{"id":21419,"date":"2021-02-24T23:53:41","date_gmt":"2021-02-25T03:53:41","guid":{"rendered":"https:\/\/apn.com\/?p=21419"},"modified":"2022-05-18T18:14:32","modified_gmt":"2022-05-19T00:14:32","slug":"basics-of-motivational-interviewing","status":"publish","type":"post","link":"https:\/\/apn.com\/resources\/basics-of-motivational-interviewing\/","title":{"rendered":"Motivational Interviewing in Therapy: What is It?"},"content":{"rendered":"

Have you tried, again and again, to walk away from drugs and alcohol, and found that you keep going back? Have your friends and family told you over and over again that you just need to stop – until you\u2019re sick and tired of hearing it? Have you ever thought that you just need to have the willpower to stay away from drugs, only to wonder where you\u2019re ever going to find that willpower?<\/p>\n

If you said yes to any of these questions, then Motivational Interviewing<\/a> may be helpful for you. Motivational Interviewing is an evidence-based practice that\u2019s been shown to be incredibly effective in helping people start living an addiction-free life.<\/p>\n

 <\/p>\n

What Is Motivational Interviewing?<\/h2>\n

In short, Motivational Interviewing1<\/sup> is a conversation about change. The conversation is designed to help people get unstuck and take steps towards actually making healthy lifestyle changes once and for all.<\/p>\n

 <\/p>\n

The History of Motivational Interviewing<\/h2>\n

Renowned psychologist Dr. William Miller started developing the practice of Motivational Interviewing2<\/sup>, otherwise known as MI, back in the 1970s. After working in substance abuse treatment for many years, he realized something that many of his clients probably knew all along: the counseling they were receiving wasn\u2019t working. Not only wasn\u2019t it working, but it also often made his clients feel degraded and manipulated, like they didn\u2019t know anything at all about what was best for their own lives.<\/p>\n

Dr. Miller3<\/sup> started to experiment with different ways of interacting with his patients. His therapeutic practice was largely based on Carl Rogers\u2019 work in human-centered therapy, but he realized quickly that human-centered listening alone wasn\u2019t quite enough to guide his patients towards actually giving up drugs and alcohol.<\/p>\n

Together with his colleague Dr. Stephen Rollnick, Dr. Miller developed the practice of Motivational Interviewing in 1983 – which was, at the time, a revolutionary way of treating patients with addiction. Founded in the basic philosophies of Rogerian therapy, MI takes things one step further by using those principles toguidepatients towards making healthy changes in their lives.<\/p>\n

 <\/p>\n

The Basic Principles of Motivational Interviewing<\/h2>\n

Miller and Rollnick taught (and the subsequent research has confirmed) that when practitioners push for any kind of behavioral change, the patient is actually less likely to change at all. MI takes the opposite approach: practitioners treat clients as equal partners and don\u2019t push for anything whatsoever.<\/p>\n

Motivational Interviewing and Autonomy<\/h3>\n

If you\u2019re a human being, you can probably understand intrinsically that pushing for change just doesn\u2019t work. Think about it the last time that someone told you that you had to do something; that you had no choice. How likely were you to do it just because they told you that you had to? Probably not very likely – and you may have even felt less likely to do it after they told you that you had to.<\/p>\n

That\u2019s because our motivation to change is inherently based on choice and ambivalence. No one can make you change; you have to make that decision for yourself, at the end of the day. One of MI\u2019s basic principles is autonomy or the respect for people\u2019s irrevocable right to make their own choices. There might be consequences for those choices, but in the end, you can\u2019t take away people\u2019s right to choose.<\/p>\n

Motivational Interviewing and Ambivalence<\/h3>\n

On top of that, people have their own reasons for wanting to change or not wanting to change. Those reasons may have nothing to do with why you think somebody should change.<\/p>\n

As a case in point, we\u2019ll ask you this: how many of you actually drink 8 glasses of water a day? Eat complete servings of vegetables every day? Exercise at least 20 minutes every day? Maybe some of you do, but likely not all of you.<\/p>\n

That\u2019s because knowing we should do something isn\u2019t the same as actually doing it. And each of us probably has our own reasons for wanting to do some of these things and not wanting to do it. Maybe I\u2019m too busy to get my exercise in, but you simply get bored while you\u2019re on the treadmill.<\/p>\n

That\u2019s what, in Motivational Interviewing, is called ambivalence. Instead of shaming people for feeling ambivalent about making changes in their lives (even important changes like getting off of drugs), MI practitioners accept ambivalence as a natural part of the change process. Ambivalence is worked with, instead of fought against.<\/p>\n

MI practitioners work with ambivalence by using the concepts of change talk and sustain talk. Instead of telling clients why they \u201cneed\u201d to change (we\u2019ll remind you again: no one needs to change), they draw out from within each client their own reasons for wanting to change – even if these reasons are quite different from the practitioner\u2019s reasons. In MI, these reasons are referred to as \u201cchange talk\u201d.<\/p>\n

When patients get the opportunity to talk about their own reasons for wanting to make healthy changes in their lives, the research shows, the more likely they are to actually make a change. All of us, at the end of the day, are more convinced by our own arguments than someone else\u2019s.<\/p>\n

 <\/p>\n

The Four Processes of Motivational Interviewing<\/h2>\n

There is no set amount of time that the MI technique lasts for. Some people may receive just one 15-minute MI session, and others may come back for weekly visits. The research does show, however, that people accomplish actual change much faster with MI than with traditional talk therapy.<\/p>\n

There are four processes of MI that practitioners try to go through. Again, these aren\u2019t time-limited; a practitioner could get through all four of these processes in one session, and other patients might stay in the engagement process for several sessions. MI\u2019s flexibility is one of its greatest attributes.<\/p>\n

These four processes are not linear, and some patients may go back and forth between them. However, they are built upon one another. These processes, in this foundational order, are:<\/p>\n