Many therapies consist, in most cases, of telling the patient what he or she should and should not do, hoping that he or she will decide to follow this advice or, on the contrary, continue to engage in behaviors that lead to discomfort and a dysfunctional lifestyle.
This is not the case with , the therapy of stimulating motivation , with which the aim is to motivate a change from within the patient, that is, to make him take charge of his life and to encourage him to improve the situation in which he finds himself.
This therapy, which although it would be within clinical psychology takes knowledge from the social and organizational field, has given quite promising results with several disorders. If you want to know more about this therapy, we invite you to continue reading this article.
Motivational Stimulation Therapy, what is it?
Motivational enhancement therapy is a type of directive treatment, centred on the person who is responsible for focusing on achieving increased patient motivation for change .
People who engage in self-destructive behaviour, such as addiction, self-harm or risk-taking behaviour, often have an ambivalent motivation to change, or none at all. In spite of this, these people are aware, in most cases, that the behaviours they are carrying out harm them both themselves and their closest environment, in addition to damaging their health.
Therapists who specialize in this type of therapy can help the patient achieve a more objective view of his or her own behavior, which can help make the patient more likely to change his or her own behavior once the problem behaviors have been addressed.
Historical background of this therapy
Motivation Stimulation Therapy was one of the three interventions first implemented in 1993 within the MATCH project. This American project consisted of a clinical trial focused on obtaining a better understanding and improving existing treatments for alcoholism .
This therapy is based on the knowledge obtained by less clinical branches of psychology, such as organizations and coaching. Thus, the therapy of motivation stimulation takes aspects of human resources, such as motivational interviewing, developed by William R. Miller and Stephen Rollnick, and adapts it to the therapeutic environment.
Objectives and principles of this treatment
The main objective of the therapy is to motivate the patient to participate in his or her change , thus initiating the therapeutic process. By motivating them so that they can achieve their vital goals and leave aside or, preferably, extinguish their problematic behaviours, not only will they achieve a greater degree of well-being, but they will also move away from that which was hurting them and their immediate environment.
In turn, as the patient sees that he is progressively able to do more and that it was only a matter of making the decision to initiate change, he will feel increasingly confident in himself and in his ability to cope with adversity . This is not achieved by having the therapist tell the patient what to do and what not to do, but by providing feedback that encourages the patient to go for what he or she wants.
Motivational Stimulation Therapy is based on five motivational principles, which must be applied and taken into account during treatment to ensure the best results:
1. Expressing empathy
It is very important that a good professional relationship between patient and therapist is generated from the very first session of therapy. It is necessary that both parties trust each other , within what is considered to be therapeutically appropriate.
The patient should feel in a safe environment, where he or she feels respected, listened to and accepted.
2. Develop discrepancy
The patient discusses with the therapist his personal goals . The practitioner measures the distance between the goal the patient wants to achieve and the state or situation he or she is currently in.
3. Avoiding arguments
During therapy, no discussions should be held with the patient. At this point, we refer to discussions in the moderate sense of the word, i.e. discussing negative experiences that have caused the patient to be in consultation.
Therefore, during this brief therapy, rather than confronting the patient with the bad things in his behaviour, the therapist is in charge of offering positive answers and helping the patient to grow as a person.
4. Adapting to resistance
In one way or another, aspects will appear throughout the therapy that will be resistant to change. Therapy of this type accepts that there are things that in such a short time cannot be overcome ; that is why both patient and therapist must accept the existence of some resistance.
This point may seem counter-intuitive, but the truth is that it is not at all advisable to confront the patient’s resistance at the beginning, since in doing so he will show a whole repertoire of defensive behaviors, making the therapy stagnate.
5. Supporting self-efficacy
By self-efficacy we mean the ability of each person to be able to cope with adversity and to know how to achieve their own goals in the most appropriate way.
In this therapy, the patient is encouraged to be aware that he or she is capable of virtually anything he or she sets out to do, including overcoming his or her addiction.
Duration and development of therapy
This therapy is usually very brief, usually lasting about four sessions. The first session is usually the interview with the patient and the following three sessions correspond to the therapy itself.
Throughout the first session, the therapist talks with the patient about the problem that has led him/her to the consultation, whether it is a problem of substance addiction or any other psychological disorder. Once the problem is understood, the patient’s goals are addressed. Thus, therapist and patient cooperate in the planning of the rest of the treatment , however, always with the managerial role of the professional given that he or she is the mental health professional. The rest of the sessions focus on achieving the objectives set.
When setting goals, it is very important that the therapist does not confront the patient or judge him/her by the state he/she is in or what he/she has done in the past. The objective, as already mentioned, is to improve his life, and for this reason, he must be the one who motivates himself to make the change. It can also be said that during therapy the preference is to avoid the use of diagnostic labels and focus on conceptualizing the problem in terms that are more understandable to the patient.
During therapy, the therapist does not give concrete guidelines to the patient on what to do to improve. The perspective behind motivational encouragement therapy is that each patient has the resources needed to make progress, but is either not motivated enough to change or is simply not aware of his or her abilities.
Due to its short duration and the way it is applied, this therapy is usually accompanied by the application of others. It usually serves to motivate the person before he or she enters more specialised therapies in accordance with which types of disorders, such as those related to mood or anxiety. As we have already mentioned, motivation is a crucial aspect to ensure that the therapeutic process meets the objectives that one has set.
What disorders is it used for?
The main population group to which this therapy is applied is people who are suffering from some type of drug addiction , either alcohol or illegal substances such as cocaine, marijuana and others. The therapist works to develop the patient’s own willingness to deal with their drug addiction.
Compared to other therapies in the field of substance abuse, which are usually developed according to a step-by-step programme, motivation stimulation therapy focuses on arousing the patient’s self-interest. In other words, this therapy aims to make change come from within the patient.
It can be said that one of the factors that influence its success is the patient’s own willingness to come to the consultation . Normally, those who visit the therapist totally voluntarily are already motivated by themselves, hoping that the professional will know what to do to be able to get out of the tunnel in which the drugs have put them. The therapist takes advantage of this to motivate them even more, making them see how they can control their own therapeutic process and be aware of what to do to overcome the addiction.
According to the National Institute on Alcohol Abuse and Alcoholism in the United States, this type of therapy has been shown to be the best in terms of cost-effectiveness for the treatment of alcohol problems.
But has not only been applied to those who suffer from some kind of addiction . It has been especially useful in people who suffer from disorders such as eating disorders, problems with anxiety or even gambling. Also, according to research, it has worked with people with the HIV virus, promoting positive changes in their lives despite having a chronic illness and which, to this day, continues to be highly stigmatised.
- Huang, Y., Tang, T., Lin, C., & Yen, C. (2011). Effects of motivational enhancement therapy on readiness to change MDMA and methamphetamine use behaviors in Taiwanese adolescents. Substance Use & Misuse, 46, 411-416.
- Korte, K. J., & Schmidt, N. B. (2013). Motivational enhancement therapy reduces anxiety sensitivity. Cognitive Therapy and Research, 37, 1140-1150.
- Naar-King, S., Wright, K., Parsons, J. T., Frey, M., Templin, T., Lam, P. & Murphy, D. (2006). Healthy choices: Motivational enhancement therapy for health risk behaviors in HIV-positive youth. AIDS Education and Prevention, 18(1), 1-11.
- Petry, N. M., Weinstock, J., Morasco, B. J., & Ledgerwood, D. M. (2009). Motivational brief interventions for college student problem gamblers. Addiction, 104, 1569-1578.