Alcohol is known to be one of the most devastating public health problems. It ruins lives and does not allow people to function adequately in their environment. People suffering from alcohol abuse quit their jobs and experience grave consequences of social exclusion. Nurses that deal with cases of alcohol abuse try to help patients to overcome the abuse, implementing the most effective interventions on the basis of observations and assessments.
In clinical settings, a wide array of intervention can be used to address the patient`s needs. Among them, there are traditional approaches and continuing care. These both imply a wide array of subsections, including self-help courses, individual therapies, outpatient treatment, and others. Motivational enhancement therapy is referred to as individual therapy. It evolves around the premise that capability for change and responsibility for a progress lie within a patient (McKay & Hiller-Sturmhöfel, 2011). This feeling is achieved through internal motivation technique.
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Internal motivation in patients suffering from alcohol abuse is very difficult to develop. Many of them refuse to recognize the problem and deny any intervention. In many cases, patients give up following the recovery plan. Hence, nurses should be aware of this probability and build the motivational enhancement therapy regarding the patient`s conditions.
The key concept of motivation enhancement therapy is motivational strategies which may comprise receiving feedbacks on risks connected with current conduct, emphasizing on patient`s personal responsibility for their progress, or enhancement of self-efficacy (Miller, Zweben, DiClemente, Rychtarik, 1995). The nurses` major role in patient`s recovery cannot be underestimated.
The therapy entails two phases. During the first phase, nurses must avoid defensive arguments since they are usually misinterpreted by the patients. On the contrary, specialists` aim is to elicit statements about drinking. The patient must confess to their addiction. When the first objective is achieved, and a patient tells about their abuse, the second nurse`s task is to listen to with empathy. They should establish close interpersonal relationships with a patient. Otherwise, MET may not generate positive outcomes. Interpersonal communication and nurse`s ability to provide a patient with meaningful personal feedback are the core principles of MET. The patient needs affirmation and support from the nurse (McKay & Hiller-Sturmhöfel, 2011). The words of approval and encouragement are of the greatest value.
Nevertheless, during the first phase, patient` resistance is unavoidable. The degree to which patient resists depends directly on nurse`s style. To combat the resistance, the nurses should entail simple reflection on what the patient has said. They may also shift the focus away from the problematic issue. The beginning of the second phase is marked when a patient stops resisting his label and is ready for a change (McKay & Hiller-Sturmhöfel, 2011). When it happens, specialists may discuss a plan with a patient, but they should build their interaction on a patient`s free choice. They are the only people who can make a decision to give up drinking. The patient is expected to estimate the consequences of action and inaction. The patient should answer the main question “What would happen if I continued drinking?” A significant input for the decision process is a worksheet which is planned to overcome alcohol abuse. The patient should participate in plan creation (Miller, Zweben, DiClemente, Rychtarik, 1995). The nurse and other specialists serve as supervisors that provide a patient with meaningful recommendations and motivational techniques.
Evidently, motivational enhancement therapy requires the participation of both a patient and a nurse. Nonetheless, nurse`s aim is to guide a patient in his recovery plan but not insist on the specific strategies. Nurses should admit that every patient who suffers from alcohol abuse denies their addiction. The nurse should promote an ideal that a patient is the only person who is responsible for their progress and recovery. The therapy requires using motivational techniques in order to stimulate patient`s readiness for a change.
- McKay, J. R. & HillerSturmhöfel, S. (2011). Approaches to LongTerm Continuing Care. Alcohol Research and Health, 33 (4).
- Miller, W., Zweben, A., DiClemente, C. & Rychtarik, R. (1995). Motivational Enhancement Therapy. National Institute on Alcohol Abuse and Alcoholism, 2.
