Originally developed by Drs. William R. Miller and Stephen Rollnick in the 1980s through their work with people struggling with alcohol use disorder, motivational interviewing (MI) is a person-centered, goal-oriented therapeutic approach designed to help resolve ambivalence and develop the motivation needed to make meaningful changes.
Full Answer
What are the goals of motivational interviewing?
What are the 5 principles of motivational interviewing?
- Express and Show Empathy Toward Clients. ...
- Support and Develop Discrepancy. ...
- Deal with Resistance. ...
- Support Self-Efficacy. ...
- Developing Autonomy.
How to use motivational interviewing to help your clients?
Theory
- Client-Centered. Using an empathetic style of interaction is a fundamental characteristic of motivational interviewing.
- Directive. Although the therapist will be acting in a way that expresses acceptance of the client's behavior, they will also be subtly directing them toward change.
- Exploring and Resolving Ambivalence. ...
What are the six components of motivational interviewing?
What are the basics of motivational interviewing?
- Express and Show Empathy Toward Clients. Counselors or psychologists express and demonstrate empathy when discussing behaviors, thoughts and life events that clients regularly engage in.
- Support and Develop Discrepancy. ...
- Deal with Resistance. ...
- Support Self-Efficacy. ...
- Developing Autonomy. ...
How effective is motivational interviewing?
Motivational interviewing is a conversation style with a strong evidence base for supporting behavioural change in fields as diverse as health, social care, education and criminal justice. It is effective for working with clients who feel ambivalent about ...
Is motivational interviewing a treatment model?
Unlike treatment models that emphasize the counselor as an authority figure, motivational interviewing recognizes that the true power for making changes rests within the client. The counselor cannot demand this change. Put another way, it is up to the client to take the actions necessary to change their behavior.
What are the 4 main processes of motivational interviewing?
The 4 Processes include Engaging, Focusing, Evoking, and Planning. These processes are not linear or a step by step guide to MI. Engaging naturally comes first because you need to have good engagement prior to having a conversation about change.
What are the 5 principles of motivational interviewing?
5 main motivational interviewing styles are the following: expressing empathy, avoiding argumentation, rolling with resistance, developing discrepancy, and sup- porting self-efficacy.
What are the 4 elements of the spirit of motivational interviewing?
The spirit of MI is based on four key elements: Collaboration between the practitioner and the client; Evoking or drawing out the client's ideas about change; Emphasizing the autonomy of the client.
What are the three main areas of planning in Motivational Interviewing?
The “Spirit” of Motivational Interviewing The spirit of MI is based on three key elements: collaboration between the therapist and the client; evoking or drawing out the client's ideas about change; and emphasizing the autonomy of the client.
What are the five stages of change in Motivational Interviewing?
Based on more than 15 years of research, the TTM has found that individuals move through a series of five stages (precontemplation, contemplation, preparation, action, maintenance) in the adoption of healthy behaviors or cessation of unhealthy ones.
What are the 4 general principles of MI?
You will examine the four (4) principles of Motivational Interviewing with a complete investigation into these four principles; express empathy, develop discrepancy, roll with resistance and supporting self-efficacy.
What is the most frequently used technique in motivational interviewing?
One of the biggest techniques used by MI therapists is empathy. The therapist can put themselves in the client's perspective, and this can allow them to see it through their eyes.
What is Mi and oars?
The four core motivational interviewing skills, or OARS, are Open questioning, Affirming, Reflecting and Summarizing (Miller, W. R., & Rollnick, S. 2013). POs can use these essential micro-counseling skills as part of their toolbox, as they are also used in a wide variety of counseling and helping situations.
What is Agenda mapping in motivational interviewing?
Agenda mapping basically means setting the agenda. If you work in any role where you have to collaborate with others to get things done within a certain time limit, then agenda mapping could help you. If you are a doctor, counselor, teacher, mother, father, etc, you could benefit from being effective at agenda mapping.
What are oars in motivational interviewing?
Open questions, affirmations, reflective listening, and summary reflections (OARS) are the basic interaction techniques and skills that are used “early and often” in the motivational interviewing approach.
