Motivational Work versus Motivational Interviewing

Motivational work is an approach designed to help people who are considered to be unmotivated and hopeless. Most therapeutic contacts are based on the client/patient being motivated to some degree, i.e. that he or she wants to cooperate constructively and accept help.

Nobody is a hopeless case. This is the idea that I have fervently believed in during the whole of my professional career. Time after time, I have seen that it is possible to motivate all clients within psychiatry, criminal care, and social services.

When you expect constructive cooperation from clients/patients, you only reach the group that is relatively functional.

This leads to the motivation paradox: the clients/patients who have the greatest need of support receive the least. Motivational work tries to resolve this paradox so that those who are most in need actually receive help.

Motivational Work (MW) is a method that has evolved from my work in cooperation with different groups, and it differs from Motivational Interviewing (MI) by being more comprehensive and general.

MI is more specific and originates from a non-confrontational psychotherapeutic method (Roger’s client-centered therapy), which is then applied to unmotivated clients.

Motivational interviewing is a counseling style based on the following assumptions:

• Ambivalence about substance use (and change) is normal and constitutes an important motivational obstacle in recovery.
• Ambivalence can be resolved by working with your client’s intrinsic motivations and values.
• The alliance between you and your client is a collaborative partnership to which you each bring important expertise.
• An empathic, supportive, yet directive, counseling style provides conditions under which change can occur. (Direct argument and aggressive confrontation may tend to increase client defensiveness and reduce the likelihood of behavioral change.) Read More

One advantage of Motivational Work is due to it being aimed at all types of clients even those with the most destructive behaviour. There is no preconceived technique to which the client must be adapted, but instead, the method is adapted to the client’s behaviour. Working in this way, one has a different paradigm from other methods which are based on psychotherapeutic thinking.

For this reason, Motivational Work is built on a developed theory of the psyche, setting goals, defense, and the process of change, which differs from the psychotherapeutic approach. At the same time, the theory is a support for personnel, who are able to remain emotionally involved since the risk of being burned out increases as clients are less motivated and act destructively.

Even though many of the ideas are new, some of the basic premises behind Motivational Work come from the Therapeutic community and Moreno’s psycho­drama. Both emphasize feelings and actions. The method was also inspired by Carl Rogers but from his later development of “per­son-centred therapy” in which he worked using confrontation in encounter groups.

Part one of Motivational Work deals with the attitudes and approaches the motivational worker must bring with him to his meetings with the client. The contents of this section are not only of general interest, but they are also of profound significance to the motivational worker as regards the prevention of burnout and the maintenance of commitment.

Motivational Work is suitable for social workers, correctional workers, treatment personnel in psychiatry, hospital staff, and police. In other words, for all categories of people who meet unmotivated clients in their work.