About Motivational Interviewing  

Motivational Interviewing is an evidence-based client centered, yet directive consultation style that employs skillful listening to create a collaborative relationship within which the practitioner can skillfully use directive listening techniques to both address client reluctance to change as well as to elicit and elaborate the client’s often very personal motivations to initiate and persist with behavior change (Miller & Rollnick, 2002; Rose, Philips, & Welch, 2006).

MI is grounded in the following principles:

1. Motivation, or readiness to change, is better considered an ever-changing state rather than a static personality trait (i.e., the individual is neither motivated nor unmotivated). Clients enter a behavior change consultation with a certain range of motivation, and the activity of the interviewer serve to increase or decrease the individual’s readiness to change. Motivation, therefore, can be considered a product of the helping relationship.

2. Accordingly, the practitioner’s interviewing style determines, to a large extent, an individual’s readiness to change, and in turn, significantly impacts long-term behavior change. Practitioners who employ confrontational or “top-down” techniques tend to increase their client’s resistance; conversely, the use of empathic listening decreases resistance and increases readiness to engage in behavior change conversations.

3. Ambivalence regarding change is a normal aspect of the process of behavior change. Whatever the target behavior, one can anticipate that the client will have reasons to both sustain (i.e., status quo talk) and to change (i.e., change talk). Furthermore, there are almost always compelling, albeit short-term and often idiosyncratic, reasons not to change.

4. It is only human to defend the other side of the ambivalence. If we argue for change, our clients naturally will argue against change. The stronger one pushes for change, the more forcefully the other individual will articulate the argument for staying the same. This is human nature. Impassioned arguments by the consultant for change often undermine the client’s investment in the change process. This tendency to use direct persuasion and “take up” the argument for change is called the “righting reflex.” The efficacy of direct persuasion as a motivational tool is inversely correlated with the client’s level of ambivalence; the more ambivalent the client, the less likely is direct persuasion to be effective.

5. To help individuals argue the case for change, we must understand, accept, and otherwise acknowledge the argument for not changing. The righting reflex often increases client resistance to change.

6. People commit to change more readily when they have convinced themselves that they are better off changing. There is much truth to the idea that one can convince oneself of anything, if the case is stated thoroughly enough. Therefore, the ultimate goal of MI is to create a situation in which individuals persuade themselves to change, rather than having the clinician doing all of the persuasion.

7. Consistent with an active, client-centered approach, clients decide what behavior to focus upon and what goals, if any, to set. Practitioners provide information and options, but leave decision-making to the client.
   

© Gary S. Rose, Ph.D. 2003-2006

Gary Rose, Ph.D. | Tel: 978 250-8400 | 229 Billerica Rd | Chelmsford, MA 01824