Counselor’s Approach Key to Success of Brief Motivational Interviewing
Brief motivational interviewing (also known as brief motivational intervention or motivational enhancement therapy) is a form of counseling designed to help at-risk people recognize their substance problems and make the decision to enter an appropriate treatment program. The technique has established benefits for individuals with alcohol-related problems, nicotine/tobacco-related problems and marijuana-related problems. In a study published in June 2014 in the journal Alcoholism: Clinical & Experimental Research, a team of American and Swiss researchers investigated the impact that the professional conducting a brief motivational interview has on the success of the approach among young adults who are at-risk for drinking problems.
Brief Motivational Interviewing and Alcohol Use
Many people engaged in at-risk patterns of substance use either don’t recognize the hazards of their behaviors or don’t see the value in suspending their behaviors and seeking treatment. A person who doesn’t perceive or fully acknowledge his or her substance-related risks has little chance of voluntarily entering treatment and getting help. A brief motivational interview is a conversational approach intended to walk a person through the dangers of his or her substance use and reduce any resistance or ambivalence toward the idea of entering a recovery program. Typically, the approach begins with an introductory assessment session and continues with several additional sessions tailored to meet the circumstances of each at-risk person. Benefits of the approach vary according to the form of substance use in question. In the context of alcohol-related problems, brief motivational interviewing has a demonstrated ability to reduce drinking rates and improve the outlook of people who decide to enter treatment.
Factors in Counseling
Rather than lecturing or taking a removed stance, brief motivational interviewing counselors try to engage their clients/patients in a back-and-forth dialogue that allows them to relay critical information without triggering a defensive or disinterested response. However, not all counselors have the same level of experience in conducting motivational sessions or use the same style during their sessions. As a rule, factors that can enhance the effectiveness of the approach include using non-judgmental questions to encourage client/patient engagement, paying attention to client/patient reactions during each motivational session, adhering to the general therapeutic principles of the approach at all times, avoiding an aloof or superior tone and providing the client/patient with a sense of control and autonomy during the process.
Impact on Alcohol-Related Effectiveness
In the study published in Alcoholism: Clinical & Experimental Research, researchers from Brown University and Switzerland’s Lausanne University Hospital used a two-part project to determine if and how the counselor conducting brief motivational interviewing sessions for alcohol use can alter the effectiveness of those sessions. All of the participants in the study were young men with potentially at-risk drinking habits who were not actively engaged in seeking alcohol treatment. Some of these individuals took part in a single brief motivational session conducted by one of 18 practitioners with a range of professional backgrounds, while others received a basic alcohol use assessment but did not take part in brief motivational interviewing. Differences in the backgrounds of the motivational interviewing practitioners included specific professional qualifications, relative experience treating people with alcohol problems, relative experience using brief motivational techniques and gender.
Three months after the initial phase of the study, the researchers compared the drinking behaviors of the group that took part in brief motivational interviewing to the behaviors of the group that only received a basic alcohol use assessment. In addition, among the people who took part in brief motivational interviewing, they looked at the impact of various factors in the counselors’ backgrounds, as well as the impact of the counselors’ approaches during the sessions.
In a preliminary finding, the researchers concluded that, three months later, the at-risk drinkers who received a single brief motivational interviewing session had a significantly lower level of alcohol use than their counterparts who only received an alcohol use assessment. They also concluded that several counselor-related factors increase the effectiveness of the approach. These factors include receiving brief motivation from a male counselor, receiving brief motivation from a counselor with substantial prior experience, receiving brief motivation from a counselor who expects the approach to work well and, interestingly, receiving brief motivation from a counselor who varies his or her approach over the course of a session. Participants who received brief motivation from counselors who did not have the indicated characteristics did not experience a meaningful decline in their alcohol intake.