with the counselor (Rollnick & Miller, 1995). MI is also suitable for individuals that may have had a relapse after an attempt to quit drug abuse (Petrolienė, 2013). MI is considered particularly effective for people with an alcohol addiction since it is easy to ambivalent about the use of legal substances that have greater social acceptance as opposed to illicit drugs.
The success of using MI has seen its application extend to other types of addiction, behavioral issues, and mental illness (Rollnick & Miller, 1995). While motivational interviewing has been successful in helping people find the motivation to change, it is not suitable for people with co-occurring mental illness and complex addiction issues. While MI is designed for little sessions, it may not be effective for individuals with significant underlying addiction problems since they will need more in-depth counseling combined with medication (Petrolienė, 2013). Thus, the key to success in MI depends on the counselor, as it is a difficult counseling method to master.
Solution Focused Therapy
Solution-focused therapy represents a branch of psychotherapy, focusing on positive outcomes that clients desire to achieve rather than the problems they already face. Thus, this approach focuses on the solution and not the problem such that the role of the therapist is to question the client skillfully regarding their goals (McCollum, Trepper & Smock, 2004). The end should involve the determination of the sequence of change that can be used in moving towards a positive outcome. The focus of this approach entails developing realistic, concrete, and specific goals with the assumption that the client knows they need considerable assistance in achieving their goals.
The therapeutic conversation in this approach targets at understanding the client goals and the vision for reaching them (Smock et al., 2008). Thus, different approaches are employed in helping the client clarify goals and preferred methods of achieving them. The therapist might consider discussing what has worked in the past by understanding that most people have learned to solve problems in the past and have a conceptualization of the way to solve their current problems.
The solution-focused approach also proposes that the solutions to the problems brought forward by the client may have nothing to do with the problems (McCollum, Trepper & Smock, 2004). The argument is true, especially when dealing with a drinking problem where any of the various life experiences on the client’s part has nothing related to drinking alcohol. There is no one agent of change in solution-focused therapy (McCollum, Trepper & Smock, 2004). For instance, the question on the agent of change can be considered as one of the obscures instead of illustrating the nature of most effective approaches to dealing with drug abuse.
The purpose of developing solution-focused therapy was to use as family therapy but has extended beyond different formats, including couples and groups (Smock et al., 2008). Solution-focused therapy can also be employed together with other interventions aimed at maximizing an individual’s ability to recover from addiction. Solution-focused therapy has been linked with a variety of problems when used as an intervention for drug abuse (McCollum, Trepper & Smock, 2004). For instance, if the client already knows the solution to their problems, then it would be problematic, especially for conditions like substance abuse.
While the client might have an idea on the way to handle their problems, there may be a need for a structured approach to helping them reach their goals. Furthermore, therapists have learned that taking what the client says at face value can be a mistake. The approach has also been considered brief for chronic issues like substance abuse and major depression (McCollum, Trepper & Smock, 2004). Therefore, solution-focused behavioral therapy is only applicable when the client’s problems are not chronic or severe.
Therefore, from the analysis of the three approaches to drug abuse, it is evident that one major element of success involves combining two or all three approaches as they supplement one another in achieving therapeutic benefits. However, the element of time and nature of the problem at hand has been considered vital in the choice of a particular approach. For instance, chronic issues require more time such that the use of solution-focused intervention may not be a possible solution. Furthermore, when employing other approaches like cognitive behavioral therapy, the therapist must include motivational interviewing as it can help increase the chances of achieving positive outcomes.
Petrolienė, R. (2013). Motivational interviewing: theoretical model and working mechanism. In Social transformations in contemporary society (STICS): proceedings of an international scientific conference for young researchers [elektroninis išteklius]. Vilnius: Mykolo Romerio Universitetas, 2013,[t.] 1 (1).
McCollum, E. E., Trepper, T. S., & Smock, S. (2004). Solution-focused group therapy for substance abuse: Extending competency-based models. Journal of family psychotherapy, 14(4), 27-42.
Smock, S. A., Trepper, T. S., Wetchler, J. L., McCollum, E. E., Ray, R., & Pierce, K. (2008). Solution‐focused group therapy for level 1 substance abusers. Journal of marital and family therapy, 34(1), 107-120.
Rollnick, S., & Miller, W. R. (1995). What is motivational interviewing?. Behavioral and Cognitive Psychotherapy, 23(4), 325-334.
Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. American psychologist, 64(6), 527.