Motivational Interviewing Information

Motivational interviewing requires collaboration between the counselor and the patient.

Motivational interviewing is a widely used technique used by mental health counselors, psychologists, psychiatrists and researchers. In essence, motivational interviewing incorporates a spirit of collaboration between practitioners and patients and clients in the development of a plan to change behaviors. William R. Miller, a world renowned clinical psychologist, is credited as the developer of motivational interviewing.

Definition of Motivational Interviewing

The concept was developed by W.R. Miller, a clinical psychologist, in his work with alcoholics.

Motivational interviewing enables mental health practitioners to assist their patients to become proactive in embarking on the road to change their lives and behaviors. It is defined by Miller as "a directive, client centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence."

History

Miller, a British-born clinical psychologist, is universally acknowledged and credited as the author and developer of Motivational Interviewing. Stephen Rollnick, Ph.D., assisted him in developing the pioneer work. The technique resulted from Miller's therapeutic experiences with alcohol-dependent clients.

Miller first described the concept in 1983, in an article published in Behavioural Psychotherapy magazine. In 1991, Miller and Rollnick authored "Motivational Interviewing: Preparing People to Change Addictive Behavior," (Guilford Press). Miller serves as Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico.

Applications

Best practices engage the patient as a "co-author" in developing a plan to change his life and behaviors.

Motivational Interviewing techniques are applied and used to form a relationship between the health practitioner and his clients that is collaborative instead of adversarial. The goal is to gain the client's involvement so that the counselor becomes proactively engaged by understanding of why patients need to change their lives, and "co-authoring" the plan to make change happen.

Using Motivational Interviewing relies on practitioners to focus on four central tenets: 1) express empathy; 2) identify discrepancies between the client's current behaviors and her broader goals and values; 3) "roll with" resistance instead of opposing it; and 4) support the client to increase his confidence about the upside and possibilities to change.

Types of Clients

Motivational Interviewing is most often used for clients who are homeless, alcoholic, drug dependent, or drug ambivalent in using prescribed medications correctly.

The "Spirit" of Motivational Interviewing

"Many people are trained to view clients in a paternalistic manner, like they are children. This attitude says that providers always know what is best for a client, says Alan Pickett, a Mental Health Outreach Nurse in Ann Arbor, Michigan. "I may not indulge a choice that is not healthy. But I am not going to stop listening to someone just because he or she is not making decisions that reflect healthy changes."

The "spirit" of motivational interviewing relies on three fundamentals: collaboration, evocation and autonomy. Practitioners develop a spirit of collaborative partnership with the client. Evocation relies on having the client originate and provide the arguments for change. Autonomy requires the practitioner to respect the client's responsibility and freedom of choice.

Additional Best Practices: the DARN-C Strategy

In 2004, Miller and Rollnick developed the DARN-C strategy, with the goal of engaging clients themselves in making their own arguments for change. The acronym stands for: D=Desire: I want to change. A=Ability: I can change. R=Reasons: I should change because. N=I have to change. C=Commitment: I am going to change.

References

• Motivational Interview.org: What is MI?
• Info.Med.Yale.edu: Motivtional Interviewing
• FullSpectrumRecovery.com: Motivational Interviewing
• Homeless.SAMHSA.gov: Motivational Interviewing