Motivation in Psychotherapy

Today, there are two well-known therapies in which the concept of motivation is profoundly utilized. These include Motivational Therapy (MT) and Motivational Interviewing (MI).

Motivational Therapy

Motivational Therapy (MT) is a psychotherapeutic approach in which humanistic treatment is combined with improved cognitive-behavioral strategies. MT is commonly used among patients suffering from substance abuse. MT aims to encourage the patient to view their substance abuse as a negative experience. As the patient develops such negative view of abuse, the therapy facilitates him to have a desire to achieve a positive change in his behaviour.

According to Carlo DiClemente, proponent of Stages of Change Model, a patient who undergoes MT experiences the following stages one after another:

Stage 1: Precontemplation. The patient is not prepared to undergo change.

Stage 2: Contemplation. The patient starts to think about undergoing change.

Stage 3: Preparation. The patient decides to undergo change, prepares for it through planning and commitment.

Stage 4: Action. The patient and the therapist implement the plan. The patient takes the action towards change.

Stage 5: Maintenance. The patient sustains behavioral change until he is able to integrate such change into his lifestyle.

Stage 6: Relapse or Recycling. The patient slips back to previous negative behavior and re-enters the cycle of change. This is when the strongest struggle of addiction occurs.

Stage 7: Termination. The patient leaves the cycle of change.

Studies show that patients whose family members are also involved in the pre-treatment phase of MT are strongly engaged to the therapeutic plan of MT and long-term treatment goals are more assured.

Motivational Interviewing

A counselling approach developed by psychologists William R. Miller and Stephen Rollnick, motivational interviewing (MI) is a client-centered therapy aims to help patients in exploring and resolving ambivalence. In this semi-directive approach, the counsellor (therapist) facilitates intrinsic motivation within the patient to lead him towards positive behavioural change. In order for the therapist/counsellor to intentionally direct a client towards change in his behaviour, he must possess the following skills:

1. able to ask open-ended questions
2. able to give affirmations
3. capable of reflective listening
4. capable of providing summary statements to the patient in appropriate periods

Motivational Interviewing involves four basic principles, which include:

1. Empathy expression. The counsellor must be able to view the world through the eyes of the patient (i.e. putting one’s feet to another person’s shoes)
2. Discrepancy development. The counsellor guides the client to view the discrepancy or difference between their “present self” and their “ideal self”, for them to realize the value of change.
3. Utilization of resistance. The counsellor does not argue with a resistive client; rather, he uses that resistance in exploring the views of the client regarding his present self, ideal self, and the change process.
4. Self-efficacy support. The therapy promotes patient autonomy, which means that the counsellor will not force any “right method” to change, but will assist the client in creating plans that are geared towards change.