The Spirit of Motivational Interviewing as an Apparatus of Governmentality. An Analysis of Reading Materials Used in the Training of Substance Abuse Clinicians

摘要

Substance abuse clinicians working at the coal face with clients daily are confronted with client problems that are robust and tangible. The understanding of these problems is granted epistemological and ontological legitimacy by the psy-sciences. As a result, practice in the substance abuse treatment and addiction fields are rarely subject to the scrutiny provided by post-structural analysis. Moreover, the disciplines of addiction treatment and sociology rarely collaborate in any meaningful way for numerous reasons. For the AoD clinician caught betwixt and between biological psychological and sociological discourses, there has been a tendency to opt for the perceived problem solving capabilities of psychological discourses. However, in a post-aetiological hemisphere, attention is increasingly fixated on the fiscal imperative. Clinician/Client relationships have been reconfigured in neo-liberal society. In this study, materials used to train undergraduate students Motivational Interviewing skills in an Alcohol and Drug degree programme were subject to a textual analysis deploying the Foucaultian concept of governmentality. The familiar aetiological descriptor model used in the field was transposed into the Foucaultian term discourse. One article subject to analysis is presented here. The intention was to interrogate the effects of Motivational Interviewing on client and clinician and the resultant repositioning. It was found that Motivational Interviewing technologies reposition the client as an active self-governing autonomous subject while the clinician is professionally and spiritually imprecated in the manufacture of a neo liberal subjectivity within the client. It is argued that the client/clinician interaction constituted, owes less to clinical considerations than to contemporary neo liberal agendas. Proponents of the practice cite progressive and enlightened facets of Motivational Interviewing through an uncritical indebtedness to ascendant resilience and strength based discourses. Alternatively it can be understood as an individualising strategy that displaces clients from former robust communities of understanding, latterly positioned as primitive or deficit ridden. In the resulting motif client/clinician interaction is reconfigured so that the active rational, self-empowered client is produced by the newly embourgoised clinician. Clinical concerns are casually jettisoned. Thus Motivational Interviewing is at once a political/apolitical apparatus, which requires further interrogation.