The BestNotes blog has been exploring different types of therapy used by addiction treatment and behavioral health providers. This time, we’re looking at motivational interviewing (MI).
Motivational Interviewing Overview
MI is a type of counseling that helps individuals resolve conflicting beliefs or feelings that have prevented healthy behavioral changes. It can be applied to individuals who are unmotivated, unwilling, or unprepared to make necessary changes in their lives.
Rather than trying to compel or direct clients toward changing their behavior, a therapist or counselor uses MI to guide a patient or client through their feelings and help them examine the need for change. Clinical psychologists William R. Miller and Stephen Rollnick are often credited for helping to develop this approach.
Who Motivational Interviewing Is For
According to some sources, MI was originally developed to address people struggling with alcohol problems. However, MI can help many other individuals who struggle to make necessary changes in their lives, including those with:
Addiction and substance abuse
Behavioral and mental health concerns
Chronic physical conditions, such as diabetes or asthma, that often require lifestyle changes
What Motivational Interviewing Involves
MI counseling involves a few basic ideas and assumptions:
Ambivalence toward one’s substance use, or changing substance use, is normal and common
Counselors can help individuals resolve their ambivalence by exploring and addressing their individual, inner motivations and values
The counselor and the patient are allies and equal collaborators in the counseling process
Change is most likely when the counselor is empathic, supportive, and yet directive, without arguing or confronting aggressively, which may make patients defensive and so hinder their progress
In their book, Motivational Interviewing: Preparing People To Change Addictive Behavior, Miller and Rollnick note that MI should involve persuasion and support, not coercion and arguments. They write, “The motivational interviewer must proceed with a strong sense of purpose, clear strategies and skills for pursuing that purpose, and a sense of timing to intervene in particular ways at incisive moments.”
During MI sessions, the counselor or motivational interviewer will encourage the patient to talk about their need to change their behavior and why they want to change. An MI clinician should take care to use reflective listening and empathy to help the patient see the discrepancy between their goals or values and their current behavior.
How Motivational Interviewing Works
MI aims to help increase a person’s motivation to change, and then encourage them to commit to change. By helping a patient explore their conflicting feelings and the necessity for change, MI can help encourage self-efficacy and optimism.
While the effectiveness of MI therapy needs more research, existing studies have shown positive results. One study of MI found that it “outperforms traditional advice giving” for several diseases and behavioral health issues.
While it can be combined with other types of therapies, including cognitive therapy and support groups, MI is usually short-term. In many cases, only one or two sessions may be needed.
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