Motivational Interviewing

I attended an eight hour training to learn about Motivational Interviewing. Here are some of my thoughts about the training:

The story that was told about Motivational Interviewing is that it started in the substance abuse field with people who were called resistant to change.They have six stages for readiness for change which are precontemplation, contemplation, preparation, action, maintenance, and relapse. The precontemplation stage is supposed to be those who are in "denial" or do not think that they have a problem. I guess a lot of therapists were complaining that their clients were not motivated to meeting their treatment goals so along came an answer to resistant clients. How to motivate clients to participate in therapy is exactly what it is.

The presenters taught us that the therapist is supposed to develop a bag of tricks to move the client up the stages to maintenance. What I perceive that they have done is incorporate the CBT, SFT, and Collaborative ideas for an agenda of guiding the client to what they call true and appropriate behavior. They have scaling questions and reflective listening along with an agenda towards "right" behavior set forth by the therapist expert knowledge about how life is meant to be lived.


Link:
http://www.motivationalinterview.org/

Suicide

Has suicidal behavior always been seen as a mental health issue? One of the ethical obligations is that a mental health counselor is to put up barriers to prevent people from committing suicide. These barriers may involve involuntary hospitalization. Failure to make attempts to save the client from killing him/herself may result in lawsuits and removal of the mental health counselors license priviledges. It is apparent that western society values life and condems death. Other cultures have perceived suicidal behavior as an honorable act such as killing yourself because you have dishonored your family so it gives them a chance to die with their honor. Such behaviors today have been severely criticisized by our western culture. It was a surprise to me to read a psychiatrist by the name of Dr. Thomas Szasz write about his perspective on suicidal behavior and how the mental health intentions to treat sucide as a medical problem may be erroneous. Dr. Szasz writes:

Not long ago the right-thinking person believed that masturbation, oral sex, homosexuality, and other "unnatural acts" were medical problems whose solution was delegated to doctors. It took us a surprisingly long time to take these behaviors back from physicians, accept them comfortably, and speak about them calmly. Perhaps the time is ripe to rethink our attitude toward suicide and its relation to the medical profession, accept suicide comfortably, and speak about it calmly. To accomplish this, we must demedicalize and destigmatize voluntary death and accept it as a behavior that has always been and will always be a part of the human condition. Wanting to die or killing oneself is sometimes blameworthy, sometimes praiseworthy, and sometimes neither; it is not a disease; it cannot be a bona fide medical treatment; and it can never justify deprivation of liberty.

Link to Szasz paper:
http://www.szasz.com/iol2.html