Motivational Interviewing

We offer a mindfulness-based approach to mastering the skill of Motivational Interviewing (MI), which includes in-person training in mindfulness-based Motivational Interviewing skills; ongoing guided skills practice; systematized coding, analysis and critiquing of  client session tapes; onsite and telephone coaching; and online and in-person communities of practice.  Our programs are customized to the specific needs of the client or corrections agency.

Motivational Interviewing is a collaborative, person-­‐centered form of guiding to elicit and strengthen motivation for change

Motivational interviewing (MI) refers to a counseling approach in part developed by clinical psychologists Professor William Miller, PhD and Professor Stephen Rollnick, PhD.  The concept of motivational interviewing evolved from experience in the treatment of problem drinkers, and was first described by Miller (1983) in an article published in Behavioural Psychotherapy. These fundamental concepts and approaches were later elaborated by Miller and Rollnick (1991) in a more detailed description of clinical procedures. Motivational interviewing is a semi-directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with non-directive counseling, it is more focused and goal-directed. Motivational Interviewing is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior. The examination and resolution of ambivalence is a central purpose, and the counselor is intentionally directive in pursuing this goal.

 

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.

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. In order for a therapist to be successful at motivational interviewing, four basic skills should first be established. These skills include: the ability to ask open ended questions, the ability to provide affirmations, the capacity for reflective listening, and the ability to periodically provide summary statements to the client.

Motivational Interviewing is considered to be both client-centered and semi-directive.

It departs from traditional Rogerian client-centered therapy through this use of direction, in which therapists attempt to influence clients to consider making changes, rather than non-directively explore themselves.

MI: Four General Principles

Express Empathy

Empathy involves seeing the world through the client’s eyes, thinking about things as the client thinks about them, feeling things as the client feels them, sharing in the client’s experiences. Expression of empathy is critical to the MI approach. When clients feel that they are understood, they are more able to open up to their own experiences and share those experiences with others. Having clients share their experiences with you in depth allows you to assess when and where they need support, and what potential pitfalls may need focused on in the change planning process. In short, the counselor’s accurate understanding of the client’s experience facilitates change.

Develop discrepancy

This guides therapists to help clients 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). MI counselors work to develop this situation through helping clients examine the discrepancies between their current behavior and future goals. When clients perceive that their current behaviors are not leading toward some important future goal, they become more motivated to make important life changes. Techniques used can include decisional balance sheets.

Roll with resistance

In MI, the counselor does not fight client resistance, but “rolls with it.” Statements demonstrating resistance are not challenged. Instead the counselor uses the client’s “momentum” to further explore the client’s views. Using this approach, resistance tends to be decreased rather than increased, as clients are not reinforced for becoming argumentative. MI encourages clients to develop their own solutions to the problems that they themselves have defined. In exploring client concerns, counselors may invite clients to examine new perspectives, but counselors do not impose new ways of thinking on clients. Rolling with resistance allows therapists to accept client reluctance to change as natural rather than pathological.

Support self-efficacy

This guides therapists to explicitly embrace client autonomy (even when clients choose to not change) and help clients move toward change successfully and with confidence. As clients are held responsible for choosing and carrying out actions to change in the MI approach, counselors focus their efforts on helping the clients stay motivated, and supporting clients’ sense of self-efficacy is a great way to do that. One source of hope for clients using the MI approach is that there is no “right way” to change, and if a given plan for change does not work, clients are only limited by their own creativity as to the number of other plans that might be tried.