What is motivational interviewing?
Motivational interviewing developed from Carl Roger’s person-centred approach to therapy as a way to aid individuals in committing to change. Motivational interviewing is a technique that involves guided communication and effective listening. It is a practical and short-term tool that is underlined by the idiom that individuals have the capacity to change. It empowers individuals and aids them in resolving uncertain feelings and insecurities, by guiding them to find the internal motivation required to change a behaviour.
Motivational interviewing is made up of four principles, which include expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy and reflection. During motivational interviewing the practitioner tries to understand the client’s problem by actively listening in a non-judgemental manner. Individuals may be more inclined to change when they are able to identify that what they are doing does not coincide with what they want, which is where the practitioner will aid the client in developing discrepancy. The practitioner will furthermore try to understand the client’s values and motivation for change by asking open ended questions such as “what changes were you thinking of making?” or “why would you want to make these changes?”. The practitioner may feel inclined to help, especially when the client is engaging in harmful behaviours and so may try to convince the client to change their behaviours. It is therefore important for the practitioner to roll with resistance and resist the urge to convince or point out the harmful behaviour in order to support the self-efficacy of the client. Finally empowerment is a vital element of motivational interviewing as clients are more likely to improve if they take an active role in their treatment.
How does motivational interviewing work?
Motivational interviewing works by increasing the individual’s motivation and by strengthening the individual’s commitment to change. It is often short term, may require one or two sessions, and may be used in conjunction with other interventions such as CBT. The motivational interviewer directs the client to voice their desire to change and the reasons for change, as simply saying these out loud have been proven helpful to increasing motivation and commitment to change. The interviewer’s purpose is to stimulate a supportive and non-judgemental discussion about change and commitment to change. The interviewer does so by listening and reflecting the client’s thoughts back to them, in turn increasing self-efficacy and exploring internal strengths.
What can motivational interviewing be used for?
Motivational interviewing can be used alongside other interventions for eating disorders, anger issues, smoking cessation, addiction and managing physical health conditions such as diabetes, heart disease or asthma. It aids individuals in increasing their awareness and motivation to change behaviours that are potentially harmful to them. It can also prepare them for future therapy. Studies have suggested that this tool works best with individuals that are not motivated for change and is less likely to aid individuals that are already motivated to change.
Is motivational interviewing effective?
There are several studies that have researched the effectiveness of motivational interviewing. Motivational interviewing is an evidence-based technique that has shown promising results in a variety of settings and issues. Goal setting and negotiating a change plan of action is an important factor of the motivation interviewing effectiveness. The therapist will elicit change talk by asking questions exploring the benefits and disadvantages of change, the resources or the intention for change and the optimism for change.
Motivational interviewing has been effective in aiding individuals with addiction, smoking cessation, and physical health conditions such as diabetes, obesity, and pain management. It encourages the client’s autonomy, prevents confrontation, and evokes positivity. It enables clients to feel understood and listened to and promotes them to search for their own solutions, which in turn can have longer term outcomes.
It has been effective in increasing participation in treatment, changing risky lifestyle behaviours, such as alcohol and drug abuse, developing self-confidence, enabling clients in becoming more self-reliant and taking on the responsibility of change. Motivational interviewing has also been proven to be effective in increasing the confidence of health professionals that utilise the tool and as a result improved job satisfaction. To conclude motivational interviewing is an effective tool in increasing commitment to change and has been utilised in several settings with a variety of presentations. Nevertheless, it is not a one size fits all technique and has been ineffective when used with individuals that are already motivated to change.