What Is a Motivational Interview (MI)?

A Motivational Interview is used when a patient wants to learn how to manage life-changing conditions that are affecting their health, such as addiction. This is a form of therapy and intervention that helps patients to find and keep their motivation so they can change behaviors that are preventing them from healing.

Motivational interviews are also used to help patients lead healthier lives both in the body and mind. It also prepares them for further therapy, such as cognitive behavioral therapy or dialectical behavioral therapy.

As defined by Psychology Today:

“Motivational interviewing is a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes.”

How Does Motivational Interviewing Work?

The process is twofold:

The first goal is to increase motivation in the patient
The second is for the patient to make the commitment to change.

Instead of simply stating a need or desire to change, hearing themselves express their commitment out loud has been shown to help improve an individual’s ability to actually make those changes.

The role of the therapist is more about listening than intervening. Motivational interviewing is often combined or followed up with other interventions, such as cognitive therapy, support groups such as Alcoholics Anonymous and stress management training.

When and Why Is Motivational Interviewing Used at Elevate?

We use Motivational interviewing to address addiction, which helps patients become motivated to change the behaviors that are preventing them from making healthier choices. This prepares them for further therapies, such as cognitive behavioral therapy.

Research has shown that Motivational Interviewing works well with patients who start off unmotivated or unprepared for change. It is not as necessary for those who are already motivated to change.

Motivational interviewing is also appropriate for patients who are hostile to change, but angry about their situation. They may not be ready to commit to change, but motivational interviewing can help them move through the emotional stages of change necessary to find their motivation.

What Can the Patient Expect in a Motivational Interview?

A motivational interviewer supports and encourages patients to talk about their need for change and their own reasons for wanting to change.

The role of the interviewer is mainly to start a conversation about change and commitment. The interviewer listens and reflects back the patients thoughts so that the patient can hear their reasons and motivations expressed back to them.

Motivational interviewing is generally short-term counseling that requires just one or two sessions, though it can also be included as an intervention along with other, longer-term therapies.

Three common elements involved in Motivational Interviews are:

Collaboration:

Instead of being confrontational or argumentative with the patient, the therapist will attempt to see the situation from the patient’s point of view.

Along these lines, the therapist is not the expert because no one has a better understanding of the patient’s experience than the patient. The goal here is for the therapist to act as a support rather than a persuader.

Listening:

In other forms of therapy, like cognitive behavioral therapy, the patient is given information by the therapist as encouragement to change their ways of thinking, beliefs, or behaviors. At times, this approach can trigger feelings of defensiveness in the patient.

Motivational interviewing has the goal of creating an internal desire for change from the patient. The therapist listens more than talks and draws out the patient’s own perceptions instead of imposing perceptions. This way, the patient will be more interested in maintaining the change over a longer period.

Autonomy

Motivational interviewing places all of the power on the patient. The therapist shows respect for the patient’s responsibility and decision-making ability

What Does the Therapist Do?

The therapist must practice some very specific techniques for the Motivational Interview to be effective. They must:

Express Empathy:

This is one of the core values of person-centered therapy that motivational interviewing includes. Here, the job of the therapist is to build an understanding of the patient’s issues, struggles, and barriers to improvement.

By doing this, the patient becomes more open and free about their expression since there is a lack of judgment and criticism. A therapist might say, “I can understand why using drugs seems appealing in this situation.”

Develop Discrepancy:

It becomes the job of the therapist to have the patient point out the disparity between what they are doing and what their goals are. If the goal is to be happy and have a successful career, using heroin daily may get in the way of that.

Of course, the therapist will use interventions that are not based in confrontation to produce this. The therapist will only ask a series of questions to lead the patient to this natural conclusion.

Roll with Resistance:

Motivational interviewers expect there to be some resistance and reluctance from the patient during this process. Keeping in line with the non-confrontational views, the therapist will not try to force or manipulate the patient into acceptance.

The therapist will work to understand the patient’s point of view and avoid the desire to correct what may be viewed as flawed ways of thinking while offering alternative ways of thinking for the patient to consider.

Support Self-efficacy (a Belief in Change):

Many patients, especially those dealing with addiction, recovery, and relapse, have tried to maintain their sobriety with limited success.

Because of this, they can become less hopeful for future success. The therapist will work to illustrate areas of strengths and compile a number of instances where the patient was able to accomplish their goal.