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Motivational Interviewing: Empowering People to Change

     

Motivational interviewing is a counseling technique to help people change behaviors. It involves “collaborative conversation to strengthen a person’s own motivation for and commitment to change.”

It was initially developed in the early 1980s by psychologist William R. Miller to help people with substance use disorders. It has evolved since and is used in many other circumstances, such as managing symptoms of mental illness, changing diet or exercise.

Motivational interviewing can help people when they are uncertain about making a change and can help them move forward. It focuses on a person’s own values and concerns and can help a person build confidence about the ability to make change and strengthen commitment to change.

Carla Marienfeld, M.D., and colleagues, authors of “Motivational Interviewing for Clinical Practice,” describe it this way: “Instead of repeatedly asking closed questions, telling patients what to do, or confronting patients who do not follow your recommendations, MI uses a combination of open questions, reflection, affirmation and summaries to engage the patient in treatment, as well as giving information and advice in a respectful and collaborative manner.”

The ideas about change and the actions for change come from the individual, rather than a provider telling a person changes he/she should make. For example, in the case of quitting smoking, a traditional approach might mean confronting the individual and focusing on the negative health effects of smoking. A motivational interviewing discussion would use open-ended questions to draw out the individuals concerns and motivations, such as rather than concerns about his/her own health, focusing on the person’s concerns about smoking around his children. The discussion could then focus on specific actions building on that motivation and leading to reducing and quitting smoking.

Extensive research supports the effectiveness of motivational interviewing. Hundreds of studies have found motivational interviewing to be effective for reducing substance use and gambling and improving behavioral and psychiatric health, diet and exercise and managing chronic disease.

Some basic conversational techniques are used in motivational interviewing discussions include:

  • open-ended questions – inviting the person to think about an issue
  • affirmations – recognizing a person’s strengths that can support change
  • reflections – or reflective listening, acknowledging what the person has said
  • summaries – pulling together discussion that has occurred in the session

The motivational interviewing approach can be integrated with other types of therapy, such as cognitive behavior therapy. It can be used to help with management of medication for mental health disorders and it can also be used in group therapy.

The basic concepts of motivational interviewing, understanding and tapping into a person’s motivation to help make a change, can be used by anyone in many common everyday situations. If you’d like to learn more, see the resources below.

Resources/References

  1. Motivational Interviewing www.motivationalinterviewing.org. Hosted by the Motivational Interviewing Network of Trainers
  2. Fact sheet: Definition of Motivational Interviewing. From the University of Massachusetts
  3. Marienfeld, Carla, et al. Motivational Interviewing for Clinical Practice: Just Do It. Psychiatric News. March 1, 2017.
  4. Levounis, P, Arnaout B, Marienfeld, C. 2017. Motivational Interviewing for Clinical Practice. American Psychiatric Association Publishing.

     

AnxietyDissociative DisordersADHDBipolar DisordersIntellectual DisabilitySleep DisordersDepressionPatients and FamiliesHoarding DisorderGender DysphoriaOCDPersonality DisordersEating DisordersGambling DisorderSpecific Learning DisorderSomatic Symptom DisorderPostpartum depressionAddictionPTSD

 

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