Understanding Motivational Interviewing

What is Motivational Interviewing (MI)?

Motivational Interviewing (MI) is a therapeutic approach to exploring an individual's own motivation to change. Developed by William R. Miller and Stephen Rollnick, this client-centered counseling method was particularly effective with people who show ambivalence about making behavioral changes, such as in overcoming addictive behavior or in managing mental health problems.

In contrast to externally supplied directives, MI focuses on an examination of the feelings and desires of clients themselves to promote responsibility for their actions. Motivational interviewing techniques have proven very effective in changes in behavior, such as smoking cessation and weight loss, and even reducing alcohol consumption.

Core Principles of Motivational Interviewing

Motivational interviewing therapy is built on four core principles that help develop the counselor and client's trust or collaboration. These include:

• Express Empathy

The use of MI was based on empathy. Counselors try not to be judgmental of the client yet trying to understand their take and establish a safe place in which the client can freely open up about his or her issues and problems.

• Support Self-Efficacy

MI is based on the principle that all clients possess the potential for change. Counselors enhance this phase by making clients aware of their strengths, skills, and past successes. This makes them confident in their ability to make durable changes.

• Develop Discrepancy

The client is then motivated when they can acknowledge where they are compared to where they may wish to be. The counselor guides the client in reflecting on important values and goals, therefore pointing out the discrepancy between their current behavior and desired outcomes.

• Rolling With Resistance

Resistance to change is expected. Rather, MI therapists do not argue or debate but explore the client's perspective and their ambivalence in order for the client to reach a resolution which is consistent with their goals.

The Spirit of MI

By nature, the essence of motivational interviewing is collaborative and empowering in approach; hence, it is often referred to as the "spirit" of MI.

Cooperation, Not Confrontation 

In MI, the therapist and client work together as partners. The counselor supports the client with their own interests in making changes and develops a trusting relationship in which open communications are promoted. This approach, by being non-confrontational, allows the clients to take responsibility for recovery.

Evocation Rather Than Education

Unlike the traditional approach, where most of the leading is done by the counselor for the client, MI elicits the client's own reasons for change. This principle leads to the belief that long-term behavioral change comes from within. The counselor is supposed to help the clients realize their intrinsic motivation and use these as driving forces toward recovery.

Autonomy Over Authority

MI leaves one thing crystal clear: the power to change is with the client, not with the therapist. Self-empowerment reassures them about being responsible for themselves and, more importantly, reinforces in their minds that the journey towards recovery sits within their hands.

At Nuview, our team of professionals in motivational interviewing therapy inspires the clients to make choices toward recovery while letting the treatment be a process that upholds the respect of individual journeys.

The Four Processes of MI

At the core of Motivational Interviewing (MI)  is a set of four processes that guide the conversation between the therapist and client. These processes allow the client to progress and develop motivation and commitment to change:

• Engaging

The foundation of MI involves the establishment of a positive and productive client-counselor relationship. The process encompasses concentrated listening, validation, and affirmation of the experiences and autonomy of the client. Engagement helps in developing trust that is necessary for meaningful progress.

• Focusing

Once relationship building has occurred, the identification of a mutual agenda for change is formulated. Client and counselor collaborate in setting goals and defining areas of focus to be addressed. This keeps the client's needs and concerns at the forefront and provides direction for the conversation.

• Evoking

At this stage, the counselor empowers the client to start thinking about their own reasons for change. The therapist evokes the client's own motivations for change and resolves ambivalence by helping the client name and identify why they want to make changes in their life. Evoking gives the clients the green light to make the first step towards change.

• Planning

This is the last stage and entails the compilation of a concrete plan of change. Not all sessions require planning, but when the client is ready, it is a start to solidify commitment and outline specific steps toward change based on the client's insights and readiness.

Techniques Used in Motivational Interviewing

Therapists use a range of motivational interviewing techniques in order to guide clients toward positive change:

1.) Open-Ended Questions

Open-ended questions allow for deeper reflection and give the client an opportunity to express themselves. Rather than a simple yes or no answer, these questions call for more significant responses. Examples of these include:

• How would you like things to be different?
• What have you done in the past when problems arose?"

2.) Affirmations

Affirmations acknowledge the strengths of the client and the successes from the past, which reassure him that he is capable of bringing about positive changes. This instills self-esteem and confidence. An example of this is:

• You have faced this challenge with a lot of strength and perseverance.
• It took a lot of courage to come for help today.

3.) Reflective Listening

Reflective listening assures the client that they have been heard and understood. Reflecting back what the client says helps to clarify thinking and feelings. For example,

• It sounds like you're feeling quite undecided about what to do next.

4.) Summaries

Summaries are used to help the client put himself together and gather their thoughts and ideas. They give a clear overview of what has been discussed. The client sees what progress has been made during the conversation and prepares him for what will follow.

What Motivational Interviewing Can Help With?

Initially, motivational interviewing was developed to help individuals with substance use disorders. In time, the focus has expanded as this method becomes widely used in treating other health behaviors and mental health conditions, which include :

• Diabetes management: Helping the patients make life changes to better manage their disease.
• Diet and obesity: Supporting individuals to make healthy food choices.
• Physical activity: Encouraging more regular exercise on a frequent basis.
• Smoking cessation: It helps in reducing or quitting smoking.
• Cognitive Behavioral Therapy (CBT) support: Improve access and delivery of CBT for anxiety disorders, including posttraumatic stress disorder (PTSD).

Nuview allows clients to take ownership of their recovery process through motivational interviewing techniques across the spectrum of treatment programs.