Motivational Interviewing: Can We Motivate People to Change?

Can we motivate people to change?

How do you encourage a person in the pre-contemplation stage, to take the next step on the cycle of change? Motivational interviewing (for beginners), may help the aspiring recovery coach, or concerned family and friends. Bear in mind, this is a simply approach to encourage a person to start thinking about change. They will eventually require experienced support.

How do you persuade a loved one or a close friend that they are destroying themselves and causing distress to those around them? How do you say that it is time to get professional help or go to a rehab?

The best way is for them to take ownership of their problem. But how will they do that if they believe they don’t have a problem. How can we motivate them to change? How can we encourage them to come up with their own reasons to change and accept help for their drinking or drugs problem.

Here are some things to do, and some things not to do, in the process of communicating with your friend or loved one (motivational interviewing for beginners!):

Be careful not to de-motivate

DON’T get angry. It may be difficult not to, but it just creates another wall to break down.

DON’T get into the blame game. They will have another reason to blame you for their problems.

DON’T confront with advice about getting treatment or stopping now. It may be true, but it can be counter productive.

DON’T keep nagging with 100 reasons why they need to stop – health, money, relationships, losing their job, their home! And so on. You can express your concerns, but focus on the behaviour and why it worries you. Don’t make them out to be BAD because they are on drugs or alcohol.

DON’T concentrate on the scare stories, “You’re gonna die!” “You’ll get cancer if you keep on doing this” “You’ll end up in prison”. All these are your concerns, but they won’t carry much weight if the person in question doesn’t own these conclusions. Our minds are very good at suppressing bad news.

DON’T use threats. The ‘tough love’ approach has its place in a culture of love because there are consequences to our actions. Boundaries are important. But it is not effective when distributed with harsh words or violence. It will just lead to more conflict and probably, to more drug use. Try and operate in an atmosphere of love and genuine concern. This will be a more effective strategy when trying to motivating people to change.

Ways to encourage motivation to change

DO ask questions that will evoke their own reasons for change, and that will help you to concentrate on their feelings, not your own feelings. So this is a case of good questions being better than good advice.

DO start by saying, “You know that I am extremely concerned about your drug taking, but I know that it’s your decision on whether to change your habit or not.” (this is actually true – you cannot change them, they need to decide this option for themselves) and you might continue, “I can’t keep an eye on you around the clock so I have to leave it to you. It’s your life. But just so that I can clarify things in my own mind, can I ask you a couple of questions?”

This approach, by acknowledging their autonomy, will, hopefully, allow your friend to lower their defence and be more open and receptive to those questions that will follow.

Do ask questions like:

“Under what circumstances would you get support to stop your drug taking?” They may respond by saying that they don’t want any help. You can reply with, “Well what I mean is, if you were to get help, what would make you do it?” This is not as aggressive as saying something like, “Why haven’t you got help before now for your drug problem?”

It’s a hypothetical question that directs them to the question of getting help versus not getting help. This is a positive approach and may get an answer like, “If I had to go stealing again to finance the drugs I might get help” Or, “If my work started to be affected, I would take some sort of action.”

Other questions might be:-

“If you continue doing what you are doing, where will you be in 6 months time?”

“Have you done something that you regretted while on drugs?” – “What was it?”

“On a scale of 1 to 10, how ready are you right now to seek treatment?”

(If they say 3, you could ask why they didn’t pick a lower number, or if they picked the lowest number, 1, you could ask what would be need to make that into a 2)

Sowing seeds for future change

Reflect back the good answers and ignore the bad. There may be no obvious movement from your initial questions, but you have sown some seeds which may start to germinate at a later date.

These are basic questions that an interested friend or a Recovery Coach can ask. If the addiction is serious, there may be a need to encourage them to refer to a specialist service where physical and mental health can be properly assessed.