What are the 4 aspects of acceptance?
Motivational Interviewing breaks acceptance down into 4 components: absolute worth, accurate empathy, affirmation and autonomy support. Absolute worth in the form of unconditional positive regard is the basis of acceptance, this is the notion that all humans deserve our respect and compassion.
Motivational Interviewing Assumptions
Motivational interviewing focuses on resolving ambivalence toward recovery. Ambivalence refers to conflicting emotions about substance abuse.People...
Principles of Motivational Interviewing
Psychologists William R. Miller and Stephen Rollnick helped develop the motivational interviewing approach to counseling. In their book “Motivation...
Types of Motivational Interviewing Techniques
Helping clients find motivation for recovery is easier said than done. Therapists use a variety of techniques to elicit responses that change the w...
Motivational Enhancement Therapy
Motivational interviewing is a broad therapeutic approach to helping clients overcome ambivalence toward change. Motivational enhancement therapy i...
Effectiveness of Motivational Interviewing
The National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration recognize motivational interviewing and moti...
What are the limitations of motivational interviewing?
What are the limitations to Motivational Interviewing? 1 Insurance companies often require mental health interventions to be conducted swiftly, which doesn't always allow for the time needed with this approach. 2 A counselor or mental health professional who is not equipped to "roll with resistance" may grapple with this approach. 3 Motivational Interviewing may not work well in treatment for trauma or depression. 4 The patient needs to be ambivalent about changing their behavior, habits or lifestyle; MI doesn't work well if you're already highly motivated to make a change—or on the flip side, if you absolutely don't believe you have a problem. 5 Time constraints could prevent a therapist from fully adopting the "spirit of MI" if they're managing a high caseload.
What is the counseling approach?
The counseling approach is now also widely used by therapists and health care providers to help patients address eating disorders, thoughts of suicide, smoking, gambling, hoarding, substance use disorder, co-occurring disorders and other chronic medical conditions such as diabetes, cardiovascular conditions and asthma.
What is the action stage?
Maintenance stage. When you understand which behavioral stage you're in—as well as your hesitancy or readiness to change your behavior—you are better positioned to not only find the motivation to change but to maintain that motivation.
What is motivational interviewing?
Motivational interviewing is a counseling approach designed to help people find the motivation to make a positive behavior change. This client-centered approach is particularly effective for people who have mixed feelings about changing their behavior.
What is the spirit of a therapist?
According to Miller and Rollnick, the "spirit" is collaborative, evocative, and honors client autonomy. 1. In order for motivational interviewing to be effective, the therapist must maintain this overall "spirit.".
What is reflection in therapy?
Reflection is a foundational skill of motivational interviewing and how therapists express empathy.
What is collaboration instead of confrontation?
Collaboration Instead of Confrontation. Collaboration is a partnership formed between the counselor and the client. In motivational interviewing, this relationship is based on the point of view and experiences of the client.
Why are people reluctant to go to therapy?
People may initially be reluctant to go to therapy for fear of being judged by their therapist. Some may even feel guilty about their negative behavior, making that judgment valid in their eyes. But judgment is not what motivational interviewing is about.
What is the concept of a counselor drawing out a client's ideas rather than imposing their own opinions?
The notion of the counselor drawing out a client's ideas rather than imposing their own opinions is based on the belief that motivation to change comes from within. As such, it cannot come from the counselor.
What is the first session of counseling?
Prepare for the first session. The first session is usually a clinical assessment. You’ll be asked to complete intake paperwork, similar to what you complete for a medical appointment. The counselor will likely also ask what changes you're hoping to make and your concerns and your overall priorities.
What is motivational interviewing for substance abuse?
Motivational Interviewing for Substance Abuse. People addicted to alcohol or other drugs don’t always recognize the need to stop drinking or using. Some may not realize that they’re addicted. Others may not want to change, or they may not think recovery is possible.
Why is motivational interviewing important?
Motivational interviewing is an important complement to traditional therapies for substance abuse and addiction. Without motivation for change, clients may be resistant to the lessons that rehab tries to teach. Motivated clients are more likely to buy into the rehab process and benefit from other therapies.
