Motivational Interviewing - What Is It And How Can It Change Your Life?
By Sarah Fader
Updated May 09, 2019
Reviewer Wendy Boring-Bray, DBH, LPC
Most of us have aspects of our lives where we would like to make changes. Maybe you want to be better at managing money or hope to make real improvements to your lifestyle in order get healthy. Perhaps you have a serious health condition like diabetes or high blood pressure that needs managing or are struggling with addiction a substance abuse disorder. Does hoarding or gambling control your life and keep you from doing the things you want to do?
Whether you're looking to make a small change or to turn your life around, Motivational Interviewing (MI) may help set you on the right path even when other counseling techniques have failed. As its name implies, Motivational Interviewing helps those struggling to find the motivation to make important changes in their lives.
What Is Motivational Interviewing?
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 is now a tested and proven method of counseling show to be effective for a wide variety of conditions.
In their 1995 article in Behavioral and Cognitive Psychotherapy, "What is Motivational Interviewing?", Miller and Rollnick define MI 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 internal motivation for change through empathy with the client's situation, acknowledgment of how difficult making life change is, and client-oriented goal setting.
The counselor helps the client identify whether his current actions are taking him closer to or farther away from his stated goals. Essentially, a counselor leads a client to see how negative behavior is at odds with desired outcomes without creating tension or confrontation. This type of counseling focuses on being completely non-confrontational.
The Spirit Of Motivational Interviewing
Many scholarly articles about MI focus on what is referred to as, "the spirit of Motivational Interviewing." This is not a prescription for how to practice MI, but rather a change of framework or frame of mind in which a counselor or therapist 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 it 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 change.
- 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 push the client toward a certain path, but rather the counselor should ask questions to help lead the client to his or her 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 built on trust and understanding that life change is difficult and not always perfect.
Motivational Interviewing Principles
As stated above, Motivational Interviewing isn't a perfect list of techniques, but there are recommended principles and strategies to help a counselor follow the spirit of MI.
Express Empathy - Miller says, "The 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 trying to truly understand where the client is coming from and then expressing 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 a client that if one plan to change does not work, they are only limited by their creativity to find another. Clients must believe that change is possible. If they do, then they will be more likely to continue trying new options and plans.
Roll with Resistance - In the spirit of reducing conflict, counselors should not fight against a client's resistance, but rather lean into it. This should not feel like the typical client/counselor relationship where the counselor prescribes solutions or challenges incorrect ways of thinking. Instead, the counselor simply acknowledges a client's resistance and allows the client to find his or her solutions to perceived problems.
Develop Discrepancy - Ambivalence, or having mixed or contradictory ideas and feelings about something are at the core of MI. Following the spirit of MI, Counselors should help their client identify areas of ambivalence. Leading clients to see how current behaviors may lead 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 just a few of the proven strategies used by counselors who practice successful MI.
- Open-ended questions - Questions that require more than a yes or no answer. For example, "What brings you here today?", "Why do you think you feel this way?", and "How have you been able to stay sober in the past?"
- Affirmations - Sincere affirmations can help to build a stronger relationship with a client.
- Reflective listening - This is a technique where the counselor repeats back what he thinks the client is saying or feeling to check and deepen his understanding of the client's thoughts and feelings. A counselor may reflect, question, or summaries what he has 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, like getting high or having a drink, with long-term consequences like losing custody of one's children or severe long-term health outcomes related to substance use. MI helps lead a client to see these conflicting goals and actions and create a self-directed plan to make a change.
Other issues that Motivational Interviewing has shown to be particularly helpful with include:
- Weight Loss
- Medication Adherence
Who Does Motivational Interviewing Work Best For?
Motivational Interviewing can be very useful depending on the person and their particular needs. However, like any counseling, Motivational Interviewing is not a silver bullet that will help every patient overcome every issue.
Because MI is specifically non-confrontational, it can work well for clients who are angry or combative. Counselors lead the client, through empathy and a series of self-reflective questions to conclusions about behavior and consequences.
Research suggests MI works best for those who are having trouble finding the motivation to begin the journey to change their behavior. If a client is already motivated but is just struggling with long-term change, MI may not be as effective.
Motivational Interviewing is a proven counseling method. Working with a counselor experienced in Motivational Interviewing can help those with certain conditions find internal motivation to make long-term change. This is especially true with those struggling with substance abuse disorders, clients who struggle to find a reason to change, or who have had trouble with other, more aggressive methods of counseling.
To find a counselor who will be a good fit for a particular issue, visit www.betterhelp.com/start/ and take a few minutes to complete the therapy match quiz.
Motivational Interviewing. (n.d.). Retrieved January 31, 2018, from https://www.psychologytoday.com/therapy-types/motivational-interviewing
Rollnick, S., & Miller, W. R. (1995). What is Motivational Interviewing? Behavioural and Cognitive Psychotherapy,23(04), 325. doi:10.1017/s135246580001643x
Treatment, C. F. (1999, January 01). Chapter 3-Motivational Interviewing as a Counseling Style. Retrieved January 31, 2018, from https://www.ncbi.nlm.nih.gov/books/NBK64964/
The Pharmaceutical Journal17 MAY 2016 By Alistair Duff Alistair Duff, Gary Latchford (2016, May 17). Using Motivational Interviewing to improve medicines adherence. Retrieved January 31, 2018, from https://www.pharmaceutical-journal.com/learning/learning-article/using-motivational-interviewing-to-improve-medicines-adherence/20200954.article