NCJ Number
167615
Journal
Journal of Interpersonal Violence Volume: 12 Issue: 4 Dated: (August 1997) Pages: 607-619
Date Published
1997
Length
13 pages
Annotation
Highly confrontational interventions in encounter groups and substance abuse treatment are risky and often less effective than more supportive and empathic alternatives.
Abstract
An alternative approach to working with unmotivated clients relies on a comprehensive model of the change process, with supportive clinical strategies tailored to the client's stage of change. The motivational therapist does not insist that the client accept a label, such as alcoholic or batterer. Rather than emphasize the power of the pathology, this approach emphasizes the power of the person to take responsibility and make choices. The motivational therapist works to elicit the client's own statements of concerns. Resistance is not viewed as a symptom of denial that must be confronted but as a sign that the therapist is pushing beyond the client's readiness for change. Likewise, treatment goals and change strategies are not specifically prescribed. At the proper time, the therapist offers a menu of change strategies to help the client make a commitment and plan for change. The client is trusted to make sound decisions based on counselor-provided support, information, and advice. Miller and Rollnick (1991) recommend using the transtheoretical model to match intervention choices to the client's place in the change process. Generally, this involves therapeutic strategies to raise consciousness about the need for change (in the precontemplation stage); to enhance the perceived benefits of change and resolve ambivalence (in the contemplation stage); to choose, plan, and commit to specific change strategies (in the preparation stage; to initiate and implement behavioral change (in the action stage); and to identify and cope with the potential for relapse (in the maintenance stage). 3 notes and 43 references