Motivational Therapy in Addiction Treatment

Addiction is referred to under many other terms, such as substance use disorder [1], substance addiction, substance abuse (although this carries worse connotations), and so on.

When someone is suffering from an addiction, they are suffering from a brain disease.

People respond to addictive substances such as drugs and alcohol differently, and some people are more susceptible to developing a dependency or addiction than others.

In our brains are reward pathways. These reward pathways are primarily useful to motivate us to eat, have sex, and so on.

However, when someone exposes themselves to intoxicating substances such as alcohol or drugs too many times, they are at risk of developing an addiction.

Their reward pathways will be altered in a way which makes them rely on and crave these substances in order to experience pleasure and stimulation.

Substance Use Disorder Treatment

In order to recover optimally from addiction or substance use disorder, patients will need to be admitted into a drug and alcohol rehab facility. Here, they can have access to medically supported facilities, medication (if necessary), and 24/7 professional help for their alcohol use disorder or drug addiction.

When a patient enters a drug and alcohol addiction rehab facility, they may undergo a medicated detox. This will help them overcome any immediate physical or psychological withdrawal symptoms they are suffering from.

Then, they will undergo extensive therapy and relapse prevention planning. There are different forms of therapy, such as individual therapy, behavioural treatment, motivational treatment, and more.

What is Motivational Therapy?

Although different to traditional forms of therapy and the counselling approach used in cognitive behavioural therapy or dialectical behavioural therapy, motivational therapy can have a profound impact on someone’s addiction recovery process.

The objective of motivational therapy is to increase the patient’s commitment and level of participation towards addiction recovery.

By increasing their level of motivation, they become more committed and thus see better results because they are more determined to optimise their health through the use of therapy.

Motivational therapy is used to treat a range of substance use disorders and behavioural addictions such as:

• Alcohol addiction/alcohol use disorder
• Drug addiction
• Gambling addiction
• Sex and porn addiction

While you would typically think that patients associate recovery with positive connotations – because it ultimately means a life free from addiction – many people associate it with negative connotations.

When struggling to recover from a drug or alcohol addiction, bringing themselves to recover at rehab and undergoing a range of treatments can be daunting.

This is because it requires a high level of commitment towards changing your current behaviour and lifestyle. Additionally, some patients may feel sceptical about the effectiveness of an addiction treatment programme.

Understanding the Benefits for Motivational Therapy

Patients will respond differently to therapeutic methods, whether it be behavioural therapy, holistic therapy, or motivational therapy.

When patients consistently attend treatment sessions related to motivational therapy, they can expect to see benefits such as:

• Improvement in self-efficacy: Patients have the necessary skills and knowledge to overcome addiction, however, motivational therapy helps guide them to understand this and it ultimately boosts their self-efficacy. Self-efficacy is defined as an individual’s belief in their capabilities to achieve something.
• Increased participation: Patients who consistently attend motivational therapy treatment sessions will see a significant increase in effectiveness and results in other areas of their recovery. Because the objective of these forms of therapy sessions is to increase the level of motivation within patients, they will place more of an emphasis on taking an active role in their other therapy sessions. Rather than being a passive member of the therapy session, they will learn to form a collaborative partnership with their licensed therapist.
• Better response to recovery methods: As a result of becoming an active patient and increasing the level of participation into therapy sessions, patients will respond better to recovery methods. Therapy such as Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Family Therapy, and so on will become even more effective when motivational therapy is incorporated in a recovery plan.
• Shifting priorities: In addition to becoming more active in recovery methods, patients may see that they have shifted their priorities. Motivational therapy can help patients understand what is most important to them, and in this case, it is their physical and mental health. Patients who enter a drug and alcohol rehab want to improve their health due to intrinsic or extrinsic factors. Motivational therapy will help them emphasise and reinforce the factors behind their decision in entering rehab.
• Focus on improving life: The shift in priorities which can be guided by motivational therapy may also become a catalyst for a healthier and more proactive life. Patients become more aware about what they want and how they can attain these goals. Not only does motivational therapy help patients realise how they can improve their recovery, it helps them understand their values in life.
• Reduce risk of relapse: Not only will patients undergo thorough relapse prevention planning during their time at a drug and alcohol rehab, but motivational interviewing will also help them sustain their recovery. Because the patient has a heightened sense of awareness of their newfound priorities and self values, they can use these as tools to sustain their recovery.
• Encourage patients to help themselves: Just like how it will help patients take a more active role in their addiction recovery, it will also teach them to become more proactive in life. Patients will understand that they have the prerequisite skills and tools which are necessary for addiction recovery. They will become more proactive in other areas of life, not only recovery.

