What is Motivational Interviewing?

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Motivation to change varies from person to person, from one situation to another, and over time. Some of us are unwilling, others are unable to change, and many are not fully ready.

 

Motivational Interviewing techniques rest on the findings in clinical experience and research that simply show that clients who believe that they can change do so, and “those who are told that they are not expected to improve indeed do not” (Miller, & Rollnick, 2014).

 

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People are better persuaded by the reasons they themselves discovered than those that come into the minds of others. Blaise Pascal

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Motivational interviewing is a patient-centered counselling style based on the principles of the humanistic psychology of Carl Rogers. He argued that for a person to “grow,” we need an environment that provides us with genuine openness that enables self-disclosure, acceptance that includes being seen with unconditional positive regard, and empathy where we feel like we are being listened to and understood.

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Rogers discovered that it was more effective to let clients guide the direction of the process in the person-centered form of therapy.

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The curious paradox is that when I accept myself just as I am, then I can change. Carl Rogers

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Motivational Interviewing (MI) is a technique for increasing motivation to change and has proven to be particularly effective with people that may be unwilling or unable to change.

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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.

Part of the reason was that motivational interviewing accepts that ambivalence about change is a normal human experience and often a necessary step in the process of change.

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Motivational interviewing rests on the assumption that people are ambivalent about change versus weak or resistant to doing so. It’s an optimistic approach to change aimed at resolving this ambivalence through eliciting and reinforcing change talk.

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Change talk is the statements we make that reflect our desire to change, focus on our ability to do so, list specific reasons for change, and express the commitment to change. Studies show that change talk, particularly in clinical settings, has been linked with successful behaviour change (Sobell & Sobell, 2008).

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The only person who is educated is the one who has learned how to learn and change. Carl Rogers

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Motivational interviewing aims to encourage the patient’s autonomy in decision making where the clinician acts as a guide, clarifying the patient’s strengths and aspirations, listening to their concerns, boosting their confidence in their ability to change, and eventually collaborating with them on a plan for change.

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The process consists of engaging patients, deciding on what to change, evoking their reasons for making the change, and agreeing on a concrete plan.

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One relevant psychological theory that explains how and why motivational interviewing works is self-determination theory. 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.

• Another useful theory is that when we hear ourselves talk about change, it tends to increase our motivation. Within motivational interviewing, this is known as “change talk.” An emerging body of research is currently tracking the language that patients use when talking about change, and it appears that change talk predicts better outcomes (Gaume, at al, 2013).

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Finally, it was also noted that practitioners’ behaviour could influence clients’ behaviour in measurable ways. One review of research suggests that minimizing practitioners’ behaviour that is inconsistent with motivational interviewing, such as disagreeing with and confronting clients, has a clear positive influence on outcomes (Gaume, at al, 2013).