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What Is Motivational Interviewing (MI)?

Learn about motivational interviewing (MI) and how it can significantly improve people’s lives in this informative article.

A Look at Motivational Interviewing (MI)

Motivational interviewing (MI) is an approach to counseling that focuses on motivating people to make positive behavioral changes. It aims to resolve people’s ambivalence toward change to improve the quality of their live

Motivational Interviewing

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How Does MI Work?

Motivational interviewing helps people resolve hesitant feelings and make positive decisions. Hesitancy toward change can be due to a variety of reasons, such as a lack of readiness. MI works by helping people explore their emotions and find the motivation to change based on their own reasons.
When used successfully, MI can produce exceptional results. For instance, one study evaluating the effectiveness of motivational interviewing treatment (MI group) versus treatment as usual (control group) on cigarette smokers with cardiac disease showed statistically significant findings. In the MI group, the rate of heart attacks was reduced by more than 50%, nearly 85% reported a decrease in nicotine dependence, and 92% stopped smoking (compared to 45% in the control group).1

What Does a Motivational Interviewing Session Entail?

Conversation is the primary tool in MI. The therapist’s goal is to evoke a conversation about what the client wants to change and why. Then, they help the client commit to the change they desire. Expressing commitment out loud goes a long way and has been proven to increase the likelihood of people following through.2

Motivational therapists help people identify strengths that can inspire change and weaknesses that may hinder their ability to change. The key is to guide the client to discover and overcome discrepancies themselves and realize they are capable of change.

Key Principles of Motivational Interviewing (MI)

There are five major principles used by therapists who practice MI. Therapists adhere to these principles to build trust and establish mutual ground with clients. The five principles are as follows:

Express Empathy

This principle requires reflective listening and empathy to understand the client’s perspective. The therapist listens to and understands the client’s thoughts and feelings without judging.
Agreeing with the client’s views doesn’t depict the therapist condoning the negative behavior. However, they should avoid expressing a personal opinion to make the client feel comfortable to share their concerns. 

Develop Discrepancy

Motivation and change arise from potential outcomes. Thus, helping people see the difference between their current life and the life they could live can decrease hesitancy. A therapist has to make a client see the imparity of living with problematic issues. This can spark motivation to change, realize their values, and set goals for the future. 
A detailed exploration of the merits and demerits of making positive changes is a motivational therapy method that helps the client see the future clearly and weigh the options of developing discrepancies.

Avoid Arguments

Arguing with clients about their views could inhibit motivational counseling almost immediately. When an argument against the client ensues, they will defend their perspective and lose the enthusiasm to change.
Therapists should avoid forcing their opinion on clients, as this could lower their confidence and cause a relapse. Instead, they should create a safe space and encourage the client to recognize the need for change.

Adjust to Resistance

It’s normal to go back and forth regarding the decision to change. After all, everyone faces resistance to changing an aspect of themselves every once in a while. Resistance to change comes in different forms, such as the client arguing with the therapist, belittling the therapist’s professionalism, giving irrelevant excuses, and transferring the blame for their behavior to others. 

It’s normal for people to oppose change when receiving this treatment for addiction. The purpose of motivational interviewing is to adjust ambivalence by making the client reach a certain point of understanding about themselves.

Support Self-Efficacy

Self-efficacy is when people believe in themselves and their capabilities to reach their goals. Following the motivational interviewing approach, therapists help clients recognize their strengths and ability to change.

Therapists use this type of psychology to steer clients into making a positive change to their behavior. The therapist provides the support needed to change, allowing the client to realize their ability to change.

Spirit of Motivational Interviewing (MI)

In MI, a relationship built on trust between the therapist and the client is essential. Three elements must characterize this relationship—collaboration, evocation, and autonomy.

Collaboration Instead of Confrontation

Instead of the therapist running the session, the motivational interviewing techniques state that the therapist and the client should work hand in hand with decision-making. 
Collaboration forms a bond or partnership between the therapist and the client, establishing a mutual understanding and willingness to reach the targeted goals. Working together helps the client develop trust in the therapist and feel more comfortable revealing their concerns.

Evocation Rather Than Education

Evocation is one of the motivational interviewing activities used to bring clients out of their shells and motivate change. People receiving motivational interviewing for substance abuse need evoking to foster the motivation for positive change.
Change can only happen if the client wants it. No matter how quickly the therapist wants the client to change, the motivation and commitment are up to the individual. The therapist should evoke the client to recognize their reason for positive change.

Autonomy Over Authority

In motivational interviewing, perspective matters, as the client holds decision-making power. The therapist cannot dictate, only suggest and advise. The client’s rights and freedom must be recognized.

In the instance of MI for adolescent clients, it’s imperative for therapists to establish autonomy. It’s common for adolescents to feel ambivalent toward receiving help from adults, making the therapist’s ability to step away from an authoritative role crucial.

Techniques of Motivational Interviewing (MI)

Below are the techniques designed for MI.

Open-Ended Questions

People can’t simply answer open-ended questions with a yes or no. The questions are meant to make the client explore and express their feelings. Open-ended questions typically begin with how, what, or why. For example, “How do you view yourself in five years?” or “What would be the likely consequences if you do not change this negative behavior?”

Affirmations

Affirmations are a method of complimenting the client to serve as a form of motivation. They build the client’s self-confidence and affirm their strengths.

Reflective Listening

Reflective listening shows the client that the therapist is paying attention. This is one of the most important motivational interviewing skills, as it helps build the client’s trust, openness, and expression.

Summaries

Summaries show how the therapist was attentive to the client. The therapist provides summaries by clarifying, linking, and transitioning the details and information.

What MI Can Assist With

Motivational therapy is an evidence-based treatment, with a plethora of studies proving its effectiveness. For instance, 67% of patients across a total of thirty-nine studies reported a significant improvement in substance abuse treatment outcomes.3

Another review evaluated the effectiveness of MI on physiological and psychological conditions. Significant and clinically relevant effects were found in 72% of physiological and 75% of psychological diseases.4

When is MI Most Appropriate?

There are many situations, issues, conditions, and disorders that can benefit from MI, including:
  • Substance use disorder
  • Smoking
  • Weight loss
  • Medication adherence
  • Cancer care
  • Diabetes care
  • Health behaviors among children

Benefits of MI

The benefits of motivational interviewing (MI) are plentiful. We outlined a few of the most significant benefits below:
  • Increases self-reliance and confidence 
  • Encourages clients to accept responsibility for their actions
  • Reduces the risk of future relapse 
  • Improves responsiveness to therapy
  • Helps clients see that they possess the power to bring positive change

How to Get Started With Motivational Interviewing

Motivational interviewing

Here are tips on how to get started on your wellness journey:

Locate a Professional Counselor

The first step is finding a therapist who specializes in motivational interviewing. You can ask your doctor for a referral or contact your health insurance provider for a list of therapists in your network.

Check With Your Health Insurance

If you have health insurance, it may cover the total cost or at least a portion of the therapy. Be sure to check if potential therapists are covered by your health insurance provider or request a list of therapists.

Prepare Ahead for Your First Session

To prepare for your first session, you can complete any paperwork provided and begin thinking about the specific changes you wish to implement.

Get Motivational Interviewing at Ripple Ranch Recovery

Begin your journey of positive change-making by getting motivational interviewing at Ripple Ranch Recovery. Our team of professional counselors is ready to unlock the confidence you need to commit to change and guide you to a higher quality of life.

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Ripple Ranch Recovery Center provides detoxification services and residential care through evidence-based treatment methods and a holistic approach.
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