Trauma Based Motivational Interviewing

Using Motivational Interviewing to Overcome Trauma Disorders

There is an increased awareness of just how much trauma from our past impacts our lives, especially for those who struggle with substances, PTSD, or CPTSD.

And it has become evident that a lack of access to trauma-informed care can be a barrier for those who have experienced traumatic events. If you have been through trauma and are struggling on a daily basis, it is important that you’re able to access trauma-informed care.

This is why trauma-based motivational interviewing is one of multiple evidence-based forms of therapy used in evidence based mental health and addiction treatment.

At Catalina Behavioral Health, our trauma-informed providers use motivational interviewing and other evidence-based practices to help clients heal. So, what should you know?

First, let’s define what trauma-informed motivational interviewing consists of. Then, we’ll discuss its role in treating trauma disorders, what to expect during sessions, and how the modality is used in our programs at Catalina in Tucson, Arizona.

What is Trauma-Informed Motivational Interviewing?

As a standalone therapy method, motivational interviewing (MI) is a powerful form of talk therapy that helps people act in a way that aligns with their values. It can be used to address various mental health concerns, including but not limited to substance abuse, eating disorders, and trauma recovery.

Trauma-informed motivational interviewing uses the same activities and strategies as the treatment typically would. If you’ve heard of common activities used in MI, like sorting value cards or making a pros and cons list, you can expect to engage in the same practices.

What sets trauma-informed motivational interviewing apart is that the therapist will use trauma-informed strategies in the course of working with a client to improve perspectives and the likelihood of a successful treatment outcome.

When a provider is trauma-informed, they are trained to understand and work with people who have trauma. As a result, a trauma-informed provider might:

• Check in with a client regarding triggers, allowing a client to decide if and when they want to interact with certain topics.
• Phrase questions in specific ways (e.g., in ways that aren’t perceived as demands).
• Take extra care to express empathy and use reflective listening skills.
• Avoid potentially triggering, presumptive, or judgmental language.

At its core, trauma-informed care provides the highest respect for a person’s autonomy. It considers the context of your life and offers additional patience and understanding.

While health care practitioners who are not trauma-informed may not intend to cause harm, they may not have the in-depth understanding that a trauma-informed provider will.

Motivational Interviewing for Trauma Disorders and Co-Occurring Conditions

Sometimes, trauma survivors can’t act in a way that best aligns with their values, goals, or desires before they get therapy and support. There are multiple potential reasons for this. For example, let’s say that you experience one or more of the following concerns.

• People-pleasing.
• Ambivalence or lack of motivation.
• Addiction or maladaptive behavior patterns (e.g., eating disorder behaviors).
• Low self-esteem.
• Anxiety.

All of these can coincide with trauma. Maybe, you experience people pleasing, but you value authenticity and justice. Your people-pleasing could disrupt your ability to stand up for what you believe in, which might not align with your values.

Trauma-informed care helps those who have experienced trauma feel safe and work through the things that are holding them back. Motivational interviewing doesn’t shame the client. It emphasizes your strengths and positive traits.

A therapist using MI who has undergone a motivational interviewing competency assessment may help you work through concerns such as those listed above, helping you to establish new patterns. A trauma-informed provider will stay by your side while you do so and help you work through any challenges or fears that come up along the way, even if others haven’t understood those challenges and fears in the past.

What to Expect in a Trauma-Informed Motivational Interviewing Session

Your very first motivational interviewing session may seem similar to that of any other type of mental health therapy. During your first session, therapists, counselors, psychologists, or social workers using MI will get to know you. They may ask questions about your history, goals, symptoms, and current quality of life or life satisfaction.

After that, you’ll get into the bulk of treatment. Throughout MI, your therapist will ask open-ended questions, which is where the “interviewing” part of motivational interviewing comes in.

These questions are designed to help clients learn about themselves, understand the gap between where they are and where they want to be (this relates to the principle “develop discrepancy” listed below), and ultimately, meet their therapy goals.

There are four principles of motivational interviewing, which include:

1. Express empathy.
2. Develop discrepancy.
3. Roll with resistance.
4. Support self-efficacy.

Motivational interviewing is a client-driven approach and collaborative process. Therapists using MI promote self-efficacy, meaning that they will help the client learn to believe in themselves and their ability to use tools.

If a client resists, the therapist will not argue, though they may offer guidance and suggestions. Instead, collaboration, patience, and exploration help clients make progress.

How Trauma-Informed MI is Used in Our Programs

Catalina Behavioral Health has an expert team of diverse medical and mental health treatment clinicians.

All of our providers have unique areas of specialty, including motivational interviewing. Providers who use motivational interviewing have specialized training that allows them to use the technique properly and for optimal client outcomes.

For example, they may participate in various trainings via the Motivational Interviewing Network of Trainers (MINT).

We use motivational interviewing alongside other evidence-based practices, such as Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavioral Therapy (DBT), and other techniques. That way, clients get the benefits of various interventions instead of just one.

We offer inpatient mental health treatment, partial hospitalization, an intensive outpatient program (IOP), and outpatient mental health programs. Trauma-informed motivational interviewing can be used in any of our inpatient or outpatient programs.

Call Catalina for Trauma-Informed Care in Arizona

If you’re looking for a treatment center with a trauma-informed approach, you’re in the right place. Catalina Behavioral Health is an Arizona-based treatment center offering trauma-informed care for mental health, substance abuse, and co-occurring disorders.

To find out more about how Catalina Behavioral Health can help trauma survivors like you or your loved one, verify your insurance coverage for treatment, or get answers to your questions about our programs, call our admissions line today.

FAQs About Trauma-Based Motivational Interviewing

What are the 5 A’s of motivational interviewing?

The five A’s of motivational interviewing are:

• Ask: MI always involves asking clients guiding questions. For example, “Would you say you have healthy boundaries with that family member right now?”
• Advise: While expressing empathy and supporting self-efficacy, a therapist using MI may advise the client. For example, “It sounds like setting a boundary with them would be helpful.”
• Assess: Providers using MI will assess whether you are on the same page and want to engage in a specific behavior change.
• Assist: Upon understanding your willingness to change, a therapist using MI will assist you in working through any potential barriers you might face. They may ask questions like, “How do you feel about setting a boundary using these words? How do you think your family members will respond?”
• Arrange: A therapist using MI will arrange for a follow-up (e.g., scheduling your next session, where you’ll focus on how setting the boundary went), or for the next steps (e.g., a referral to a drug rehab program), depending on what MI is being used for.

MI can be used to promote health behavior change (e.g., implementing new health behaviors or stopping maladaptive behaviors, like smoking or drinking), help individuals overcome past trauma, or help clients reach other goals. While the five A’s are always applicable, your specific therapy goals can impact what they look like.

Can Motivational Interviewing be used for PTSD?

Yes. Behavioral health clinicians use a range of different therapies to address PTSD, including motivational interviewing. Sometimes, MI is combined with other therapies, like cognitive processing therapy (CPT), to best serve trauma survivors.

References

1. https://www.aipc.net.au/articles/principles-and-techniques-of-motivational-interviewing/
2. https://nida.nih.gov/sites/default/files/MIA-STEP_Factsheet.pdf
3. https://www.researchgate.net/figure/The-5-As-to-facilitate-effective-health-behavior-change-counseling-during-a-medical_fig3_303091727