William Miller and Stephen Rollnick originally developed the process to help alcoholics overcome their addictions. Since then, it’s been expanded to treat a wide variety of ailments. It’s unique in its focus, empowering people to take charge of their own recoveries.
Key Concepts of Motivational Interviewing
Other therapies can be confrontational, with therapists trying to impose their views on their clients. With motivational interviewing, clients form partnerships with their therapists, who are not seen as an ultimate source of knowledge. Rapport and trust build between the therapist and the client. They’re working together as a team to overcome a problem.
Evoking means “calling out.” Other therapeutic approaches place the therapist in the role of a teacher. Motivational interviewing places them in the role of a guide. They’re not there to tell you what’s wrong with you. Instead, they’re there to help you discover the true motivations behind your actions. The goal is to help the client discover the reasons for their behavior within themselves.
Instead of viewing the therapist as an authority, you’ll view them as a teammate. The goal is to empower clients to take control of their own behavior. This isn’t just self-empowering. It also helps you realize your own responsibility for your actions. In this view, true change only occurs when people want it for themselves.
Principle of Motivational Interviewing
Expressing Empathy
Plenty of people avoid therapy for fear of judgment. They’re worried that therapists will think badly of them or make them feel bad about themselves. Most of them already feel the guilt associated with their behaviors. Motivational interviewing seeks to avoid judging.
Instead, therapists focus on understanding a client’s perspective. They’ve got to surrender judgment to truly put themselves in the client’s shoes. This is also known as empathy. Creating an empathetic space helps clients feel safe, which makes it easier for them to dig deeper.
Identifying Discrepancies
To succeed in recovery, you must begin to understand where you are versus where you would like to be. Your therapist helps you in this process by identifying your core values. You’ll work with them collaboratively to determine your goals, needs, and wants. Developing goals in a trusting environment encourages you to make positive changes.
Reframing to Overcome Resistance
Other approaches might involve explaining how and why you’re wrong for behaving a certain way. Motivational interviewing takes a different approach. The therapist helps you develop a new understanding of yourself. They won’t tell you how to think. They’ll help you understand situations from a new perspective by reframing them.
One example might be when someone is suffering because their romantic partner has been unfaithful. They might’ve felt they were responsible for their partner’s behavior. However, after reframing, they’ll realize it happened because of their partner’s own issues.
Developing Self-Efficacy
Self-efficacy relates to how capable we believe ourselves to be. A self-efficacious person truly believes they can accomplish their goals. Motivational interviewing aims to develop that as the therapist reminds you of your own power.
You’ll have someone to help guide and encourage you throughout the process of therapy. Your therapist will recognize when you’ve made positive changes. At the start, they may have more belief in you than yourself. But this changes throughout the process. By the end, you’ll recognize how powerful you really are.
Techniques Used During Motivational Interviewing
They’ll learn about you through open-ended questions. Then, they’ll support you with affirmations. They express empathy by using reflections. And, they’re able to group information using several summarizing techniques.
Open-ended questions are simply questions without a yes or no answer. They’re meant to get you thinking deeply about things. Usually, they’ll start with the words “how” or “what.” This gives you an opportunity to tell the therapist about yourself. An example of an open-ended question is “What can you tell me about your marriage?”
Affirmations are simple, empowering statements meant to acknowledge your positive behaviors. These help build your confidence in yourself, which is a core part of this process. An example of an affirmation is, “I’m happy that you’re seeking support. That’s not always easy to do.”
Reflective listening helps show you that your therapist is listening to you. Plus, it demonstrates how the therapist is putting forth the effort to understand you. Expressing empathy helps you feel comfortable in a therapeutic environment.
Reflection is the foundation of motivational interviewing, and it’s how therapists express empathy. As the client, you have a chance to correct any misinterpretations.
These skills are collectively referred to as “summaries.” They’re also meant to show you that the therapist has been listening to you.
Collecting lets the therapist reinforce what’s already been said. They might say something like, “From what you’ve said so far …” and then summarize previous statements as they understand them.
Linking helps therapists create associations between different concepts. It can help clients see how different things they’ve said are related. A therapist might say, “Earlier you said … Now you’ve said … Can you tell me more about that?”
Transitioning helps to move the conversation forward. It shows that the therapist has understood what you’ve said so far. It also helps the therapist wrap up a session.
How Is Motivational Interviewing Used?
It can even be used as a supplement to other therapies such as CBT. This type of therapy is great for helping people change how they see themselves. And that’s useful for a lot of things. It can help children overcome their fears. It could be helpful for someone afraid of childbirth, too. You could even use it to help make positive changes in your diet or activity levels.
Motivational interviewing is about learning how to create positive change in your life. Learning to take responsibility for yourself makes many good things possible.
Benefits of Motivational Interviewing
Developing Confidence
Many people who suffer from substance use disorders lack self-confidence. The specific approach used by this therapy tackles that at its core. You’ll work directly with your therapist to become more confident. Building self-confidence makes it easier to believe that you can change.
Building Responsibility
Reframing your situation helps you recognize your own power. Then, you’ll begin to see how you can change your situation. Learning to see your own power makes it a lot easier to create positive change in your life. You’ll want to be more responsible since you’ll feel more capable.
Lowering the Chance of Relapse
Believing you can overcome an addiction is half the battle. Motivational interviewing helps you make that a reality. You’ll develop rapport with your therapist. And they’ll encourage you to build on your progress.
Making Clients More Receptive to Treatment
Other therapies can feel more confrontational. This makes a lot of people avoid them. Motivational interviewing’s unique approach eliminates much of this hesitation. You’ll learn to accept yourself, and you’ll become less afraid of change.
Effectiveness of Motivational Interviewing
However, motivational interviewing may not be the right fit for everyone. If you’re highly motivated already, it might not be as effective for you. Or if you have no desire to change, it could also be less effective.
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MD, Psychiatrist
Dr. Vahid Osman, MD is a psychiatry specialist in Indianapolis, IN.
Dr. Osman completed a residency at Austin State Hospital. He has over 32 years of experience in Psychiatry & Behavioral Health. He is board certified by the American Board of Psychiatry and Neurology.
