Motivational Interviewing (MI) can be a tremendously helpful technique for people experiencing OCD who may be stuck in their treatment.  MI acknowledges the ambivalence people might feel about changing their behaviors or thought patterns in OCD. It helps explore both the reasons for wanting to maintain current habits and the desire for change. This can help individuals understand their conflicting feelings and motivations.

MI emphasizes empathetic listening without judgment.

Therapists using MI for OCD stuckness aim to deeply understand the individual's experience, validating their struggles without reinforcing the OCD behaviors. This approach builds trust and encourages openness. However, it does not allow for the highly destructive rumination cycles or reassurance seeking in the therapy room.  

MI aims to draw out an individual's intrinsic motivation for change.

By asking open-ended questions, individuals may articulate their own reasons and desires for overcoming the challenges posed by OCD. This process helps in developing internal motivation rather than relying on external pressures. 

Often, clients of Kairos have less of a sense of their “why” when they come into treatment, but rather have been persuaded into our office by well-meaning family members. While we can still work with this presentation of OCD, treatment is far less effective when the client is agreeing to therapy for someone else, rather than for themselves.  

Through MI, therapists and individuals can collaboratively set realistic goals that are in line with the individual's values and aspirations. This approach empowers individuals to take ownership of their progress and fosters a sense of autonomy. Goals are incredibly important in the OCD treatment process, as progress should be measured.  

In OCD treatment, resistance to change is common. MI teaches therapists to navigate resistance without creating further confrontation. Instead, it helps therapists gently guide individuals toward exploring the discrepancies between their goals and current behaviors. For OCD, we must grapple with the aspects of our anxiety that are “ego-syntonic” (in other words, OCD that is fundamentally in alignment with values) and aspects that are “ego-dystonic” (in misaligned with our core beliefs).  

MI assists in building self-efficacy by highlighting past successes and strengths. By focusing on previous instances where the individual managed OCD symptoms effectively, MI helps in reinforcing the belief that change is possible.

In the context of OCD stuckness, MI serves as a collaborative and empathetic approach that respects an individual's autonomy.

It doesn't aim to directly challenge the validity of their experiences but rather helps them explore their own motivations and capabilities for change. This can be a powerful tool in addressing the rigidity and difficulty in moving forward that often accompany OCD symptoms.

What if OCD and Depression coexist? 

In the case of severe or moderate depression, concurrent with OCD, our clients may not have the energy, sense of hope, and ability to self-regulate that are necessary for Exposure Response Prevention (ERP) treatment. In this case, motivational interviewing (MI) can be a beneficial technique in addressing certain aspects of depression, especially when considering the motivation for change and readiness to engage in treatment or behavioral modifications. However, its effectiveness might vary based on the individual and the specific stage of their depression.

MI acknowledges the ambivalence individuals may feel about seeking help or making changes in their lives due to depression. It helps in exploring the reasons for maintaining certain behaviors or attitudes while simultaneously desiring change.

MI aims to increase intrinsic motivation by helping individuals recognize and verbalize their reasons for wanting to overcome depression. It helps in identifying personal values and goals that may drive the desire for change.

For individuals hesitant about seeking treatment due to depression, MI can help in identifying and addressing barriers. It allows for a non-confrontational exploration of concerns, allowing individuals to express their doubts or fears about treatment.

MI assists in highlighting past successes or strengths, even small ones, to bolster an individual's belief in their ability to make changes. 

Focusing on strengths and wins can be particularly helpful in depression, where feelings of low self-worth and hopelessness are common.

However, MI might not be the sole approach for severe or clinical depression. Often, a combination of therapeutic techniques, including cognitive-behavioral therapy (CBT), medication, and support groups, is more effective. If a client presents with Depression and OCD, the clinician may consider tackling the depression first, in order to pave the way for anxiety treatment.  

It's crucial to consider that while MI can help with motivation and initiating change, depression and OCD also require professional treatment and support tailored to the severity and individual needs.

Seeking guidance from a mental health professional can help determine the most appropriate approach for addressing your mental health needs.
If you or your loved one are in need of professional mental health support, please contact Kairos Wellness Collective today.