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How motivational interviewing works

How does motivational interviewing (MI) work?

MI uses a guiding style to engage clients, clarify their strengths and aspirations, evoke their own motivations for change and promote autonomy in decision making (Rollnick et al 2008).

MI is based on these assumptions:

  • how we speak to people is likely to be just as important as what we say
  • being listened to and understood is an important part of the process of change
  • the person who has the problem is the person who has the answer to solving it
  • people only change their behaviour when they feel ready - not when they are told to do so
  • the solutions people find for themselves are the most enduring and effective.

There are four general principles of motivational interviewing:

  • R - resist the urge to change the individual’s course of action through didactic means
  • U - understand it’s the individual’s reasons for change, not those of the practitioner, that will elicit a change in behaviour
  • L - listening is important; the solutions lie within the individual, not the practitioner
  • E - empower the individual to understand that they have the ability to change their behaviour. (Rollnick et al 2008)

What makes MI different from other, confrontational approaches?

MI does differ substantially from more aggressive styles of confrontation. It is not:

  • arguing with the client who has a problem and needs to change
  • offering direct advice or prescribing solutions to the problem without the person’s permission or without actively encouraging the person to make their own choices
  • using an authoritative/expert stance that leaves the client in a passive role
  • where the health care professional does most of the talking, or only gives information
  • imposing a diagnostic label
  • behaving in a coercive manner.

What is the evidence that MI works? 

Clinical trials have shown that patients exposed to MI (versus treatment as usual) are more likely to enter, stay in and complete treatment, participate in follow-up visits, decrease alcohol and illicit drug use and quit smoking. 

Why should I change the way I do things? 

It isn't a matter of changing what you have learnt, rather adjusting your skills to be better equipped to deal with your clients. Techniques taken from the motivational interviewing approach can be integrated into your consultation with your clients and this resource provides you with an overview of some of these.