Motivational Interviewing and CBT: Combining Strategies for Maximum Effectiveness
Sylvie Naar and Steven A. Safren
Guilford Press, New York, NY, 2017
242 pages (hardcover), ISBN 978-1-4625-3154-7
Naar and Safren intended the book Motivational Interviewing and CBT: Combining Strategies for Maximum Effectiveness to show how integrating cognitive behavioral therapy (CBT) with motivational interviewing (MI) can lead to better client outcomes than using either approach on its own. The book provides tools to enhance treatment of many clinical problems and claims that the two strategies will improve mental and emotional health more than either used alone. According to Naar and Safren, "the book can be utilized as the beginning of trans diagnostic protocol to address various processes of change with both MI and CBT as the underlying core" (p. 3). The book also addresses situations when the combination of the two may or may not work.
The book begins by describing ways of integrating MI and CBT. The authors suggest using MI as a pretreatment to increase self-motivation, but also using it throughout the implementation of CBT as the therapist and client relationship continues to be developed. Naar and Safren believe that MI can "serve as an integrative framework in which other interventions, such as CBT strategies, could be delivered" (p. 3).
In the second chapter, "Building Alliance and Motivation," the authors describe techniques for beginning treatment with a method they refer to as ask-tell-ask and reflection. The authors describe this planning process and give practice situations for drawing out and strengthening change talk. The ask-tell-ask technique is described as a way to engage people by eliciting (i.e., asking) what the client might already know or feel about a situation, providing brief information or advice from the social worker's practice experience (i.e., telling), and then asking the client what he or she feels about the professional information provided (i.e., asking). This method provides respect for a client's autonomy in making choices.
The authors discuss the change process throughout the third and fourth chapters. For example, plans for change, strategies for monitoring the importance of change, and confidence in change are all examined. The authors review the importance of creating motivation and specific plans to change, as well as investigating barriers to change, such as barriers that may impact self-monitoring.