Types of Motivational Therapy

Motivational therapy is not just one form of treatment, but rather a branch of therapy. There are many examples of motivational therapy which use different methods in order to achieve results for patients who are recovering from alcohol and drug addiction:

1. Motivational Interviewing

Motivational interviewing [2] is one of the most popular forms of motivational therapy and can complement other forms of therapy within an addiction recovery programme.

Before starting Motivational Interviewing, the patient will complete an assessment which determines the severity of their addiction, their physical, psychological, and social symptoms, and other factors.

Once they have completed the assessment, the licensed therapist or counsellor will be able to evaluate these results.

Then, during a typical session of Motivational Interviewing, the licensed counsellor (or in this case the interviewer) will help the patient recognise the ways in which their alcohol or drug addiction is hindering their life.

By accepting these flaws, the patient can then begin to understand that change is the only way they can improve their physical, mental, and spiritual health.

They will also help reinforce to the patient why becoming sober and overcoming alcohol or drug addiction will positively influence their lives. The therapist will place an enormous emphasis on the driving factors behind the patient’s change.

Not only will the therapist highlight the negative aspects of addiction as a reason to change but also the positive influences in the patient’s life.

During a session of Motivational Interviewing, the therapist or counsellor may do this by asking a range of open-ended questions which are thought-provoking and elicit a deep response from the patient.

These questions may be similar to the ones listed below:

• How have drugs or alcohol negatively affected your life?
• What reasons make you think that you have a problem with drugs and alcohol?
• What are the benefits to consuming drugs or alcohol?
• Why did you contact a drug and alcohol rehab facility?
• How has your addiction affected the lives of those close to you?
• Are you driven by intrinsic motivation (internal motivation to change)?
• Are you driven by extrinsic motivation (external motivation to change)?

2. Motivational Enhancement Therapy

Motivational Enhancement Therapy [3] (MET) is similar to Motivational Interviewing, and they have the same objective – to increase the motivation and commitment towards recovery in patients. However, there are some notable differences.

Someone who is yet able to bring themselves to undergo addiction recovery will benefit from Motivational Enhancement Therapy.

It is especially effective in the earlier stages of the addiction recovery process, because it can help them build up towards undergoing therapy and entering a drug and alcohol rehab.

Motivational Enhancement Therapy is a non-judgemental and non-confrontational form of treatment which carefully guides the patient towards undergoing treatment. Motivational Enhancement Therapy places a lot of focus on individualisation and personalisation.

3. Contingency Management

Contingency Management is very different to the previously listed forms of therapy, and it is a form of behavioural therapy. The objective of Contingency Management is to use incentives (in whatever form) in order to encourage behavioural change and healthier lifestyle habits.

These incentives can include a number of things and should be highly personalised according to the patient. Incentives can include gifts, vouchers, and so on.

Contingency Management can offer patients an alternative reason to reach goals alongside the objective of recovery.

By creating more reasons to complete these goals, they are more likely to stick to healthier lifestyle habits. Patients can be awarded gifts when they complete a range of objectives, such as:

• Going one week, one month, one year, and so on, entirely sober without relapsing
• Attending and completing a certain number of therapy sessions
• Displaying positive behavioural changes
• Completing a certain amount of the steps according to the 12-step plan

When developing a Contingency Management plan, it is important to consider a particular behaviour to target. The counsellor and addiction specialists will first need to understand the behavioural patterns of the patient.

Then, they can understand which forms of behaviour they want to encourage and which forms of behaviour they want to discourage. Each patient will display their own unique behavioural patterns.

Selecting a reinforcer is crucial to the effectiveness of Contingency Management. The purpose of Contingency Management is to entice the patient to embody these positive behavioural changes.

The prize, or reinforcer, needs to be something which is deemed valuable to the patient for there to be any significant impact on their behavioural patterns and recovery.

The timing is also another essential aspect to consider. It is essential that the person who is providing these prizes does not reward the patient too frequently.

If they reward the patient too frequently, the patient may become desensitised to the significance of the reward, and the value of the reward will decrease.

The Stages of Change: A model for understanding motivation

There are a lot of methods to the idea of motivational therapies. In fact, there is a model – the stages of change – which is incredibly helpful to understand the stages of motivation which patients go through during the recovery process.

The Stage of Change model was developed in the 1970s and has been incredibly useful, especially when deciding how to use motivational therapy throughout addiction treatment.

