Blog 81. Motivational Work Reverses the Paradigm

a suspension bridge: It is always possible to build a bridge to the client
It is always possible to build a bridge to the client.

Motivational Work turns upside-down the traditional notions of how to motivate. In my last blog (no. 80), I focused on the influence of the psychotherapeutic paradigm in interaction with the hierarchy of society. In this blog, I will concentrate on other affections which follow the psychotherapeutic model. Moreover, Motivational Work has an opposite view of approaching the client. To conclude, Motivational Work reverses the paradigm.

The Traditional Paradigm

As mentioned before, the traditional paradigm of how to motivate is intimately connected to the psychotherapeutic model. The notion is that psychotherapy is the method par preference to help a client with psychological problems. However, one dilemma with this view is that the clients need to be least to some extent motivated.

In other words, he must be able to come to sessions and have the capacity for self-reflection. On the other hand, the client cannot be influenced by drugs and alcohol. Neither can he be threatening and very aggressive or emotionally cut off from himself. Thus, one solution to this dilemma is for other personnel to motivate the client to the treatment. Here is an example:

An Example

At a psychiatric hospital managing many patients with severe psychoses, psychotherapists (who also were psychologists) only receive patients who have called them about their initiative during the telephone reception hours of 8.30–9.00 am, Monday to Friday. During the telephone conversation, the psychotherapist and patient must agree on consultation time. Subsequently, the psychotherapist has one or more meetings with the patient to evaluate such concerns as the nature of the problem and the client’s motivation.

The patients accepted for treatment are the ones who, on their own initiative, can regularly attend sessions with the psychotherapist several times a week. Moreover, they must not be under medication or have problems with substance abuse. The psychotherapist must also feel that his contribution to the motivational encounter elicits an emotional response in the patient.

The Motivational Paradox

As I mentioned in my last blog, the psychotherapeutic paradigm leads to the motivational paradox, which can be seen in the above example: the clients with the most need of help received the least. In contrast, those who need the most minor help gain the most.

Low Prestige

As a result, the arrangement is that well-educated psychologists and psychotherapists sit and wait for their patients. It is up to the staff at the wards to motivate the patients. This effort is not considered as advanced as psychotherapy. It has a low status (compared with blog 80). Consequently, the activity is accomplished at wards with personnel without an academic degree.

Furthermore, the labor to motivate is performed without any training or supervision. Another peculiarity is that the psychotherapists could not see any reason to guide the staff at the wards. One reason was that they did not know how to supervise them. Nevertheless, if the psychotherapists had been trained in the existing methods of motivation, all of them would have been built on the psychotherapeutic model. Consequently, you would have been back to square one.

No Stress

The psychotherapists were not too stressed about not seeing the most severe patients. The consequences of the system meant that they met fairly well-functioning clients. All the other patients were taken care of by the staff at the wards and biologically oriented psychiatrists. Moreover, the psychotherapists had no guilt feelings about this arrangement. Instead, it was the psychotherapeutic method that demanded strict regulations to be functioning.

The Paradigm of Motivational Work

Conversely, if you use the paradigm of Motivational Work, the approach would be completely different. The pursuit of motivating the patients is regarded as an essential part of the treatment. At the same time, this effort is the most advanced and complicated in treating the patient. When the patient is motivated, most of the endeavor is achieved. Motivational Work reverses the paradigm.

The Object

The object of Motivational Work is not to change the behavior; the patient attends the psychotherapeutic sessions. Instead, the essential goal is to strengthen his life energy.

In other words, the patient takes better care of himself, is hopeful, have increased self-confidence and self-esteem. He also has a better ability to bond with others. When this life force has grown strong enough, the patient will be ready to participate in psychotherapy.

Thus, being motivated means that the patient’s engine is running, and he will participate actively in rehabilitation. Earlier, he was on his way to drowning but has currently been rescued out of the water.

Actively Committed

If the psychotherapists at the hospital practice Motivational Work, they will not sit waiting for patients but go to different wards. There they ask the staff; which patients have the most need of help or are considered hopeless. Then, they will start to supervise the staff about Motivational Work and work together with them.

Furthermore, the patients are sought out, and the treatment mainly occurs in the ward. It is often done in corporation with the staff. From the start, there is no claim that the patient is well-functioning. Additionally, there is no hindrance from working with active drug addicts or heavily medicated patients.

All Patients

In place of waiting for the patient, the motivational worker searches out the patient in need. Neither does he pick out patients suitable for the method. On the contrary, Motivational Work has ways to meet all patients. Everyone is treatable. Nor are there any requirements for an emotional response from the patient. Motivational Work is designed to make a relationship with even the most emotionally suppressed sufferers.

Summary

In conclusion, Motivational Work meets the patient where he is and is committed to strengthening his life force. It is always possible. In other words, everyone can be motivated. Motivational Work reverses the paradigm.

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