What is motivational enhancement therapy?
Motivational enhancement therapy is a specific type of motivational interviewing that involves structured feedback and future planning. Motivational enhancement therapy begins with an extensive assessment of the client’s history of substance abuse and co-occurring mental health issues.
What is the rule of treatment for substance use disorders?
RULE is based on the same principles as motivational interviewing for patients with substance use disorders. Doctors and nurses should avoid telling patients about the “right” path to wellness without ensuring that patients are motivated to change.
What is the relationship between a therapist and client?
The relationship between a therapist and client is a collaborative partnership. An empathetic, supportive and directive approach to counseling can establish conditions for change to occur. Many people who begin treatment with motivational interviewing sessions are in the early stages of change.
Who developed the motivational interviewing approach to counseling?
Psychologists William R. Miller and Stephen Rollnick helped develop the motivational interviewing approach to counseling. In their book “Motivational Interviewing: Preparing People to Change Addictive Behavior,” they outlined five principles that therapists should adhere to.
Is motivational interviewing more effective than traditional advice giving?
A 2005 analysis of 72 randomized and controlled clinical trials that studied motivational interviewing for a variety of lifestyle problems found that motivational interviewing was more effective than “traditional advice giving.”. The review was published in The British Journal of General Practice.
What is motivational interviewing?
One approach to counseling called motivational interviewing emphasizes the importance of a person's motivation for change. Someone who thinks about leaving their job and searching for a new career will likely be wrought with ambivalence. Their thought process might look something like this: Pros of Current Career.
How motivated is a client to make a change?
Ask your client to describe how motivated they are to make a change on a scale of 1 to 10. At 1, they have no motivation to change , and 10 they have no doubt about wanting to change. It can be helpful to present them with a ruler or the linked worksheet to help them visualize the task.
What is client centered interview?
Client-Centered. Using an empathetic style of interaction is a fundamental characteristic of motivational interviewing. This means expressing acceptance toward your client, even if you feel that their behaviors are harming them or their loved ones. You do not need to condone their behavior or agree--just accept.
What is a directive in therapy?
Directive. Although the therapist will be acting in a way that expresses acceptance of the client's behavior , they will also be subtly directing them toward change. This will be achieved by encouraging change talk, which will be described later in the guide.
What is the role of a client in identifying and exploring their values?
Assist a client in identifying and exploring their values to better understand which ones they are living up to, and which they are failing. If a client states that they value family and success, it can be meaningful when they realize these are two areas that are damaged by their drug use.
How to overcome ambivalence?
Directing a client toward change talk will help them overcome ambivalence. Change talk occurs when a client discusses the changes they would like to make in a positive light, such as identifying the benefits of quitting a harmful drug. Listed below are several techniques to help with this process:
What does acceptance mean in therapy?
Acceptance shows your willingness to listen, understand, and to respect your client as a human being. Research indicates that empathic client-therapist relationships have a significant positive influence on treatment outcome (1).
What is motivational interviewing?
Motivational interviewing (MI) is a technique that was developed to address ambivalence and help increase a person’s motivation to change unhelpful or harmful behaviors, such as substance abuse. 1. Additionally, you may come across the term motivational enhancement therapy (MET) in regard to MI since they are often used together or used ...
What is the challenge of a therapist?
The therapist is challenged with first trying to understand where the client stands regarding their perception of their behavior and their need to change it. Once the therapist and client identify this, the therapist can develop a treatment plan to effectively help the client.
How does a therapist use reflective listening skills?
The therapist uses reflective listening skills in order to develop a better understanding of your perspective and experiences by listening to you without judgment, criticism, or blame. Develop Discrepancy: You are guided to think about the different ways your current behavior might impact your future goals.
What is the evoke in therapy?
Evoke: The therapist directs the conversation so that you, not the therapist, are the one making the argument for change. It is called evoke because the therapist asks questions that promote and reinforce your internal motivations to change. Plan: This is the actual “how” of the change process.
What is MI technique?
The major approach used in the MI technique is the transtheoretical model of change that was conceptualized by its originators. This model of change was developed to help a therapist or other clinician to first understand how problematic a person perceives their use of tobacco, alcohol, and/or other substances to be.