The five stages of change include:

• Precontemplation: Precontemplation refers to the stage where change has not yet been considered. An example of this is the patient or addicted person resigning themselves to living a life of substance addiction and dependency. During this stage, patients or addicted people are not seeking change, and may not even desire change.
• Contemplation: Contemplation refers to the stage where the patient or addicted person has thought – but not yet acted – about making a change in order to improve their lives. This stage can go on indefinitely, where someone understands that their habits are negatively impacting their life, yet they are unable to change their lifestyle.
• Preparation: The addicted person or patient has finally admitted that they have a problem with substance addiction (or behavioural addiction) and they have made a commitment to change.
• Action: Action refers to the stage where the addicted person has finally started abstaining from their addictive substances, or have been admitted into a drug or alcohol rehab and are undergoing treatment for their condition. They will likely undergo a range of therapies, including CBT, DBT, Motivational Interviewing, and more. , while they have taken action, their motivation levels may fluctuate during this period. Relapse is still possible during this stage.
• Maintenance: During this stage, the patient has overcome their cravings and is now sober. They have undergone recovery and are now equipped with new skills and coping mechanisms to sustain a healthy lifestyle. They will have completed their addiction treatment programme, however, they must maintain their newfound sobriety in order to avoid a relapse.

What are the limitations of Motivational Therapy?

Although therapeutic approaches such as Motivational Interviewing, Motivational Enhancement Therapy, and Contingency Management are incredibly effective in increasing the patient’s activity and commitment towards recovery methods, they are not a solution by themselves.

Motivational Therapy cannot address the root causes of addiction, such as genetic predispositions, trauma, poor relationships, a problematic social life, co-occurring disorders (e.g. anxiety, depression), and so on. By itself, motivational therapy will only get the patient so far.

However, when used in an addiction treatment programme alongside behavioural therapies, family therapy, and more, motivational therapy can have a profound impact on the patient’s recovery.

Essentially, motivational therapy has a unique objective when compared to other forms of therapy.

While the objectives of CBT and DBT, for example, are to help patients recognise and manage their cognitive or behavioural problems, motivational therapy aims to help patients increase their input into treatment. Just because its objective is different, it does not mean that it is not effective.

Other forms of therapy which Motivational Therapy complements include:

• Cognitive Behavioural Therapy: Cognitive Behavioural Therapy [4] (CBT) is a form of individual therapy which has the objective of reconfiguring problematic cognitive and behavioural patterns in patients. It is essentially employed in order to identify and address the bad habits which patients have. These bad – or self-destructive – habits include but are not limited to self-hatred, self-harm, cognitive distortions, and so on.
• Dialectical Behavioural Therapy: Dialectical Behavioural Therapy (DBT) is a form of therapy which helps patients overcome their irrational thoughts or intense emotions. Patients will learn about the intricacies of mindfulness, stress management, and more in order to improve their lives and become more rational.
• Family Therapy: Family Therapy [5] is used to offer emotional counselling and support to family members, as well as improve relationships between the patient and their family members. This can not only improve relationships but create a healthier home environment which can act as a recovery environment and support network.
• Holistic Therapy: Holistic therapy is another unique form of therapy because it employs practices related to holism – the idea that we must treat patients as a whole. The idea is that the physical, mental, and spiritual are tightly interconnected and have a profound effect on each other. Holistic therapy examples include acupuncture, massages, yoga, adventure therapy, pet therapy, music therapy, and more.

Contact us Today to Beat Addiction

Contact us today by dialling the number 0800 111 4108 from the UK or +44 345 222 3509 internationally. With our expertise and knowledge in the field of addiction recovery, and your intrinsic motivation to recover, we can beat addiction together.

When you call us, we will be at your disposal to answer any questions that you may have about the recovery process. Only when you are comfortable enough to do so and with your consent will we complete the necessary health and pre admission assessment [6].

This will be done over the phone and will be free of charge for patients. Then, we can locate a drug and alcohol rehab facility which is optimal for your recovery. Then, former patients can enjoy a life of health and sobriety following their time at rehab [7].

References

[1] Substance Use Disorder https://www.ncbi.nlm.nih.gov/books/NBK570642/

[2] Motivational Interviewing https://www.ncbi.nlm.nih.gov/books/NBK589705/

[3] Effects of Motivational Enhancement Therapy (MET) on the self efficacy of individuals of alcohol dependence https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132760/

[4] Cognitive Behavioural Therapy for Alcoholism – Rehab 4 Alcoholism https://www.rehab4alcoholism.com/alcohol-treatments/cbt

[5] Family Therapy for Addiction – Rehab 4 Alcoholism https://www.rehab4alcoholism.com/alcohol-treatments/family-therapy

[6] Admission into Alcohol Rehab – Rehab 4 Alcoholism https://www.rehab4alcoholism.com/alcohol-treatments/alcohol-rehab/admissions

[7] Life After Rehab for Alcoholism – Rehab 4 Alcoholism https://www.rehab4alcoholism.com/alcohol-treatments/alcohol-rehab/life-after-rehab-alcoholism