appendix d: motivational interviewing - National Drug and Alcohol ...

Appendices
Building motivation
It is common in the pre-contemplation stage of change to encounter client resistance.
DiClemente and Velasquez 329 identify five styles of resistance, and treatment strategies for each
group these are outlined in Table 28.
Table 28. Building motivation
Type of Resistance
Revelling
Those who are having too good a time
to change.
Reluctant
Those who are simply unwilling to
consider change.
Resigned
Those who feel hopeless and helpless,
may have a history of failed attempts
and do not feel they can change.
Rebellious
Those who actively resist attempts to
encourage change.
Rationalising
Rationalises why the addictive
behaviour does not pose a problem.
Appears to have all the answers.
Strategies
• Stimulate concern about the negative
consequences.
• Raise doubt about their illusory sense of elevated
self-efficacy.
• Focus on how their behaviour affects others.
• Shift focus from problematic issue.
• Counter the hesitance by working through their
concerns about changing.
• Build confidence in their ability to change.
• Use the support of individuals who have made
similar changes.
• Provide hope.
• Share success stories of similar individuals.
• Evaluate prior attempts and suggest different.
strategies to use.
• Link autonomy and freedom to change.
• Shift high-energy levels from rebellion to change.
• Make sure they feel in charge of the change at all
times.
• Offer choices and options for managing their
change.
• Continue to make a clear connection between
behaviour and consequences.
• Do not deride their reasons but try and work with
them to your advantage.
• Build confidence in their potential to change.
Adapted from Clancy and Terry 118 .
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