The Person in Distress: On the Biosocial Dynamics of Adaptation

Abstract

The application of Motivational Interviewing (MI) principles in Modified Interpersonal Group Therapy (MIGT) addresses two gaps in the literature. First, it explicitly extends MIGT to non-abstinent, addicted patients who are in the precontemplative and contemplative stages of change in contrast to most MIGT models where abstinence is usually required. Second, it provides a novel, process-oriented group intervention for MI, in contrast to current applications of group-based MI which are more structured in their format. The main modification in technique was to prioritize the horizontal exploration of substance use disclosures with a focus on the here-and-now experience of disclosure and the interpersonal impact on the group, in order to: 1) encourage members to openly discuss their ambivalence and shifting motivational states, 2) harness the evocative impact of substance use disclosures between members to elicit change talk (self-motivational statements), and 3) selectively reinforce change talk when it emerges from these exchanges. The authors illustrate these concepts with a case report of an open-ended MIGT group with comorbid mental illness and addiction.