"to be or not to be"..... motivated?
Young people are often "reluctant" to seriously address their substance use or are "simply looking" at what options are available to them. Young people often present as being unmotivated and disinterested in services that agencies offer. Young people who come to youth services are often no different.
A worker's role, therefore, is twofold:
- to raise awareness of AOD and related issues and,
- to engage with the young person.
Motivation largely depends upon the engagement process.
Motivational Interviewing is a technique that has been used to assist young people who are in the precontemplation or contemplation stages (see Stages of Change). However, it can be used to enhance change and motivation at any of the stages at which a young person may be. It is a style that allows an individual to appropriately weigh up the real consequences of their substance use.
Obviously, Motivational Interviewing skills are important, however, just as important is the underlying beliefs and principles of this approach.
Three underlying beliefs:
- The individual is seen as 'rational' and 'responsible'; that is, faced with enough evidence the person will change. The best type of evidence is evidence that one thinks of themselves.
- The individual is responsible for making their own decisions.
- The process of change is assisted by creating tension between substance-using behaviours and how a young person sees themselves.
Five principles:
- Express empathy - this is done through skillful reflective listening (listening carefully to the young person and letting them know that you hear/understand them).
- Develop discrepancy - between present behaviour and important goals.
- Avoid arguments - arguments generally make people more guarded and less open to discussion and introspection.
- Roll with resistance - resistance from the young person is seen as a signal to change strategies or that the worker has overestimated the young person's readiness to change
- Support the young person's sense of ability to change - support the young person's hope in the range of alternative approaches available.
Issues to discuss and questions you might ask:
a) Good things/ Perceived benefits of substance use
- "What are the things you like about your use of alcohol?" OR "What are the things that you get out of your use of cannabis?" (exhaust this list).
b) Less/Not so good things about substance use
- Explore the young person's concerns about the "less good things"
- "What are the 'not so good things' about your use of alcohol? Can you give me some examples of that?"
Get the young person to argue for change by asking such questions as:
- "But surely you're used to not having any money because of your use?" OR "Surely that's a consequence of your use that you've gotten used to?"
c) Cost of change
- Explore what would be different for them if they gave up or reduced their substance use
- "What would be different in your life if you stopped/cut down using 'x'?
d) Cognitive dissonance
- Heighten psychological discomfort/cognitive dissonance by helping the young person see the incongruence between their belief about self and their behaviours.
- "What words would you use to describe your best qualities?" OR "What would your friends say are your best qualities?"
- "What words would you use to describe yourself when you think of you as a smoker?"
- By making the young person aware of the incongruence, this forces the person to either change their behaviours or change their belief about themselves.
What opportunities exist for you to utilise motivational interviewing techniques in your role?
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Working with Young People with Alcohol or Other Drug Issues: A self-paced learning package Published: 2006 Funded by NSW Drug & Alcohol Workforce Development Council. Written & compiled by Kristy Delaney, YAPA, and Matt Stubbs & John Howard, Ted Noffs Institute. Additional material by Nick Manning, YAPA, & by Shopfront Youth Legal Centre. Opinions are the author's.
Be careful! YAPA and the authors took reasonable care to ensure that this information was correct at the time of publishing. However health information, and government regulations, laws and standards are complex and changing. The authors may not have health, safety, or legal qualifications, and information provided is general - it is not specific health, legal or professional advice. Do not rely on it - check with other publications and authorities and if necessary get qualified, medical, legal or professional advice for your situation.
