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..what’s a provider to do? Not surprisingly, denial and resistance are common when intervening with people struggling with addictions. As you may have gathered by now, there are often at least two competing approaches to dealing with resistance: (a) the “confrontation of denial” approach often seen in traditional “intervention” programs; or (b) the “motivational interviewing/enhancement” approach. First review the Module 8 information on “Intervention” and “Motivational Interviewing.”

After reviewing the required Module 8 information carefully, respond to the following questions: (a) for whom (i.e., what types of clients) do you think each of these approaches might work? (b) Now the harder question…if YOU had some issue (e.g., health, relationship, addiction) about which you were in denial or resistant to intervention, which of these approaches do you think would be more effective with you? Which one would you prefer and why? Please be very specific.

You need to respond back to the topic and reply to the following comment

The two competing approaches to denial and resistance are confrontation of denial and motivational interviewing enhancement. The two intervention programs vary from one another, yet I believe both are useful depending on the client and the situation. Confrontation of denial is a much harsher model than the motivational interview. The confrontation of denial system holds the person accountable and confronts the person on their substance abuse with substantial evidence to support the therapist’s diagnoses. The individual is labeled as having a problem. The motivational interviewing system is organized to facilitate change with the client’s help. Labels are discarded, and the individual is made aware that they are responsible for future behaviors. When the client becomes resistant, they are guided through the reflection of their actions.

The motivational model is best utilized when a client has recognized the negative consequences of their actions. A person may become aware of these issues when their addiction increases their levels of distress, critical life events, cognitive appraisal, and positive and negative external incentives (Treatment, 1999 ). I believe the confrontation of denial method should be used when an individual is not receptive to motivational interviewing, and they have become a danger to themselves and others. It is also essential to gather information on the individual’s motivation and personality type. Some people are more extrinsically motivated, while others are intrinsically motivated. A person who is extrinsically motivated might not want to change until they know how their actions are affecting those around them. People who are intrinsically motivated may seek change on their own to improve their circumstances. Substance abuse can also affect or change a person’s motivation making it more challenging to treat the disorder.

Under normal circumstances, I am intrinsically motivated and would benefit from the motivational model. However, I can also be extremely stubborn in those moments where I don’t see me as having the problem. If I were suffering from addiction, I might be challenging to treat because of the illness’s nature and my need to consider myself in the right. It may be necessary to start with the confrontation of denial to break through the protective boundaries I have in place. Once that is done, I am relatively confident I would respond reasonably to the motivational interviewing model.

Reference

Treatment, C. for S. A. (1999). Chapter 1—Conceptualizing Motivation And Change. In Enhancing Motivation for Change in Substance Abuse Treatment. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK64972/

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