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Nov 07, 2016

Motivating Factors in Counseling

This past week I’ve been focused on utilizing Motivational Interviewing with my clients. Although the concept is straightforward, actually practicing the technique in sessions has been a learning curve for sure. Thinking quickly to be able to pick up on the client’s emotion, reflecting that emotion back to them, and then following that up with a statement of fact has been a challenge at times. Of course, the range of how challenging this is depends on each individual client. And then there are some clients who are not even at the ambivalent stage yet (and court mandated) so that poses a different set of challenges in therapy.

I was also faced with the reality of clients who show high motivation in session to change, and then subsequently don’t call or show for appointments. This could very well be the result of the Cubs World Series situation, Halloween, being an adolescent, or a number of other factors. But I have a hunch one client in particular did not show for his appointment because he’s not at a point where he’s highly motivated to change. And if I were to see the world through that particular client’s eyes, I can understand where he’s coming from. I remember when I was sixteen. I remember thinking I could figure things out on my own, and I remember the desire to be independent. Showing up once or twice or three times a week (if teens are in an Intensive Outpatient Treatment) can be in direct conflict with an adolescent’s way of thinking. But the problem is, when an adolescent who has substance use issues decides to miss multiple therapy sessions, they have a high instance of quitting on themselves and wind up relapsing. 

So of course, as their counselor I get concerned. I wonder if they are using again? Have they relapsed a lot? Or a little?

My hope is clients return and were simply “not in the mood” for therapy. My hope is they missed a session because they wanted to hang out at their friend’s house on Halloween, or wanted to get their homework done so they could watch the Cubs.

That is my hope.

And no matter what the reason, I simply want them to come back so we can continue our work together, so I can help them learn how to effectively cope with their life without the use of substances. 
Shari Brady is a counselor-in-training at PEER Services, Inc., an agency located in suburban Chicago, dedicated to the treatment and prevention of substance use disorders. She is also an award-winning author who has a passion for adolescents and the struggles they face. You can read more about her and her books at

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