Why is MI important?
MI can be useful if you are concerned about your unhealthy pattern of alcohol or substance abuse. It can help you gain clarity or motivation if you’re not entirely sure about the benefits of making changes or if you don’t quite feel ready to change at this point in time. 2.
Is MI effective for alcohol use?
However, MI has demonstrated to be very effective for people who have an alcohol use disorder because it helps them engage in treatment and reduce problem drinking. 2.
What Is Motivational Interviewing?
Motivational interviewing is a counseling technique that helps people with addictions and other behavioral health problems change their behavior. This is on the idea that people are more likely to make changes if they are motivated to do so.
Goal of Motivational Interviewing
The goal of Motivational Interviewing is to help people resolve any ambivalence they have about making changes, and start talking about the changes they want to make.
When To Use Motivational Interviewing?
These are some of the situations in which Motivational Interviewing may be useful:
Principles of Motivational Interviewing
These are some of the principles of Motivational Interviewing as identified by the developers:
Benefits of Motivational Interviewing
These are some of the benefits of Motivational Interviewing for counselors and clients:
Side-Effects of Motivational Interviewing
There are some potential side-effects of Motivational Interviewing that counselors should be aware of:
Conclusion
Motivational Interviewing is very helpful and effective in helping people make changes within various areas of their lives. It offers flexibility and promotes collaboration between the counselor and client. The benefits of this approach include increased motivation, empowerment, and self-efficacy.
What is motivational interviewing?
The Motivational Interviewing (MI) technique was developed as a result of the ambivalence displayed by individuals with substance use disorders to therapists during both the initial assessment of their issues and their treatment. William Miller initially developed some ideas and guidelines for the initial interviews of individuals ...
What is meta analysis in motivational interviewing?
Likewise, meta-analytic studies that investigate the results of numerous individual studies have produced mixed results regarding the efficiency of Motivational Interviewing .
How to motivate a patient to change?
According to the book Motivational Interviewing in Health Care: Helping Patients Change Behavior, when clients are resistant to change, therapists need to be directive but not forceful. In general, the Motivational Interviewing model assumes the following: 1 The therapist should be directive and help the client to examine any ambivalence they have regarding change. 2 The motivation to change is drawn out from the client; it is never forced on the client. 3 Trying to directly persuade the client that they need to change will not resolve their ambivalence toward change; there is also a body of research evidence to suggest this is true. 4 It is the client’s job to resolve their ambivalence toward change; this is not the task of the therapist. 5 The therapist helps the client to examine their ambivalence and to resolve ambivalence regarding change. 6 The readiness to change is not a trait but a result of an interpersonal interaction that occurs with the client and other forces (e.g., a therapist).
What is the role of a therapist in a change process?
The therapist helps the client to examine their ambivalence and to resolve ambivalence regarding change. The readiness to change is not a trait but a result of an interpersonal interaction that occurs with the client and other forces (e.g., a therapist). A therapist using MI techniques attempts to:
What is the initial task of a therapist?
Thus, the initial task of the therapist is to identify where the client stands on their willingness to accept their need for change and their understanding of their issues. Once the person’s starting point is identified, it becomes a matter of adjusting treatment to fit the needs and understanding of the client.
Do people who are in treatment for substance abuse need to change?
Many times, individuals who enter treatment for substance abuse issues do not readily accept the notion that there is something about their behavior that they need to change . Often, these individuals are forced into treatment by family, their occupation, the legal system, etc.
Is motivational interviewing better than no intervention?
The research does most likely indicate that Motivational Interviewing works better than no intervention at all and that MI is a type of intervention that may not be applicable for everyone in substance use disorder treatment, but many individuals may benefit from it.
What is motivational interviewing?
Motivational interviewing is a consensual, negotiated process between the counselor and client. Change talk can occur in several forms and is exemplified by a statement that indicates the desire for, the ability to, the reasons for, and the need to change. Desire statements indicating a desire to make a change:
When was motivational interviewing first used?
