STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based

MOTIVATIONAL THERAPY/INTERVIEW

This therapeutic approach includes aspects of Rogers' “client-centred therapy”¹ with cognitive behavioural strategies aimed at the various stages of the behavioural change process.^2,3

Its fundamental principle is that any process of change involves costs and that the person must be motivated to face those initial costs to achieve personal goals (it is impossible to motivate someone to "sacrifice" if they do not see the potential benefit, nor do they begin to change if it is not clear that they will be able to tackle it with some expectation of success). The approach is based on two basic principles: to avoid confrontation with the client and to enable them to verbalise reasons of concern for their behaviour.

Motivational Therapy/Interview⁴ aims to help the person resolve their ambivalence about participating in the treatment and cease to use drugs, or continue to use them. Its strategy is based on causing changes in the person’s internal motivation, instead of guiding them through the different steps of the recovery process.⁵

In contrast to more direct approaches, it proposes identifying problems, stimulating client motivation and collaboration in the search for solutions, acceptance of ambivalence and ownership of the client’s point of view, respect for their opinions and decisions, and a slow and progressive journey with regard to the person’s rate of change. However, it also applies in brief formats of three to five sessions of individual treatment with a therapist.

 

Reference:

1 Rogers C. (1951). Client-centered therapy. Boston: Houghton & Mifflin.

2 Becoña E & Cortés T (coords.). (2008). Guía clínica de intervención psicológica en adicciones. Guías clínicas Socidrogalcohol basadas en la evidencia científica. [Clinical guide to psychological intervention in addictions. Socidrogalcohol clinical guides based on scientific evidence] Barcelona: Socidrogalcohol

3 Prochaska JO, Diclemente CC & Norcross JC. (1992). In search of how people change: applications to addictive behaviours. American  Psychologist. 47: 1102-1114.

4 Miller WR & Rollnick S. (1991). Motivational Interviewing: Preparing People To Change Addictive Behaviour. New York: Guilford Press (Spanish edition: The motivational interview. Prepare for the change of addictive behaviors. Barcelona: Paidós, 1999).

5 National Institute on Drug Abuse (NIDA). (2010). Principles of drug treatment: a research-based guide. Washington: National Institute on Drug Abuse.