Motivational interviewing

(from the chapter) Health workers routinely describe people presenting with dual diagnosis as 'challenging to work with'. Mental health and drug workers may benefit from training in motivational interviewing (MI) as it may help them develop a greater sense of the complexity of behaviour change and adopt more realistic goal setting with clients, which in turn helps preserve the therapeutic relationship and maximises the potential for success in future attempts at behaviour change. MI is an evidence-based way of working with people in order to enable them to make changes in their lives. The evidence to date is largely concerned with reduction or cessation of substance use (Noonan & Moyers 1997), but in recent years there is much to support other behaviours related to health (Resnicow et al. 2001). While at present the evidence to support its application with coexisting disorders is less strong, the focus of this chapter is to suggest that training mental health staff in MI principles and techniques enables them to develop a good relationship with the client and establish more realistic, achievable goals. If the plan is not achieved at that point (substance misuse being a chronic relapsing condition) with many attempts at change required before permanent change is achieved, what both worker and patient are left with is a faulty plan, rather than a faulty patient or worker. The relationship can remain intact. This may appear to some as rather negative, but it is not about expecting failure; it is concerned with a realistic approach in order to preserve a therapeutic relationship, and as a result, continued work in the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)