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What is motivational interviewing?

Motivational interviewing was originally developed by psychologists and psychiatrists in specialist settings as a form of psychotherapy for helping people with drug and alcohol addiction. Over the last 25 years the MI approach has been applied to other behaviours such as smoking, eating, sex, exercise, taking medication and in the context of many diseases such as obesity, diabetes, hypertension, HIV/AIDS, sexually transmitted diseases, TB and other respiratory diseases. In addition it has been adapted for use by other practitioners such as social workers, counselors, general practitioners and nurses. The settings in which these adaptations have been attempted range from brief consultations in primary care and general practice to even shorter 'corridor conversations' in UK prisons.

Motivational interviewing is characterized by a style or spirit that is essentially collaborative, respectful and guiding as opposed to confrontational, authoritative and instructional. Core principles include the need to express empathy through accurate reflective listening that understands the client's perspective without judging it or necessarily agreeing with it. Behaviour change is understood to be a complex and difficult process that naturally involves ambivalence rather than a simple decision to change or not to change. The counselor seeks to develop motivation to change by highlighting discrepancy between the client's present behaviour and personal goals or values. Reasons for change are elicited from the client rather than argued for by the interviewer. Resistance in the interview is seen to a large extent as a product of the interaction and not an intrinsic trait of the client. Seen in this way resistance is a signal that the counselor should respond differently rather than argue more forcefully or be more coercive. Responsibility for change is seen to lie with the client and not the counsellor who guides and supports the resolution of ambivalence and the decision making process. The counselor may be a source of relevant information but does not impose how the person should use that information. The counselor believes that the client has the ability to change and is supportive of self-efficacy.

Further reading
William R. Miller and Stephen Rollnick. Motivational interviewing: Preparing people for change (Second edition). Published by The Guilford Press 2002. ISBN 1572305630

Stephen Rollnick, Pip Mason and Chris Butler. Health behaviour change: A guide for practitioners. Published by Churchill Livingstone 1999. ISBN 0443058504  

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