NCRG Pre-conference Workshop: Motivational Interviewing For Clients With Gambling Problems
Prior to the start of the12th annual NCRG Conference on Gambling and Addiction, David Hodgins, Ph.D., professor of psychology and adjunct professor in the department of psychiatry at the University of Calgary, led a workshop on how clinicians can incorporate Motivational Interviewing (MI) into their treatment plan for patients with gambling disorders. During this workshop, Dr. Hodgins described the principles of MI, explained MI strategies and discussed how to apply MI in a clinical practice.
Dr. Hodgins began the workshop by providing the definition of MI, as described by William R. Miller and Stephen Rollnick (the inventors of MI): MI is “a directive, client-centered method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.” Dr. Hodgins explained that MI provides clients with a “motivational nudge.” When using MI, counselors should elicit client concerns, explore ambivalence, promote self-efficacy and suggest strategies for the counselor to use to assist the clients in discussing changes to problematic behavior.
Dr. Hodgins stated that there are three components to MI: Spirit; Basic Principles; and Phases of MI.
Spirit
Motivational Interviewing is “all about active listening and resolving ambivalence to change,” said Dr. Hodgins as he emphasized the importance of spirit over technique when interacting with clients. The MI spirit is (1) collaborative: provides a partner-like relationship; (2) evocative: elicits motivation rather than instilling it; and (3) respectful: the responsibility for change is with the client. Dr. Hodgins emphasized the importance of spirit over technique when interacting with client According to Dr. Hodgins, when a therapist increases empathy in their interaction with the client, the result is that clients are usually more likely to stay in treatment and less likely to relapse.
Basic Principles
Next, Dr. Hodgins discussed the four basic principles of MI:
1. Express empathy by listening to the patient;
2. Helping clients appreciate the value of change by exploring the discrepancy between how clients want their lives to be versus how they currently are;
3. Address and move forward despite resistance with the goal of evoking solutions; and
4. Support self-efficacy by helping the patient believe he/she can change.
Of these four basic principles, Dr. Hodgins stated, “Empathy is single-best predictor of success of success in addition counseling.”
Phases
Dr. Hodgins then explained the two phases of MI: (1) building motivation to change by eliciting change talk and exploring ambivalence and (2) strengthen the commitment to change by helping the patient begin to plan for change. He provided several suggestions for evoking and responding to change talk.
Also during the workshop, Dr. Hogins provided several interaction techniques that can be used throughout the process of MI. The techniques are called “OARS” and include:
Open-ended questions
Affirmations
Reflective listening
Summaries
Dr. Hodgins concluded the workshop with a video showing himself and a graduate student role-playing a counseling session and how MI is incorporated into the session.
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Spirit
Motivational Interviewing is “all about active listening and resolving ambivalence to change,” said Dr. Hodgins as he emphasized the importance of spirit over technique when interacting with clients. The MI spirit is (1) collaborative: provides a partner-like relationship; (2) evocative: elicits motivation rather than instilling it; and (3) respectful: the responsibility for change is with the client. Dr. Hodgins emphasized the importance of spirit over technique when interacting with client According to Dr. Hodgins, when a therapist increases empathy in their interaction with the client, the result is that clients are usually more likely to stay in treatment and less likely to relapse.
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