While writing a recent Research to Practice column, I reviewed a meta-analysis of positive addiction treatment outcome indicators that was related to a client’s self-efficacy and motivation. The analysis found that if either of those variables improved then the client would do better in treatment, regardless of the treatment model used.
Once counselors understand the implication of this finding, it means they need to focus on how to improve those variables with their clients. However, when I began to search for how one goes about helping clients to get motivated for treatment and stay motivated for treatment, or methods to help them increase their confidence (self-efficacy), I found that our field seems to have a dearth of such information and techniques.
Sure there are the old standbys of behavioral reinforcements and Motivational Interviewing (MI). For example, theoretically if you reward good behavior and punish negative behavior, the good behavior is supposed to win out and motivation is supposed to stay elevated. MI claims to offset ambivalence and boost motivation by increasing the discrepancy between what a client wants and how substance abuse interferes with that.
Both are purported to increase motivation and as a secondary gain increase self-efficacy. But, the results have been less than stellar for addiction treatment. To this day we seem to lack a set of really good methods to help clients become motivated and stay motivated, and to become confident in their ability to change and stay changed.
So, we need someone out there to put together some solid and reliable findings on this subject, preferably in a book. The aim would be to provide addiction practitioners some research based practical tips on how to raise client confidence and motivation.
Have a feeling the book would sell.
