by Dr. Becky Spelman on 25/06/2019
What is Motivational Interviewing?
Motivational Interviewing is a patient-centred counselling style that helps people to engage with positive behavioural change by exploring issues of ambivalence in their lives. It is a goal-directed form of counselling, in which the therapist helps the client to think about how they can make changes in their lives and facilitates them in making positive change. Motivational Interviewing is often used to help people with chronic health conditions, such as diabetes, manage their condition effectively and make lifestyle changes to mitigate the impact it has on their lives. It is often particularly effective with people who are initially quite resistant to change, or even angry about the need to make some changes.
Often, Motivational Interviewing is primarily focused on how someone can make changes with respect to a specific behaviour that is causing problems for them. The therapist and patient work together to figure out what changes the patient wants to make, and how ready they are to start making them. In the process, they develop a relationship predicated around cooperation and positivity, with respect for the patient’s right to make their own decisions at the forefront. The therapist does not judge their client or engage in confrontational questioning, but rather respects their space and the natural rate of progress that they attain. The therapist displays acceptance and empathy towards their patient and what they are going through as, together, they engage in a process of creative exploration. The motivation for change always comes from the patient and can never be imposed by the therapist.
What is involved in Motivational Interviewing?
Motivational Interviewing involves asking the patient open-ended questions, such as, “What would the future look like for you, if you managed to make the changes that you are looking for?” and “How would you like things to be different?”, to affirm them when they take a positive step towards the change they seek, to listen to them reflectively and thoughtfully, and to provide them with summaries of what they have achieved so far. The patient is encouraged to reflectively examine their own lives, looking at how they have done things in the past, why and how they want to change certain aspects of their behaviour, and what they would like their life to look like in the future. Over time, the patient becomes progressively more confident about their ability to create change in their life and better able to understand the nature and consequences of their behaviour now, and of the behaviour that they hope to attain.
While Motivational Interviewing is not a heavily structured approach to therapy, four distinct processes can be identified. These are as follows:
- Engaging. During this process, the patient is enabled to talk about the issues that have brought them to therapy, while the therapist listens reflectively. The two parties agree on the goals of therapy, and work together to meet them.
- Focusing by constantly working to keep on task and to continue seeking answers and solutions.
- Evoking by supporting the patient’s desires to change, and encouraging them to have a sense of hope, and to trust in their own abilities.
- Planning by helping the patient to develop a plan that will enable them to continue making positive change as they move forward with their life.
Every patient attains change at their own pace, often by engaging with a combination of Motivational Interviewing and another supportive modality, such as a support group or group therapy.Therapists who use motivational interviewing do not expect patients to achieve change according to a schedule. Change can occur slowly, or sometimes in relatively big increments. Sometimes it can take a long time for a patient to achieve an initial, rather modest, goal, only for them to make significant progress later on in their treatment.
Miller, W. R. and Rollnick, S. (2002). Motivational Interviewing: Preparing People to Change, 2nd ed. New York: Guilford Press.
Miller, W. R., & Rollnick, S. (2012). Motivational Interviewing, Helping People Change, 3rd ed. New York: Guilford Press
Who can I speak to further about Motivational Interviewing?
If you would like to talk to someone about Motivational Interviewing, please get in touch with us at the Private Therapy Clinic by telephone at: 020 3887 1738 or by email at: firstname.lastname@example.org.