Topic One - motivational interviewing
Motion: Motivating people to change can only happen on a one-to-one basis
For…
Motivation to change is internally located in each individual and made up of a balance of pros and cons, for and against continuing a particular behaviour; shifting the balance in favour of change requires an accurately targeted individually focussed intervention.
Against…
Motivation to change can be externally inspired. Surrounding the focal person with people who apply pressure to change, or people who encourage change through their expectations, or offering the chance of a better quality of life is the best way to promote motivation to change.
Intuitively it makes sense that any intervention should take account of a person’s motivational state. For example, if somebody has decided that they really want to stop using drugs it would be counterproductive to start therapy designed to motivate them to change. However, it has proved difficult to find evidence for the presumption that matching treatment with motivation is important. Katie Witkiewitz and her colleagues applied some sophisticated statistical analyses to assess the matching hypotheses of Project Match in the United States and did find support for the idea. In her commentary, cited below, Gillian Tober highlights three things that practitioners know even if some of the evidence is lacking…
It is important accurately to assess motivation in order to start an intervention at the right place, and then keep checking motivation throughout the intervention. People may be motivated to change one thing, for example not driving while intoxicated, but not motivated to stop drinking.
Ignoring service user motivation to change suggests a lack of empathy, that is not understanding where the service user is at, and so risks their dropping out. Also understand an individual’s sources of motivation, which may be many and varied.
There is no simple way to measure motivation for change either in research or clinical practice. It is about unravelling what the service user says.
Find the full text of the article here…
Tober G (2010) Commentary: Evidence for matching — at last. Addiction 105: 1414–1415 doi.org/10.1111/j.1360-0443.2010.03026.x
What are your thoughts about how people can be motivated?
