Blog 79. Motivational Work v. Psychotherapy

I am fascinated by the perseverance of old ideas. In particular, I will focus on treatment methods in psychology and social work. All of them are built on the psychotherapeutic model, which demands that the client needs to be reasonably well-functioning. In other words, he must be able to come to sessions all by himself, not be influenced by alcohol and drugs, not be aggressive and threatening, and not be superficially compliant. However, the essential requirement for the client is that he must be able to reflect on his life situation and change his behavior accordingly.

The Dilemma

The dilemma is that many clients in psychiatry, social services, and correctional establishments cannot live up to these standards. On the contrary, they are aggressive and threatening, they do not come to sessions, they comply, and many of them are influenced by different drugs. With such destructive acting out, they are considered to be unmotivated. Established methods are thus not aimed at this group of people who have the most severe problems but rather at those who have some measure of control over their lives.

Role Reversal

In my experience, one reason for this conception of clients is that the practitioner makes a role reversal with the client. In doing so, he presumes that the latter functions psychologically the same way as himself. In addition, the practitioner is not offered an alternative method of viewing the destructive behavior of the client.

Example

One such example is family care, where the biological parent may give the impression of being very attached to his child. In general, there are deep-founded and strong feelings about the role of the parent. Often, it is assumed that every parent loves his child. Not seldom the practitioner himself is a parent. In this situation, it is easy to identify with the client and not see the destructive parent who maybe has no attachment to his child or even hates his offspring. In this situation, neither the child nor the parent receives the help they need.

Face Value

If you interpret the client’s communication at face value, you create a picture of him as not having a very complicated and indirect way of making contact. Thus, he says one thing, and, in his behavior, he shows the opposite. Consequently, it invites the observer to begin moralizing. As a result, there is no need for an elaborate in-depth psychological explanation.

Motivational Work

One object of Motivational Work is to change the simplified view of the client. A theory is created that shows that the destructive persons’ psychodynamics is much more intricate and sophisticated than those of more well-functioning individuals.

The implication is that you can work with and help all destructive clients.

In future blogs, there will be a more detailed description of the standpoint of Motivational Work.