Van Horn, D. H.A., & Bux, D.A. (2001). A pilot test of motivational interviewing groups for dually diagnosed inpatients. Journal of Substance Abuse Treatment, 20, 191-195.

MI Group 2: The Great Debate

Primary goal: To encourage patients to become more aware of the thoughts and arguments that are likely to tempt them back to using, and to increase their ability to directly rebut these ideas.

Introduction and rationale: “There are two sides to every story. This is true for interpersonal problems like arguments between two people. It’s also true for drug and alcohol use. Although most of you here in the hospital are at a point where you believe drugs and alcohol are harming you, not everyone always does. Also, even for those who do think so now, it’s probably a safe bet that you didn’t always think so, and it’s also possible that you won’t always think so in the future. In other words, the problems with using aren’t always so clear-cut, and most addicts at times will see the issue as open for debate.

“We’re going to go over both sides of that debate here today. The idea of a debate is to give both sides a chance to express their point of view, and to shoot holes in the other side’s argument. The process of doing this helps you to think more clearly about all sides of the issue, and to prepare yourself to think up counter-arguments when the other side makes a good argument against your point of view.”

Structure: The leader divides the group into two equal teams. One team is assigned the task of arguing the “pro” side of the drug/alcohol use, and their task is explained as “proving” that drugs and alcohol are harmless, fun, and a necessary part of life. The “con” team is assigned the task of proving that using is harmful and dangerous, and of shooting down the “pro” team’s arguments.

The teams are given writing materials and 5-10 minutes to prepare their initial arguments. The “pro” side presents first with individual members each presenting a point in turn, followed by the “con” side. During each initial presentation, the teams are instructed to pay attention to the other side’s arguments and to prepare rebuttals. The facilitator writes each argument for each side on the board as a reminder. After the first round, the “pro” side goes again and rebuts the “con” arguments, with help from the facilitator who may elicit specific rebuttals to each “pro” argument. This is followed by the “con” rebuttals of the “pro” side. This activity is likely to require substantial involvement of the facilitator in order to ensure that the group maintains focus.