How To Help An Addict — Using Communication Strategies To Encourage Someone Suffering From Addiction To Find Help

How To Help An Addict — Using Communication Strategies To Encourage Someone Suffering From Addiction To Find Help
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Health And Wellness

It is hard to watch someone close to us suffering from an addiction like smoking, drinking or doing other drugs. Perhaps you want to help them, but you don’t know how to approach the issue.

Your first instinct might be to shake them, shout at them or wag your finger at them while telling them that they need to quit (or else!) with tips on exactly how they should do it. But research suggests that this confrontational approach often only increases defensiveness and can reduce the chances that your loved one will change.

For over four decades, studies in alcohol rehabilitation have shown that the confrontational approach to therapy is not effective in getting people to quit drinking and may even increase their likelihood of relapse. When counseled by a person practicing empathy, however, patients have shown less addictive behaviors, even years later.

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Is it important to realize that addiction often originates from a disease and that it is not simply within the individual’s “choice” to abuse alcohol or drugs.

According to Patterson & Forgach in the Journal of Consulting and Clinical Psychology, "people can dramatically influence an addict's defensiveness, which, in turn, predicts the degree to which the loved one will change...[P]eople with addiction problems do not generally possess high levels of denial and resistance, but these things increase as loved ones and therapists improperly get involved.

Think about a time when you came to a friend with a problem and they immediately started spouting off all the things you need to do. Did you feel any resentment, anger, uncertainty, doubt or defensiveness rising up inside of you? This is not uncommon.

If you are telling someone what to do and they are telling you reasons why they cannot or don’t want to do it, you’ve already got it backward.

What you can consider doing instead is called “motivational interviewing,” or MI. MI is a scientifically validated way of speaking to someone that can elicit motivational change. Motivational interviewing was popularized by researchers Miller and Rollnick. In their book, Motivational Interviewing: Helping People Change, they define MI as a "conversation style for strengthening a person's own motivation and commitment to change.”

More specifically, motivational interviewing is "a collaborative goal-oriented style of communication with particular attention to the language of change. it is designed to strengthen personal motivation and commitment to a specific goal by eliciting and exploring the person's own reasons for change within an atmosphere of acceptance and compassion."

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MI was originally created as a counseling model to help problem drinkers, but, over time, it has been applied to many situations (not just addiction issues) to help people make healthy changes that they need to make to improve their lives. For the purposes of this article, we will be focusing on examples from mostly addiction issues, particularly drinking and smoking.

While motivational interviewing is best practiced by a licensed counselor or psychologist, there are some techniques of effective and compassionate communication that we can garner from the principles of MI for helping friends, partners or family.

The main idea of motivational interviewing is that behavioral changes are more likely to occur when people are able to talk themselves into change. Your role as a person who cares about them is to help evoke this type of “change talk” and to enhance their motivation until they are ready to take the steps necessary to heal from their addiction.

If you attempt to use scare tactics to get your loved one to change, it could just lessen an addict's motivation to change. After all, most people learn by hearing themselves talk, and they generally trust their own judgment over anyone else’s.

The spirit of motivational interviewing is one of mutual respect, empathy, partnership, facilitation and interpersonal connection. You are looking to make your partner feel engaged, empowered, open, and understood.

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In the 1980s, there was a bias that still exists today in addiction therapy. It is the view that addicts are so often thought of as being in denial, “unable to see reason” or “out of touch with reality.” However, it is usually quite the opposite.

Most addicts are quite insightful. Most people who suffer from addiction want to change — but need some guidance. This is because change is hard. It’s hard for everyone. The problem lies in a motivational conundrum that has existed since the dawn of human time.

Studies on human behavior and motivation have shown that, before making a change, a person will oscillate between making progress towards their goal and slipping back into the old and familiar status quo. According to Miller and Rollnick, it’s a state known as ambivalence or the act of “simultaneously wanting and not wanting something, or wanting both of two incompatible things.”

Being in a state of ambivalence is uncomfortable because it causes anxiety. It's as if there's a courtroom inside your head with two sides of the argument — for and against change — both being voiced at the same time.

