Motivational Interviewing: A Counseling Method that Enhances the Motivation to Change

What is Motivational Interviewing?

Motivational interviewing (MI) is an evidence-based approach to therapy that aids in bringing about change in a person’s life and mental health. Therapy works best when the therapist and client have built a great rapport and work as a team to create positive change, so the collaborative approach of motivational interviewing piques the interest of many. In contrast to other therapy styles, MI takes neither a directive “doctor-patient” approach, in which a therapist tells a client what to do to feel better, nor a talk therapy approach with a “blank-slate” therapist who’s mainly there to listen. Therapists who use MI are somewhere in the middle and are more of a guide.

Imagine you are traveling to a foreign country where a relative or long-distance best friend lives. The excited explorer in you has some idea of the things you want to do and places you want to see. However, as a foreigner, you might not know about the country’s hidden gems or the safest and most efficient ways to get around. Your friend who’s been living there for the past ten years probably does. When exploring, this friend is not just there to follow your every move or create your exact itinerary. What your friend might do is listen to your wants and needs to suggest options for you to achieve your travel goals—guiding you according to his or her experience in the country.

How to become a successful MI therapist?

Four fundamental elements that make up the spirit of MI are collaboration, acceptance, evocation, and compassion. Additionally, there are four more techniques commonly known by the acronym OARS to convey this spirit: open-ended questions, affirmations, reflections, and summaries.

Spirit of MI

Collaboration: People are the experts of their own lives. Therefore, the responsibility of changing and decision-making cannot fall on anyone but them. The therapist’s role in MI is to guide and help “brainstorm” the options for change.

Evocation: This is the notion that people have within them what it takes to change their problems. They might not know this because it is buried deep within them. The MI therapists’ job is to help individuals dig within themselves to uncover their reasons and skills to change.

Acceptance: MI therapists must learn and understand the individuals before them without the urge to “fix” or “demand” change. The practitioner empowers clients by emphasizing their autonomy and respecting their right to make choices and changes.

Compassion: This is the commitment to prioritize clients’ welfare above all else. Through understanding clients and their experiences, the MI therapist “suffers with” them instead of placing judgment on their actions or lack of actions.

OARS Technique

Open-ended questions: These are questions that aid both practitioner and client. For the MI therapist, open-ended questions aid in the learning and understanding of clients and their experiences. For clients, open-ended questions invite introspection as they explore the depths of their minds and past experiences. Open-ended questions differ from closed-ended questions, which can be answered with a simple “yes” or “no.” Open-ended questions tend to start with the words “what,” “how,” or “why.”

Affirmations: These are statements generated by the therapist that show support, appreciation, and respect. To form them, therapists identify the effort and strength they see in clients, often using “you” instead of “I.”

Reflections: With a reflection, you can capture the essence of what clients tell you and give them the words they might have had difficulty expressing themselves. For example, when a client who’s been struggling with addiction for years says something along the lines of “I’ve done everything I can to overcome this,” head bowed in shame, you might offer a reflection by saying, “it sounds like you may feel defeated.”

Summaries: Sometimes, clients who have developed trust and rapport with a therapist can unload a great deal of information all at once. Summarizing what they’ve shared shows you are listening while also providing clarity, which is essential for the “brainstorming” part of MI.

To wrap up, I think of MI as an ongoing conversation about change. Using the 8 essential elements of MI above will help you engage your clients in what is known as “change talk,” where clients get started on the changes they want to make. When clients engage in “change talk,” you, the MI practitioner, will learn their considerations for change, their commitment to the change, and their motivation for the change. This is paramount in MI, as simply talking about changing in combination with receiving support, empathy, and guidance can be sufficient in creating meaningful advances towards their goals.

If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialists can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.

Contact a Resource Specialist

About the Author: Maria Morales has been devoted to the mental health field for the last 10 years. She received her Master’s in Mental Health Counseling and Wellness from New York University and has since worked with teens and adults suffering from anxiety, trauma, and depression. Maria is passionate about understanding societal trends and the impact they have on our collective mental health. To work with Maria to improve your mental health, please visit https://www.feelinggoodcenter.com/

References

Miller WR, Rollnick S. Ten things that motivational interviewing is not. Behav Cogn Psychother. 2009 Mar;37(2):129-40. doi: 10.1017/S1352465809005128. PMID: 19364414
Miller, W.R. & T.B. Moyers (2017) Motivational Interviewing and the clinical science of Carl Rogers. Journal of Consulting and Clinical Psychology, 85(8), 757-766
Sheftel, A. (2013). YTP and the Motivational Interviewing Approach. Youth Transition Program. https://ytp.uoregon.edu/content/motivational-interviewing

Resources to Recover and Our Sponsor Laurel House Celebrate Black History Month

February is Black History Month, a time for celebrating the outstanding achievements of Blacks and African Americans and their central role in US history. It is also a time to recognize the struggles Black people have faced throughout our nation's history and give tribute to the strength and resilience of generations of Black Americans who have risen above adversity.

Black History Month originated from an idea by Harvard-educated historian Carter G. Woodson, who wrote the Journal of Negro History in 1916 to herald the achievements of overlooked African Americans in US history and culture. In 1926 he led an effort by the Association for the Study of Afro-American Life and History (ASALH) to officially declare the second week of February as "Negro History Week." These dates align with the birthdays of two crucial figures in Black American history: Abraham Lincoln (February 12, 1809), who signed the Emancipation Proclamation officially ending slavery in the United States, and the Black American abolitionist and author Frederick Douglass (February 14, 1818), who escaped from slavery to become one of the most influential civil and human rights advocates of the 19th century. In 1976, President Gerald Ford gave official governmental recognition to the observance by declaring February "Black History Month."

Without the contributions of Blacks and African Americans to more than 500 years of US history, culture, entertainment and the arts, science, athletics, industry and the economy, public service, and the Armed Forces, we would not be the country we are today.

Photo by SHVETS production: https://www.pexels.com/photo/crop-psychologist-supporting-couple-during-appointment-7176301/

The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.