Motivational Interviewing (MI)
Motivational interviewing is a communication method often used in psychotherapy that focuses on identifying motivations for change and addressing ambivalence many people feel in the process of creating change.
Ambivalence may be confusion, frustration, or resistance in regards to how or when or why to create change. Motivational interviewing is goal oriented in that this approach is often used as a way to help create movement toward a stated goal, regardless of readiness for change. Additionally, goals may shift as the client builds insight into patterns of behavior.
In addressing the ambivalence, the person wanting change can often identify and address barriers they may not have been able to see without conversations focused on change. As the clinician shows acceptance and understanding of the ambivalence and barriers, the client too can grow to understand more about themselves and their change process.
In motivational interviewing, it is imperative that the client direct the speed and direction of change; it is important to note that while this modality focuses on change, it does not “make” anyone change nor is a method of “convincing” a client to change.
In motivational interviewing, clinicians and clients can often use the “stages of change” model to assess readiness for change and target relevant interventions. The stages of change are as follows:
- Pre-contemplative: the person is not currently thinking of creating change
- Contemplative: the person is aware that something is not working for them, that there is some sort of problem, but do not have plans to create change
- Preparation/Determination: at this point, the person had acknowledged that change needs to occur and has intention of creating change
- Action: in this stage, the person has taken action in creating change. They are engaging in a new behaviour in some way
- Maintenance: the action stage has extended; the changes made are stable and the old behaviour is no longer occuring
- Relapse or Termination: depending on the change made and the plans for ongoing efforts, the person either relapses (engages in the old behaviour in some capacity) or terminates the work being done (new behaviour has become such a part of life that intentional efforts are no longer required).
People do not always move through the stages of change in a linear way; oftentimes they move between different stages in different orders. If relapse happens, people may move back into any of the other stages.
This style of communication allows for the person wanting change to explore it in their own way and on their own timing, without being pushed or taking on the clinicians’ perspective of change; in this way, motivational interviewing helps build intrinsic motivation for change, which is often understood as more effective for long term change than extrinsic motivation for change.
Intrinsic motivation for change refers to the concept that the drive for change is internal and personal; external motivation refers to the concept that someone may feel pressured or forced to change because of someone else’s ideas or coercion from someone or something outside oneself.
Additionally, because of the focus of building internal motivation for change, motivational interviewing techniques also often help foster a sense of empowerment and self-acceptance as the client builds internal motivation and insight into their thought processes around change.
Motivational interviewing techniques include a variety of questions and approaches in which the clinician and client work together to uncover new information.
This process is often open ended and explorative as the change itself and its meaning are considered within the context of the client’s life and goals.
Motivational interviewing is also strengths-based in that any development of insight or actual change is celebrated and used to further develop insight.
A strengths-based approach also helps to build the confidence needed for change.
As with many modern approaches to psychotherapy, the client is understood as the expert. Other basic beliefs of motivational interviewing include that the client has a right to make informed decisions, that the client has the resources needed for change within themselves, that that clinician remain non-judgmental, and that the clinician and client mutually share information helpful to the process of change-making.