Developed by William R. Miller and Stephen Rollnick, motivational interviewing (MI) was created to help people suffering from substance abuse, like alcohol and cigarettes.
It grew over time, and now, the approach is here to help individuals with mixed feelings about altering their behavior.
Unlike various forms of therapy, MI is more of a person-centered, collaborative approach with minimal intervention. The clinician and the client work together, exploring the client’s thoughts and feelings to uncover their reasons for wanting change without imposing any solutions.
If you’re thinking of changing your life through motivational interviewing, this guide will walk you through the essential principles and techniques of this approach.
Table of Contents
The Core Principles of Motivational Interviewing
MI isn’t just a conversation between you and the health care professional to help motivate you; it’s an evidence-based approach that follows the principles below:
1. Express Empathy
We all know how hard it is to discuss something as personal as mental health issues with strangers.
That’s why empathy lies at the heart of motivational interviewing and many other psychotherapy treatments. The clinicians aren’t supposed to make you feel that they’re sorry for you but that they genuinely understand your experience and see the world through your eyes.
By following this main principle, the clinicians create a safe space where you or your loved ones can feel heard and understood.
2. Develop Discrepancy
Though this can be challenging, developing discrepancy is one of the key strategies in motivational interviewing.
It’s about helping the individual see where they are now and where they want to be in the future—highlighting the discrepancy in their lives.
In practice, the professional will try to help you explore your values and aspirations, and then compare those to your current behavior.
This isn’t about creating guilt or pressure; it’s about fostering a sense of awareness. That’s why this is one of the toughest principles in MI as it can evoke some friction during the process of change.
However, when clients see this discrepancy on their own, they become more motivated to make a change.
3. Support Self-Efficacy
Building self-efficacy is all about empowering individuals to believe in their ability to make meaningful changes in their lives.
That’s why the previous principle is vital! It helps you observe, analyze, and find the discrepancies yourself. Later, you’ll gain trust in your decision-making skills and map the way forward.
The clinician’s role here is to build that confidence by highlighting your past successes, no matter how small, and reinforcing your strengths.
Instead of relying on external pressures, MI helps individuals find that inner drive to pursue their goals through the different stages of change. For instance, someone struggling with substance use disorder might discover that their motivation to change comes from a desire to improve relationships or health.
4. Resist the Righting Reflex
Often when we see someone doing anything we deem wrong, the urge to “right” them rises within. We usually think this is for their own good and try to stop them from heading in the wrong direction.
However, in motivational interviewing, this impulse can be counterproductive. The righting reflex often leads to resistance because when someone feels they’re being told what to do, their instinct might be to push back or defend their current behavior.
This can be extra challenging when dealing with adolescents and young adults who may already feel strongly about asserting their independence.
Avoiding the righting reflex is essential in MI because its goal is to help you find your intrinsic motivation for change, not create or impose it on you.
5. Roll With Resistance
Resisting behavioral change in motivational interviewing is a natural part of the process. You’ve been used to a way of living or handling things for too long, and now someone is urging you to reevaluate your ways.
Instead of pushing back, MI practitioners are trained to roll with resistance, which means they work with your objections and concerns in a non-confrontational manner.
When the client resists, it’s often a sign that they’re uncertain or ambivalent about change. Rather than argue or try to persuade, the clinician falls back on techniques like reflective listening to acknowledge the client’s feelings and explore what’s behind this resistance. I
Techniques Used in Motivational Interviewing
The previous principles are the core around which MI techniques revolve. To create a safe space and allow their clients to speak freely and express themselves, MI practitioners often follow these interviewing techniques:
Reflective Listening
There’s a vast difference between hearing what others say and using reflective listening. With reflective listening, the professional hears your words and understands them, then analyzes the bigger picture, the details, and how it looks from your perspective.
This technique goes beyond simply nodding along; it involves actively engaging with your words and reflecting them back in a way that shows you were truly heard.
Open-Ended Questions
Asking someone if they’re feeling alright or bad naturally ends with a yes or no answer. However, asking them how and why they feel like that opens the door to many possibilities.
Open-ended questions are designed to encourage individuals to explore their thoughts and motivations in their own words.
When the clinician asks open-ended questions, they’re essentially saying, “Tell me more about this.” The approach gives the afflicted individuals the space to express their own ideas and concerns, leading to a richer, more meaningful dialogue.
Affirmations
Affirmations in MI depend on two factors: sincerity and relevance. Affirmations resonate more deeply when they’re heartfelt, making your efforts feel truly recognized.
The second factor, relevance, ensures the affirmations are directly related to your actions or thoughts. It’s not just about giving generic praise but acknowledging something meaningful you’ve done or said.
For instance, if you share a small victory, like attending a counseling session despite being hesitant, you might hear an affirmation like “Your decision to come shows a great deal of courage and an eagerness to improve your well-being.”
Summarizing
Summarizing isn’t about taking what you said and repeating it again; it’s about capturing the key points of the conversation and reflecting them back to you in a way that highlights the progress and insights.
When creating a summary, the clinician pulls together your thoughts, feelings, and the steps discussed, creating a clear picture of where you’ve been and where you’re headed.
It can serve as a moment of reflection, allowing you to hear your progress echoed back by the professional, which can be incredibly validating and motivating!
Practical Tips for Those Getting Motivational Interviewing
We understand how hard it is to take the first steps toward help and seek treatments like motivational interviewing.
However, learning what to expect and how to make the most of it can give you the necessary push. Here’s what we can tell you:
How to Prepare
Preparing for a motivational interviewing session doesn’t require much effort, but a little mental and emotional preparation can go a long way.
The first step is to come in with an open mind, ready to explore your thoughts and feelings in complete honesty.
It’s also helpful to reflect on what brought you to MI in the first place. You don’t need to have all the answers, but having a sense of your goals or challenges can provide a good starting point for the conversation.
Questions to Ask
Feeling comfortable and safe during your MI sessions is essential for their success. If that means you need to ask questions, don’t hesitate! Here are a few ones that can guide the conversation:
- How does motivational interviewing work?: Learning about how MI works directly from a professional can help you feel more at ease
- What should I expect during our sessions?: Asking this can clarify what a typical session looks like, including the type of questions you’ll hear.
- How can MI help my specific challenges?: This question allows you to connect the MI process directly to your life, giving you a better sense of how it can support your goals.
To Sum Up
Motivational interviewing is an evidence-based counseling approach created by Miller and Rollnick to facilitate behavioral changes.
It’s mostly client-centered, focusing on your own motivations and goals instead of a certain agenda.
The core principles of MI ensure you won’t feel judged or out of control. Instead, you’ll find empathy, understand your own reasons for change, gain confidence, and learn to take constructive feedback without feeling defensive.
Most importantly, you’ll feel empowered to make decisions that align with your values and aspirations.
