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The Ambivalence Mire | Get Out of the Mud with Motivational Interviewing

Major Depressive Disorder

Maybe substance use or compulsive behavior are bringing you down. Perhaps major depressive disorder or another mind-woe have left you chin-deep in the mire. Ambivalence has hit and “Bam!” you’re stuck! Sure seems like it’s time to change. Let’s chat Motivational Interviewing.

We’ve swirled-around a variety of therapies and counseling approaches here on Chipur. Let’s see: Cognitive/Cognitive Behavioral Therapy (CBT),  Mindfulness Based Cognitive Therapy, Eye Movement Desensitization and Reprocessing (EMDR), Future-Directed Therapy, Interpersonal Psychotherapy, Dialectical  Behavior Therapy (DBT), Thought Field Therapy (TFT), Art Therapy, and more.

I think it’s time to add another to the Chipur-mix – one that’s super-popular these days because it flat-out works…

Motivational Interviewing

“Ambivalence,” according to merriam-webster.com…
1: Simultaneous and contradictory attitudes or feelings (as attraction and repulsion) toward an object, person, or action
2 a: continual fluctuation (as between one thing and its opposite)
b: uncertainty as to which approach to follow

Doesn’t take Uncle Siggy to tell us ambivalence can put the kibosh on any needed emotional, mental, or physical recovery project. I mean, we can be all kinds of sick, but if we haven’t decided what to do about it – or if we really even want to do anything about it – well, all kinds of sick we’ll remain.

So let’s get busy!

Motivational Interviewing (MI) is an evidence-based approach to counseling largely developed by psychologists William R. Miller and Stephen Rollnick. Seems Miller kicked things off in the early-1980s, his efforts grounded in work with problem drinkers.

The goals of MI are very simple, actually – engage the client, generate talk of positive behavior change, and create the motivation to make the decided-upon change. Given motivation is crucial here, gaining insight into – and resolving – ambivalence is just huge. And resolution is found in the conscious and unconscious weighing of the pros and cons of changing v. staying the same.

So how does one come to the conclusion change is indicated? Well, increasing awareness of potential problems, consequences, and assumed risks of the behavior in question go a long way toward painting a very realistic picture.

Let’s take a look at what lies at the foundation of MI – its spirit…

  • Motivation to change is elicited from the client, and is not imposed from outside forces
  • It’s the client’s task, not the counselor’s, to articulate and resolve her/his ambivalence
  • Direct persuasion is not an effective method for resolving ambivalence
  • The counseling style is generally quiet and elicits information from the client
  • The counselor is directive, in that s/he helps the client examine and resolve ambivalence
  • Readiness to change is not a trait of the client, but a fluctuating result of interpersonal interaction
  • The therapeutic relationship resembles a partnership or companionship

Within that spirit, it’s on to the work at hand. A few highlights…

  • The client discovers her/his own interest in considering and/or making a life change
  • The client expresses the desire to change in her/his own words
  • Ambivalence about change is openly discussed
  • A plan is drafted to facilitate change, to include the initial steps
  • Change-talk is elicited and strengthened
  • Enhancement of the client’s confidence in taking action, and noticing that even small, incremental changes are important
  • Strengthen the commitment to change

So what do you think? Can you sense the power of MI?

For the record, MI is supported by over 200 randomized clinical control trials across a range of target populations and behaviors. These include substance abuse, compulsive behaviors, health-promotion behaviors, medical adherence, emotional/mental challenges, vocational rehabilitation, and criminal justice.

All Done

Alrighty, then. Thinking you’re an “addict?” (By the way, the term is falling by the wayside). Major depressive disorder got ya’ down? “Bam!” – ambivalence has hit and you’re stuck in the mire? I’m asking you to consider Motivational Interviewing as a way out.

If you’re thinking about participating in counseling, ask the counselor candidate (yes, you can interview) if s/he can facilitate MI. Already working with a counselor? If you’re not getting what you just read, ask her/him if you can change course and go with MI.

After all, change – it’s always your call. K?

image courtesy washingtonpost.com

Plenty more Chipur articles where this came from. Here ya’ go!