Ambivalence should be seen as a good thing, however. According to the founders of MI, “If you’re ambivalent, you’re one step closer to changing.”

A good helper will be empathetic to this fact and will listen patiently as their loved one externalizes the debate playing inside their head and encourage them to explain their arguments for and against change with the key motive of helping the person resolve their ambivalence. In a therapeutic setting, the counselor does this by using open-ended questions, affirmations of the client’s strengths and efforts, and reflecting and summarizing what the client says. The final question that the counselor wishes to reach is, “So, what do you think you should do about it?”

The end goal of motivational interviewing is to get the person who is suffering from addiction issues to express their own reasons for wanting to change — and to help them create an action plan to get there.

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It is important to remember that a person who needs help is also someone who is capable of making positive decisions for themselves. If you see someone as difficult, they are going to act difficult, and your loved one will be less open to you and more defensive.

According to Miller and Rollnick, “you cannot manufacture motivation.” Being too confrontational gives off the impression that you are the expert and you are going to “fix” the other person. Instead, you are there to say to your loved one, “I trust your own wisdom, will stay with you and will let you work this out in your own way.”

There are three major counseling styles people use when helping someone overcome their addiction issues: directing, following, and guiding. Motivational interviewing primarily follows the guiding style, whereas you, as the outside party, have a certain directive in mind (i.e., to get the addict to focus on what needs to be changed and how to do it). You cannot force this process, though.

The principles contained within the acronym “OARS” constitute the fundamentals of basic helping skills and are useful for anyone who wants to communicate more effectively. OARS stands for open questions, affirmations, reflecting and summarizing.

Open Questions are understood in contrast to closed-ended questions. Ideally, you want to ask twice as many open-ended questions as closed-ended questions. For example, instead of asking, “How many drinks do you drink per day?” you would ask, “What role does alcohol play in your life?”

Affirmations are positive statements that acknowledge the other person’s strengths, values, insights, efforts, and achievements whereas reflecting is when you actively listen to the person and then repeat back the meaning of what the other person had said. Reflecting shows engagement and understanding, and helps us to “walk in the other person’s shoes.” Summarizing is a type of reflection that requires you to reiterate more than one main idea that a person has expressed.

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In understanding the main principles of effective communication (OARS), they can be used during every stage of the motivational interviewing when trying to help someone who is an addict using these 4 steps:

1. Engaging: establishing trust and a mutually respectful relationship.

Some defining qualities of engaging are making your loved one feel welcome, understood and having the sense that you both have mutual goals. The opposite of engaging is telling your loved one what to do, judging them, or asking them too many questions.

If you have not seen your family member/spouse/friend for a while, or if you have had a conflict in the past, you will have more success if you try to resolve these personal issues before trying motivational interviewing tactics with them.

Trying to help them with something not associated with their use or simply spending quality time with them might be a good first step to show them that you care about them. It can show you are a trustworthy and supportive person in their life.

2. Focusing: seeking a plan and maintaining a specific direction.

Focusing involves coming to an agreement about a plan of direction with the person you're trying to help, or the goals they have in mind. In order to be done successfully, it requires the careful use of the OARS communication steps to establish a plan based on the goals, values, and priorities of the person you are trying to help, as well as your own priorities, to help your loved one get better.

3. Evoking: eliciting a person's own motivation for change.

In other words, you are trying to evoke “change talk” or things that the person with addiction issues says that is in favor of changing their behavior. Once again, you cannot force this process along. The motivation must stem originally from the person you’re speaking to.

Change talk usually starts with phrases such as “I want" or "I wish."

4. Planning: developing steps to initiate that change.

In order to be successful, the goals created during the planning process must be specific, measurable, achievable, relevant and timed. The motivational interviewing method of helping someone you love with addiction may not provide a quick and easy fix, but it may make you more successful in getting them the help they deserve.

For more help and information about addiction, including recommended treatment programs, please call 1-877-SAMHSA-7 (1-877-726-4727) or visit their website.

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Brianna Androff is a writer who covers pop culture, astrology, and relationship topics.

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