By now we are all familiar with Motivational Interviewing’s ambivalence concept. Ambivalence – I want to change, I don’t want to change (Miller & Rollnick, 2002). Other ways to describe this ambivalence is to maintain, “I am of two minds as to change,” or “I have conflicted feelings about change,”
You may personally experience something similar as to weight loss or smoking cessation. The point is you get stuck in wanting, then not wanting to change. You need to get unstuck. That is a core Motivational Interviewing (MI) principle.
I have reviewed the MI literature and find few if any references to other motivational forms.
Exceptional addiction counselors know that ambivalence is simply one piece of the proverbial motivation for change. Human nature, especially addiction human nature, is never such that it can be easily explained by a single element such as ambivalence. For example, wanting then not wanting to change is just plain lethargy, apathy, inaction, torpor to name a few other variables that impact motivation.
In addition, the proper reinforcement (positive or negative) to change may not be on hand. Certainly, some people prefer the status quo over change. And one cannot forget the fear of change itself as a motivation not to change.
To constrain client motivation to only ambivalence is a simple cause bias.
Of course, simple cause bias does not extend to MI alone. There are a host of simple cause explanations that have for decades permeated our field. Many center on what causes addiction in the first place. Examples include anger as the root cause, or spiritual deficiency as the root cause, or parental abuse as the cause, or peer pressure as the cause, or genetic disposition as the cause, or family history as the cause, or a dual disorder as the cause, or a character defect as the cause, or, or, or – you get the picture.
The key point of a simple cause bias is that it sees one point of view, no other. In addiction assessment, the simple cause point of view eliminates other client motivational or causal possibilities. And by eliminating possibilities not only does it curtail the importance of examining other client variables, but it gives rise to a false sense of certainty that you have found THE problem with a client (Burton, 2008).
Feeling you found THE key issue stops one from exploring. That is not a good idea in addiction counseling for we want to be constantly exploring.
Now that you know what a simple cause bias is, watch for it. Most importantly try not to become spellbound by its allure.
Miller, W. R. & Rollnick, S. (2002). Motivational interviewing: Preparing
people for change (2nd Ed.). New York.
Burton, R.A. (2008) On being certain: Believing you are right even when
you’re wrong. New York: St. Martin’s Press.