Originally used within the setting of alcohol addiction treatment in the 1980s, motivational interviewing encouraged patients to think and talk about their reasons to change. Soon it was discovered that this minimized their resistance and increased their motivation.
Why are open ended questions important in motivational interviewing?
Open-ended questions in motivational interviewing allow us to find out more about the client’s perspective and ideas about change. They are also crucial in building and strengthening a collaborative relationship. Finally, they are also useful in the process of evoking the client’s motivations for change.
What to do when client scores low on self efficacy scale?
If the client scored low on the self-efficacy scale and feels resigned and unable to change, increasing optimism about the possibility of change and focusing on internal strengths are some of the effective methods to encourage change talk and increase belief in one’s ability to change.
What are the three basic psychological needs?
It states that we are more likely to change if our three basic psychological needs are attended to: Autonomy in making decisions. Mastery and a sense of our competence in making the change. Relatedness and a sense of being supported by key people around us, including healthcare professionals.
When a client struggle with seeing the importance of change, it may also help to explore the client’s hopes and
When a client struggle with seeing the importance of change it may also help to explore the client’s hopes and goals by asking the following or similar questions that can lead to the exploration of the WHY of the change:
When a client has a low desire to change, what is the best way to encourage change?
When a client has a low desire to change, exploring the discrepancy between the client’s values and the current state can be an effective method to encourage change talk. Explore the client’s current values by asking the following or similar questions:
What is motivational interviewing?
Motivational interviewing is a powerful evidence-based technique that helps clients talk themselves into making positive changes in their lives. Those who believe they can change are more likely to be successful than those who do not (Miller & Rollnick, 2013).
How to motivate a group?
The following motivation tools and worksheets can help cohesion and effectiveness within a group environment to facilitate helpful discussion: 1 Creating Shapes Exercise#N#Before and during group sessions, the Creating Shapes Exercise can help change the social dynamics and stimulate new interactions. 2 Human Typewriter#N#The Human Typewriter is a communication and sharing exercise that encourages people to break down barriers and get to know each other. 3 Basic Need Satisfaction Through Communication#N#It’s helpful to weigh up the costs and benefits of new behavior using this exercise to bring clarity to decisional conflict. 4 Active-Constructive Responding#N#Sharing positive personal events with others in a group environment can positively influence a sense of wellbeing. Use this exercise as guidance to implement it. 5 Practicing Empathic Listening#N#Listening with empathy can be learned in a group session and encourages careful listening and attendance to what is said by the practitioner.
What does a therapist listen to?
The therapist listens to the answers, affirms, reflects, and summarizes. And only when there are signs of readiness to move forward does the conversation shift to planning. Focus then moves to how to approach a meeting with the boss and adopt new ways to communicate.
What are Desire Questions?
Desire questions typically use words such as want, wish, and like. The replies they generate usually show that a person wants something and are a significant component for change (Miller & Rollnick, 2013):
Can a therapist increase change talk?
While there is no single strategy for increasing the amount of change talk, therapists soon recognize what is (and isn’t) working from the client’s feedback (Miller & Rollnick, 2013). However, there are several techniques the therapist can adopt that will help the client think and talk about the reasons for change.
Theory
Building Motivation For Change
- Initiating Change Talk
Directing a client toward change talk will help them overcome ambivalence. Change talk occurs when a client discusses the changes they would like to make in a positive light, such as identifying the benefits of quitting a harmful drug. Listed below are several techniques to help with this pro… - Building Confidence
Would you like to reach your hands above your head, look up, and fly away like Superman? I'm guessing:yes. Do you believe you can actually do it? Hopefully not. This example illustrates the point that, no matter how badly someone wantsto do something, they won't even try if they don't …
Strengthening The Commitment to Change
- At some point you will recognize that your client has decided to change, and they've built the confidence to do so. Indications of a client reaching this point are decreased resistance, frequent change talk, experimenting with the change (for example, brief periods of sobriety between sessions), or asking questions about how to make the change. During this final stage of treatme…
Other Resources
- Motivational Interviewing: Helping People Change (3rd Edition)is an essential text for any clinician who hopes to use the intervention in their practice.