Keeping Clients Motivated to Pursue Recovery
Clients' confidence can ebb and flow over time. The authors of Illness Management and Recovery offer a few strategies for keeping clients motivated to gain skills and reach their personal recovery goals.
The evidence-based program for people with severe mental illness, Illness Management and Recovery helps people set meaningful goals for themselves and acquire the skills to better manage their psychiatric illness and make progress towards their own personal recovery. In this excerpt from the program manual, the authors consider the role counselors and clinicians can play in keeping clients' motivated to reach their personal recovery goals.
* * *
Motivational strategies primarily involve helping participants see how learning information and skills will help them achieve their short- and long-term goals. Developing motivation for learning information and skills is an ongoing and collaborative process. Motivation can naturally wax and wane over time, especially if participants perceive their goals as distant and difficult to achieve. To help participants sustain their motivation, practitioners need to help participants identify goals that won't take too long to achieve and to help them break their goals down into manageable steps. In addition, practitioners should both convey their own confidence that participants can accomplish goals and support participants' optimism, self-confidence, and self-efficacy.
Connecting Information and Skills with Personal Goals
One of the most powerful motivational strategies is to connect a participant's personal recovery goal to a skill that is being taught. This in turn helps the participant connect the skill to a situation in his or her own life and imagine how that skill could be useful. For example, if the participant sets the goal of getting a job and is working on coping with persistent symptoms, the practitioner could help the participant identify persistent symptoms that she experiences, such as hearing voices, and then work on strategies for coping effectively with them so she can concentrate during a job interview and on the job. A client with the goal of enjoying his hobby of playing Frisbee again might connect his practice in social skills groups to the idea of asking people to join him in a game. He could even role-play this in a session.
Promoting Hope and Positive Expectations
Practitioners should look for every opportunity to convey their belief in the participants and their ability to succeed in their aspirations. If practitioners seem discouraged or doubtful, the participants will often pick up on this and will start to feel that way themselves. This does not mean taking a "Pollyanna" approach, but rather looking for the positive things that clients have achieved, connecting past successes to the skills involved in taking steps towards current goals, and noting participants' strengths and abilities as they appear in everyday events. For example, a participant who is homeless might feel discouraged about reaching his or her goal of getting a job and claim that he or she "has no skills." The practitioner could help this person identify the many skills he or she has displayed in surviving on the streets. For example, the participant has shown the ability to solve problems (by seeking out safe places to sleep, knowing where to get meals, avoiding unsafe people, and so on) and cope with challenges on a daily basis, which will be very helpful on the job.
Re-Framing Past Experiences in a Positive Light
Some participants become demoralized and discouraged about the future when they think about unpleasant experiences in the past. Practitioners can help these clients reframe their past experiences as challenges and reframe their coping efforts as strengths. For example, a participant may say something like "spending so much time in the state hospital makes me a loser." The practitioner could explore with the person the challenges he or she experienced in the hospital (such as being confined on a locked unit with little access to outdoor activities, being around people whose behavior was unpredictable, and feeling lonely) and what coping strategies he or she used (such as reading books and magazines with pictures of nature, going to the nursing station for assistance when an altercation developed in the day room, and reconnecting with family members by phone). This strategy may help the participant to begin to see his or her hospital experience as a sign of strength and resourcefulness rather than shame and embarrassment.
Excerpted and adapted from Illness Management and Recovery: Personalized Skills and Strategies for those with Mental Illness. Third Edition. Hazelden, 2011.