Motivational Interviewing - What Is It And How Can It Change Your Life?
Updated November 20, 2019
Reviewer Wendy Boring-Bray, DBH, LPC
Most of us have aspects of our lives that we may like to make changes to. This may bring about negative feelings at times, but it's normal. It's part of our process of creating happy and healthy lives for ourselves. You may want to become better at managing money or you may hope to take real steps to overall living a healthier life. Perhaps you are struggling with a larger challenge that you would like to change. You may have a serious health condition, such as diabetes or high blood pressure, that needs managing. Or you might be struggling with addiction or substance abuse in general.
Whether you are looking to make a small change or completely turn your life around, Motivational Interviewing (MI) may help set you on the right path even when other counseling techniques have failed.
What Is Motivational Interviewing?
As its name implies, Motivational Interviewing helps those struggling to find the motivation to make important changes in their lives. Motivational Interviewing was first described by William R. Miller in Behavioral Psychology in 1983, as a method of therapy for problem drinkers. The theory and practice of MI have evolved over the preceding decades and it is now a proven method of counseling, shown to be effective for aiding in a wide variety of conditions. If you believe this method could be a good fit for you, continue reading. You may be able to join the many people that have changed their lives through the use of this therapy tool.
In an article called "What Is Motivational Interviewing?", Motivational Interviewing is described as, "a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence." In essence, MI is a short-term therapy technique used by counselors to help clients find the internal motivation for change through empathy with the client's situation, acknowledgment of how difficult making a life change is, and through client-oriented goal setting. The counselor helps the client identify whether their current actions are taking them closer to or farther away from their stated goals. Essentially, a counselor leads a client to see how negative behavior is deterring desired outcomes without creating tension or confrontation.
The Spirit Of Motivational Interviewing
Many scholarly articles about MI focus on its spirit. This is not a prescription for how to practice MI per se, but rather it's a frame of mind in which a counselor should approach Motivational Interviewing.
This spirit focuses on:
- Letting the client take the lead - Motivational Interviewing is not about coercing, convincing, tricking, or persuading a person to change their behavior. In fact, it is quite the opposite. In Motivational Interviewing, it is the counselor's job to elicit the desire to change from the client. The client should be lead to articulate the possible costs and benefits of changing on their own.
- Creating a conflict-free environment - The counselor should focus on building a relationship with the client through active listening and empathy, understanding, and respect for the client's thoughts and feelings. There is no need for the counselor to confront the client about denial or to push the client toward a certain path. The counselor should instead ask questions to help lead the client to his or her own conclusions.
- Developing a collaborative environment - Miller specifically warns against the temptation to see MI as a set of techniques to "use on" people. Rather, the counselor should aim to build a collaborative relationship with trust and a mutual understanding that life change is challenging and not always perfect.
Motivational Interviewing Principles
As stated above, Motivational Interviewing isn't a simple list of techniques. There are, however, recommended principles and strategies to help a counselor follow the spirit of MI.
Express Empathy - Miller states that "[t]he counselor's accurate understanding of the client's experience facilitates change." He encourages counselors to practice empathy by putting themselves in their client's shoes and by trying to truly understand where the client is coming from. Afterward comes the expression of that empathy through reflective listening.
Support Self-Efficacy - MI asserts that there are as many ways to change as there are problems and clients. Counselors should hold clients responsible for their choices and remind them that if one plan does not work, they are limited by only their creativity to find another. Clients must believe that change is possible, as well as be willing to try various options while working to change their life.
Roll with Resistance - In the spirit of reducing conflict, counselors should not fight against a client's resistance, but rather lean into it. This may not feel like the typical client/counselor relationship. Instead, the counselor simply acknowledges a client's resistance and allows the client to find their own solutions to the perceived problems.
Develop Discrepancy - Ambivalence, or having mixed or contradictory ideas and feelings about something is at the core of MI. Following the spirit of Motivational Interviewing, Counselors should help their clients identify areas of ambivalence. Leading clients to see how current behaviors may be pulling them away from future goals is what MI is all about. This creates real change in a client's way of thinking and decision-making.
Motivational Interviewing Strategies
Below are a few of the proven strategies used by counselors who practice successful Motivational Interviewing:
- Open-ended questions - Questions should require more than a "yes" or "no" answer. For example, "What brings you here today?", "Why do you think you feel this way?", or "How have you been able to stay sober in the past?"
- Affirmations - Sincere affirmations can help build strong relationships between counselors and clients.
- Reflective listening - This is a technique where the counselor repeats back what they think the client is saying or feeling, to both check and deepen their understanding of the client's thoughts. A counselor may reflect, question, or summarize what they have heard from the client.
What Conditions Can Motivational Interviewing Treat?
Motivational Interviewing has proven to be particularly effective for substance abuse disorders. Often those with addictive tendencies have a difficult time correlating in-the-moment decision making, such as getting high or having a drink, with long-term consequences, such as losing custody of children or poor long term health. MI helps lead a client to see these conflicting goals and actions and allows them to create a self-directed plan for change.
Other challenges that Motivational Interviewing has been shown to be particularly helpful with include:
- Weight Loss
- Medication Adherence
Who Does Motivational Interviewing Work Best For?
Motivational Interviewing can vary in effectiveness depending on the person and their particular needs. Because MI is specifically non-confrontational, it can work well for clients who struggle with anger or low self-esteem. Motivational Interviewing also works well for those who are having trouble finding the motivation to begin their journey toward change.
If Motivational Interviewing seems like a tool that would bring about positive change in your life, consider reaching out to a licensed therapist today. If you've got a busy schedule or want to avoid an additional commute to a therapist's office, consider using an online platform like BetterHelp. BetterHelp's counselors are available to help you from the comfort of your own home. Below are two reviews of BetterHelp counselors from people who have been helped.
"Erika is not just amazing, she is a game changer! I was struggling with lots of negative thoughts and procrastination that was paralyzing me but since I started my sessions with her, I have had breakthroughs. Every time I see her, something miraculous happens. I feel more energetic, clearer and motivated to continue the process of growing and changing. I definitely recommend her. She truly cares and brings tons of positive vibes into the sessions."
"Neville is a great listener and for the first time in my life I feel understood by someone. He knows my concerns and he knows how to get myself able to fix them. He's motivating me to get myself up again and try more and more, at least with babysteps. That's what I call a friend."
Motivational Interviewing has made a difference in the lives of many. It's a gentle, yet effective, therapy approach that brings about positive changes in the lives of people who use it. If MI seems like something that would benefit your life, reach out to a counselor today. You can move forward, accomplish your goals, and live a happy and healthy life no matter how many times you've set out and failed before. With the correct tools, you can achieve anything you set your mind to. Take the first step today.