The majority of my experience as a mental health professional has been in the context of treatment centers. My guess is that less than 30% of the clients in these settings came to treatment because they were motivated for substance use disorder recovery.
Instead, they came because of one or more of the following reasons:
- Family pressure
- Job or school pressure
- Doctor’s recommendation
- Health consequences
Yes, these factors can play a role in motivating an individual to pursue substance use disorder recovery, but most clients come into treatment feeling ambivalent about change or even stubbornly opposed to it.
As a therapist, this meant that I spent the early stages of therapy working on increasing motivation for recovery. Here are two approaches I found helpful.
The Bad Politician
Compulsive and addictive behaviors make promises. They promise to make people feel safe, powerful, or numb. Or they may promise to make them feel secure, accepted, or even beautiful.
But, like a corrupt politician running for office, they have no intention of keeping these promises. In fact, they only want to get re-elected and stay in office (keeping people addicted).
One way of improving motivation is by sharing this metaphor with the clients and making a list of promises the addictive behavior has made. The next step would be to examine “the politician’s record” and determine whether it has delivered on those promises.
Here’s a sample list:
After making the list, discuss with the client what it might look like to “run for office” themselves and take a more active role in governing their life.
IDENTIFY THE OBSTACLES TO CHANGE
Motivation exists on a continuum. I found it helpful to have clients identify where they stood in the journey of change by writing the following statements on a piece of paper:
- I don’t have a problem.
- I have a problem, and I like it.
- I have a problem, and it’s a problem.
- I have a problem, and I’m working on it.
- I have a problem, and I’ll do whatever it takes to change.
Next, ask the client to identify where they are on the continuum and identify the obstacles to moving to the next stage of change. This might also be an excellent time to review the broken promises of the addiction.
This activity can be used in individual or group sessions. When used in a group, ask other group members whether they see their peers making choices that align with where they put themself on the continuum.
If you are a clinician and you are looking for more tools on helping clients increase motivation in substance use disorder recovery, check out the resource Enhancing Motivation for Change in Substance Use Disorder Treatment offered as a free download by Substance Abuse and Mental Health Services Administration (SAMHSA). 
Substance Abuse and Mental Health Services Administration. (n.d.). TIP 35: Enhancing Motivation for Change in Substance Use Disorder. Retrieved December 5, 2019, from https://store.samhsa.gov/product/TIP-35-Enhancing-Motivation-for-Change-in-Substance-Use-Disorder-Treatment/PEP19-02-01-003.
About the Author:
Travis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. Travis’ website is wtravisstewart.com
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Reviewed and Approved by Jacquelyn Ekern, MS, LPC on December 23, 2019
Published December 23, 2019, on AddictionHope.com