All about Motivational Interviewing.

What is Motivational interviewing?

Motivational interviewing was created by Miller and Rollnick in the 1980’s. More than 80 randomized clinical trials have been published demonstrating its effectiveness in changing unwanted behaviors. The number of publication is doubling every two-three years in the past decade (Moyer, Miller 2006).

Motivational interviewing helps to change behaviors by exploring ambivalence to change (Parson, Rosof et al. 2005). Motivational interviewing is defined as “directive, client centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence (Rubak, sandboek et al., 2004)”. 

Motivational interviewing is a client centered approach, however, unlike Rogerian treatment (which is more open ended), MI is more goal directed. Motivational interviewing emphasizes the use of open ended questioning and a communication style to help foster changing results while respecting a clients autonomy and self determination (Resnicow, McMaster 2012).

Change

Motivational interviewing puts a focus on change as a normal human development and growth: change can move forward, fall back or stop periodically and then continue moving forward. There are three main components to motivational interviewing: 1. Collaboration, 2. Evocation and 3. Autonomy. Collaboration suggests teamwork between the therapist and client and working together to accomplish goals. Evocation refers to building on the clients intrinsic motivation for change. Autonomy suggests a clients right for self determination and direction (Kress, Hoffman 2008). 

Five stages of change

Motivational interviewing is composed of five stages of change: precontimplation, contemplation, preparation, action and maintenance. Precontimplation suggests an unwillingness or lack of recognition or denial that there is a problem. Contemplation involves a consideration to change using a pros and cons measure. Cons suggest consequences of the behavior. Preparation implies a determination in the form of a commitment in the future to change. Action suggests the change steps have begun to take place.  Maintenance occurs 3-6 months after the change. Maintenance involves lifestyle modification to avoid relapse (Shinitzky, Kub 2001). 

References

Rubak, sandboek et al., (2004), Motivational Interviewing, British Journal of General Practice, UK, P. 305-312

Miller, W. R., & Moyers, T. B. (2007). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions, 5(1), 3-17.

Ken Resnicow and Fiona McMaster. Motivational Interviewing: moving from why to how with autonomy support. International Journal of Behavioral Nutrition and Physical Activity 2012, 9:19 Available online: http://www.ijbnpa.org/content/9/1/19.