Summary of Motivational Interviewing (MI)
MI refers to a counseling a counseling approach in part developed by clinical by clinical psychologists psychologists Professor Professor William R Miller, Ph.D. Miller, Ph.D. and Professor and Professor Stephen Stephen Rollnick, Ph.D. Rollnick, Ph.D. MI is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. It is centrally focused on how to support/instigate change. It is a client-centered (as opposed to problem c entered or technique), directive (as opposed to non-directive where you just allow allow person to explore themselves). themselves). Focusing on communication rather than techniques. Motivational interviewing recognizes and accepts the fact that clients who need to make changes in their lives approach counseling at different levels of readiness to change their behavior. MI is an approach that recognizes that change c hange involves a process as introduced in the Transtheoretical model (TTM by DiClemente & Prochaska in 19 85). It was developed initially with addictive behaviors, but is used now in a variety of counseling needs. MI focuses on the idea that motivation is what provides the impetus for the focus, effort, and energy needed to move through the entire process of change.
Stages of Change or Transtheoretical Model change – unaware unaware of the problem Precontemplation - not currently considering change – behavior or are unwilling or discouraged when it comes to changing - ambivalence, resistance INTERVENTION diffuse that resistance in an unthreatening way they are at a point of Reluctance, Rebellion, Resignation, Rationalization these patterns of thinking, feeling, and reasoning helps them not to be ready for change instilling hope and exploring barriers shifting focus, reframing, agreeing with a slight change of direction – direction – rolling with resistance using ‘and’ not ‘but’ reflection using what the CE has stated, using his wo rds
Summarized from “Motivational Interviewing”, Interviewing”, Second Edition by Miller & Rollnick
undertakes a serious evaluation of considerations for or a gainst Contemplation – undertakes change, willing to consider and explore exp lore decisional balance, an error that clinicians often make is thinking that a person who is contemplating change is ready to make a commitment – commitment – this this might not be the case INTERVENTION Exploring the choices
Preparation – planning planning and commitment are secured Action – make make specific behavioral change maintain and sustain long-term change Maintenance – maintain
Each stage requires a different approach and MI is a counseling style that is most helpful in the early stages – stages – precontemplators precontemplators do not want to be b e lectured to or given “action” techniques when they are not ready to change. Contemplators who are considering the possibility of making a change but are not quite ready to make a commitment, are resistant to more traditional approaches that encourage them to make changes for which they are not yet ready, fearful of, or resistant to. If the counseling is mandated, they may never have thought of changing the behavior in question. Some may have thought about it but not taken steps to change it. Others, especially those voluntarily seeking counseling, may be actively trying to change their behavior and may have been doing so unsuccessfully for years. The motivational interviewing approach attempts to increase the client's awareness of the potential problems caused, consequences experienced, and risks faced as a result of the behavior in question. Alternately, therapists help clients envisage a better future, and b ecome increasingly motivated to achieve it. Either way, wa y, the strategy seeks to help clients think differently about their behavior and ultimately to consider what might be gained through change.
Motivational interviewing’s four general principles: 1. Express empathy (Acceptance facilitates change, Skillful reflective listening is fundamental, ambivalence is normal) share with clients their understanding of the clients' perspective 2. Develop discrepancy (The client rather than the counselor should p resent the arguments for change, change is motivated by a perceived discrepancy between present behavior and important personal goals or values)
Summarized from “Motivational Interviewing”, Interviewing”, Second Edition by Miller & Rollnick
appreciate the value of change by exploring the discrepancy between how clients want their lives to be vs. how they currently are (or between their deeply-held values and their day-to-day behavior) 3. Roll with resistance (avoid arguing for change, resistance is not directly o pposed, new perspectives are invited but not imposed, the client is a primary resource in finding answers and solutions, resistance is a signal to respond differently) accept client reluctance to change as natural rather than pathological 4. Support self-efficacy (a person’s belief in the possibility of change is an important motivator, the client, not the counselor is responsible for choosing and carrying out change, the counselor’s counselor’s own belief in the person’s ability to change becomes a self-fulfilling prophecy.) explicitly embrace client autonomy (even when clients choose to not change) and help clients move toward change successfully and with confidence The main goals of motivational interviewing are to establish rapport , elicit change talk, and establish commitment language from the client.
Summarized from “Motivational Interviewing”, Interviewing”, Second Edition by Miller & Rollnick
