Session-by-Session Guide - Phase 2 - Motivational Interviewing

Excerpted from Structured Relapse Prevention: An Outpatient Counselling Approach.

Therapists use Motivational Interviewing to provide feedback on the assessment results and to help a client reach a decision to change his or her alcohol or other drug use.

It is important for clients to reach an explicit decision—to state their definite intent—to try to work toward changing their use of alcohol or other drugs before proceeding to SRP counselling.

The basic principles of this component of the SRP approach include the following:

• Labels are de-emphasized: acceptance of the “alcoholism” or “drug addict” label is not necessary for change to occur.
• Personal choice is emphasized regarding future use of alcohol and other drugs.
• The therapist conducts an objective evaluation but focuses on eliciting the client’s own concerns.
• The therapist presents objective assessment feedback in a clear but low-key fashion, without imposing conclusions on the client.
• Resistance is seen as an interpersonal behaviour pattern influenced by the therapist’s behaviour.
• Resistance is met with reflection.

Treatment goals are negotiated between the client and therapist based on assessment feedback data and acceptability of treatment goals to the client; the client’s involvement in and acceptance of goals is treated as vital.

NOTE: For more details, see “Motivational Interviewing” by Tupker and Sagorsky (2004), reproduced in Appendix B.

Description	Clinical Tools
The client receives feedback on the Assessment phase findings, with a focus on exploring the client’s: reasons for change in alcohol or other drug use pros and cons of change  strength of commitment for change coping strengths triggers for use (exploration of IDTS-8 profile, if undifferentiated).	Client’s completed IDTS-8 Decisional Balance Assignment Feedback about Goal Setting and Commitment to Change

Return to the index of excerpts from Structured Relapse Prevention: An Outpatient Counselling Approach.

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