How To Integrate Motivational Interviewing Into Your Therapy Groups

Motivational interviewing (MI) is one of the most well-known and frequently utilized evidence-based approaches used in substance abuse treatment today. MI is considered a "best practice" and most counselors are trained to engage their clients using the principles of MI.

In my experience, MI is often taught as an approach to use with clients individually and there is less emphasis on utilizing it in group settings. Since groups in the Motivation for Recovery curriculum are structured in a way that MI is inherent to the group process, I decided to write a little about how that is accomplished.

First, groups should conform to the spirit of MI. As the group facilitator, you can create a welcoming, nonjudgemental atmosphere. Learn what is most important to the clients and encourage positive change. In Motivation for Recovery groups, we begin by asking for the clients to express their motivations for change. This is a collaborative and client-centered approach that helps the client stay in an open and receptive mindset. Once we learn the clients' motivations, we can work towards empowering them to set and achieve goals.

Open-ended questions are an important tool in MI. Starting groups with a "check-in" can give you information about who's doing well and who may be struggling. Check-ins are an important component of most process groups. In Motivation for Recovery groups, we begin with an open-ended question to assess clients' motivation for change, and build the group around those motivations. This allows the clients to have a greater investment in the process. The clients often express hope and willingness, and this makes it easier for the counselor to guide clients towards their goals.

Reflective statements let the clients know that you are listening to them and understand what they are communicating. In Motivation for Recovery groups, reflective statements are built into the format of the group. Reflecting back to the client allows them to hear out loud what they were thinking. 

Affirmations are genuine compliments that recognize the difficulties or struggles of the client. You can highlight successes, build rapport, and show appreciation. This helps build a sense of hope and self-efficacy. Affirmations should be used when clients are expressing their motivations for change. Reinforcing their motivations can empower them to believe in themselves and to set good goals.

Motivation for Recovery groups have the elements of MI built into the format of the groups, which can help you and your counselors maintain fidelity to this evidence-based treatment modality.

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