Helping People Change: Motivating, Engaging and Attracting Clients into Treatment

David Mee-Lee, M.D.

Workshop Description:

Clinicians expect to encounter denial, resistance, reluctance and ambivalence about treatment with most client's presentation.  Helping people change has too often depended on seeing resistance as negative, as pathological, or as "breaking through denial".  These views lead to strategies which disempower and disrespect people. This workshop will review how people change and the processes of change - what actually increases and decreases resistance.  It will propose ways to enhance motivation, retain clients in treatment; it will suggest ways to encourage change that is honest, not game playing, and change with client accountability, not argumentation or debate about one's problem.

Identifying what the client really wants helps motivate him/her to become a participant in his/ her own treatment plan.  Many clients come to the professional unready to simply follow directions and ambivalent about improving one's functioning.  This process of assessing a client's motivation and readiness for change can be challenging, especially in the context of time pressure, mistrust by clients and an increasing variety and complexity of clinical presentations.  Yet the clinician must be adept at quickly engaging the client into treatment and enhancing his/her motivation for change.

This workshop outlines models and methods for assessing and joining with clients, especially individuals with complex presentations such as comorbidity, chronic and persistent behavioral health issues, substance use, abuse and dependence, domestic violence and resistance to change.  Focus will be on the how-to of develop ing collaborative and participatory treatment strategies.  Clinical examples and case consultation will be drawn from mental health and addiction treatment, covering adults as well as adolescents.

Objectives:

1. Understand the background and rationale for re-defining how denial and resistance are conceptualized.

2. Review the range of models on how people change and the processes of change.

3. Discuss ways to better assess people's readiness to change and how to engage them into treatment through motivational interviewing principles.

4. Improve the flexibility of services and documentation to promote accountable participation in treatment.

Helping People Change: Motivating, Engaging and Attracting Clients into Treatment