Are you trying to quit smoking? Beat an addiction? Stick with a diabetes management regimen? Maybe motivational counseling could help.
Motivational counseling helps people who lack adequate motivation to engage in a process of changing harmful or unhealthy behaviors. It is based on principles of motivational psychology, and is designed to produce rapid, internal motivation to change. Motivational strategies mobilize the client's current and potential resources in the change process.
Treatment often doesn't work because individuals aren't adequately motivated. For example, about 80 percent of smokers lack sufficient motivation to succeed in treatment. This helps the client work through his ambivalence and discover his own motivation for change. This therapy helps him make a personal commitment to invest in the process. Motivational counseling has been used successfully in the treatment of addictions and eating disorders. More recently it has been used to help patients with chronic illnesses, such as diabetes and asthma, follow their treatment plans.
No absolute goal is imposed through this. Rather, the therapist helps the client describe problems from a non-clinical perspective. With the counseling, the client sets her own goals, although counselors may help clients see the possibilities and potential life improvement as a result of behavioral change. For example, the therapist may provide facts regarding treatment outcomes or health risks in non-judgmental language. The client can then make informed decisions about her health care and will be more likely to invest the time and energy necessary to succeed. Instead of telling the client how to change, this approach builds motivation and elicits ideas from the client as to how change might occur. It focuses explicitly on motivation as the key factor in triggering lasting change. Counselors ask open-ended questions, engage in reflective and empathetic listening, reframe statements, and encourage questions and dialogue.
Through this process the client is able to see "discrepancies" in his life. In other words, he can see conflicts associated with problem behaviors in terms of his personal goals and values. Counselors assist clients in expressing discrepancies in their own words, and encourage them to voice their objections to change.
When resistance is met, counselors are trained to "roll with" it rather than confront it directly. By continuing to ask open-ended questions in non-judgmental language, counselors can help clients begin to identify why they resist making seemingly healthy lifestyle changes.
Self-efficacy is an important concept of this counseling. It is the belief that one has the ability to take charge of certain aspects of one's life. Many clients resist change because they lack this belief or lack the knowledge necessary to move forward with treatment.
With motivational counseling, interactions with health care providers are collaborative and collegial, not authoritative or confrontational. It empowers patients, identifies barriers to change, encourages reachable goals and, most importantly, increases treatment participation.