motivational interviewing

Motivational Interviewing

Chapter 4What is Motivational Interviewing?

What is Motivational Interviewing?

There is a fundamental spirit of MI that is much more important than any particular set of techniques 

Important aspects of that spirit include collaboration, evocation and autonomy

Collaboration• The counselor avoids an authoritarian

one-up stance, instead communicating a partner-like relationship.

• Exploration and support rather than persuasion or argument

Evocation• The interviewers tone is not one of

imparting things (such as wisdom, insight, reality) but rather of eliciting, or finding these things within and drawing them out from the person

Evocation• It is not an instilling or installing but, rather,

an eliciting, a drawing out of motivation from the person

Autonomy• Responsibility for change is left with the

client• Respect is shown for the individual's

autonomy

AutonomyWhen motivational interviewing is done

properly, it is the client rather than the counselor who presents the arguments for change

There are four general principles of Motivational Interviewing

1. Express empathy2. Develop discrepancy3. Roll with resistance4. Support self-efficacy

Express Empathy• A client-centered and empathic counseling

style is one fundamental and defining characteristic of motivational interviewing

• The counselor seeks to understand the client's feelings and perspectives without judging, criticizing, or blaming

Express Empathy• Acceptance is not the same thing as

agreement or approval• The crucial attitude is a respectful listening

to the person with a desire to understand his or her perspective

Express Empathy• The attitude of acceptance and respect

builds a working therapeutic alliance and supports the client's self-esteem, which further promotes change.

Develop Discrepancy• Motivational interviewing is intentionally

directive -- directed toward the resolution of ambivalence in the service of change

Develop Discrepancy• Motivational interviewing is specifically

directed toward getting people unstuck, helping them move past ambivalence toward positive behavior change

Develop Discrepancy• A second general principle of motivational

interviewing is thus to create and amplify, from the client's perspective, a discrepancy between present behavior and his or her broader goals and values.

Develop Discrepancy• If the behavior gap is very large, it can

decrease motivation by diminishing confidence

Develop Discrepancy• When skillfully done, motivational

interviewing changes the person's perceptions (of discrepancy) without creating any sense of being pressured or coerced.

Develop Discrepancy• People are often more persuaded by what

they hear themselves say than by what other people tell them.

Roll With Resistance• Resistance that a person offers can be

turned or reframed slightly to create a new momentum toward change

Roll With Resistance• In motivational Interviewing one does not

directly oppose resistance but, rather, rolls or flows with it

Roll With Resistance• What to do about a problem, if anything, is

ultimately an individual decision• It is not the counselor's job to provide all

the answers and generate all the solutions

Roll With Resistance• It is assumed that the person is a capable

and autonomous individual, with important insight and ideas for the solution of his or her own problems

Roll With Resistance• Resistance is an interpersonal

phenomenon, and how the counselor responds will influence whether it increases or diminishes

Support Self-Efficacy• Hope and faith are important elements of

change• A general goal of motivational interviewing

is to enhance the client's confidence in his or her capability to cope with obstacles and to succeed in change

Support Self-Efficacy• A person may also be encouraged by the

success of others or by his or her own past successes in changing behavior

Summary• It is vital to understand the overall spirit

and underlying assumptions of the method• Motivational interviewing is a skillfull

clinical method, not a set of techniques that can be easily learned

SummaryMotivational interviewing is more than a set

of techniques for doing counseling.  It is a way of being with people.