Using Motivational Interviewing for Success in Counseling.

Using Motivational Interviewing for Success in Counseling.

1.    Motivational Interviewing is not new to me, having attending several trainings provided by County Learning Partnership.  This was a good review and a good opportunity to go over the ideas that have come through the substance abuse treatment realm but now are part of therapy in the mental health side as well.  The idea behind motivational interviewing is that is a client driven focus, and you are determining the client’s readiness to change so they can direct their own willingness to be in services.  It posts five levels of change in a progressive type fashion, precontemplation, contemplation, ready for action, action and maintenance.  The four skills used are: “OARS,” Open-ended questions, Affirmation, Reflective Listening and Summary Statements.  In this context you use these skills to recognize and then tease out change-talk.  You do this by employing DEARS: Develop Discrepancy, Express Empathy, Amplify Ambivalence, Roll with Resistance and Support Self-Efficacy.

**Dr. David Mee-Lee Dual Diagnosis from Dynamic Health: Powerful Strategies for Healthy Living!

David Wright interviewed Dr. David Mee-Lee about dual diagnosis services.  This is treatment for people with co-occurring substance us and mental health problems.  Dr. Mee-Lee consults with Santa Clara County departments of Alcohol and Drugs as well as Mental Health.  As such I have had the opportunity to attend his trainings as well as sit in consultation of cases with him.  He is a pioneer of motivation interviewing, and he works with the call center on being able to figure out what people would like to get from mental health.  “You start at the door they open and where they let you in rather than telling them they have to work on a problem they don’t think they have.  Work on what they’re there for and from that point move to how their substance use and their mental health problems have been shooting themselves in the foot, preventing them from getting what they really want. 

This article is best when it talks about rehabilitation of mental health and substance abuse problems.  “Recover doesn’t necessarily mean they’re cured when you’re talking about a chronic illness—no more than if somebody with diabetes  or hypertension or asthma. … A person suffering from a mental illness as well as a substance problem won’t be able to be cured in the sense that they will never have a mental health problem or substance problem again.  They can recover, meaning they can live beyond just the fact that they have alcoholism or a mental illness.  They can have goals and aspirations and be empowered to have hope to change their life in terms of their relationships, in terms of productivity in the community, and reaching their dreams and aspirations. … Recover really means stabilizing their mental health and substance problem, but then living and growing to have an identity beyond just their illness.”

Dr. Mee-Lee concludes with advice for family and community.  The first is to realize that mental illness is not unusual.  There is “nothing bizarre or weird about…having substance problems or mental health issues.  The second point he makes is that there is help for mental illness.  Getting treatment sooner rather than later leads to a better result.