Helping Patients Find Their Why

Behavior change doesn't come easily for most of us, even when we know we could be healthier or happier if we tried doing things differently. So how do therapists guide patients through their reticence or ambivalence, and toward making some of the biggest, most daunting life changes possible? Heather Jones, PhD, our vice president of mental health, family and children's programs, explains why the spirit of motivational interviewing—an evidence-based therapeutic approach—is at the heart of Hazelden Betty Ford's healing brand of science, love and lived experience.

What is motivational interviewing, and how does it help people change?

Motivational interviewing is a collaborative, person-centered method of eliciting, guiding and strengthening a person's motivation to change a negative behavior. As your counselor or therapist, I work in partnership with you to uncover the most-important, most-motivating reasons to change your behavior. I would ask open-ended questions and listen for what matters most to you—your values, hopes, interests, aspirations, wishes for the future. Then we would look at the tension that comes into play with the realization that, "Gee, what I'm doing isn't aligned with what I care about most and how I want to live."

What's an example of that "tension" between a value and a behavior?

Having a strong connection with your children might be a deeply held value for you. And yet you know that when you're using substances, you're not physically or emotionally avail¬able to your children in the ways you want to be. So the ability to be there more fully for your children is going to be a strong motivator for shifting your behavior.

Are there specific conditions that motivational interviewing is most effective for?

Even though the approach was originally designed to help people with alcohol use disorder, motivational interview¬ing is now used across the board in behavioral and mental health care. I think of motivational interviewing as a way of interacting with clients rather than an intervention, per se. At Hazelden Betty Ford, it's a sense of empathy, a spirit of care, a therapeutic alliance that we have adopted across all levels and aspects of the care we provide. Hazelden Betty Ford is unique in that we have highly trained experts in motivational inter¬viewing who train clinicians throughout our organization.

Why is motivational interviewing so central to Hazelden Betty Ford's model of care?

Recovery is a process that involves making the right choice every moment, every hour, every day, a day at a time—and maintaining that momentum and motivation over time. With substance use and many other mental health disorders, motivational interviewing helps people take those initial steps toward recovery and greater well-being, and stick with those new behaviors because the experience is self-reinforcing.

People come to us feeling desperate, overwhelmed and scared. And we need to let them know that in order to live, in order to get healthier and have a better quality of life, they're going to have to make huge, dramatic changes in their life and their lifestyle. That's a tall order for anyone.

Motivational interviewing is about empowering a person's self-efficacy, the idea that you possess everything you need in order to make these big, healthy, dramatic changes in your life. We focus on reinforcing that for you and with you, con¬necting the changes you're making to what's most important to you, and building on that positive momentum to help you persevere and sustain those changes for the long term.