Motivational Interviewing

Motivational interviewing is a therapeutic approach that is used to help individuals make positive behavioral changes to support a healthier lifestyle. Although this therapy was originally developed to treat addiction, it is also used to treat mental illnesses, and other chronic conditions Unlike some forms of psychotherapy, motivational interviewing is a collaborative technique. Instead of acting as an “expert,” the therapist works with the individual to help them find what their motivation for change is and then discusses feelings and concerns related to the change(s). The therapist is there for support and to help spark the person’s own desire to change.

The motivational interviewing technique is based on the Stages of Change Model, which was developed about 20 years ago by Carlo DiClemente and J.O. Prochaska. When a person begins motivational interviewing, the therapist helps the individual determine what stage of change they fall into and works with them to move through the stages of change.

1. Precontemplation – Does not see behavior as a problem and not thinking about changing.
2. Contemplation – Begins to recognize they have a problem and considers change, but still not committed to changing.
3. Determination – Committed to changing and prepares to do so.
4. Action – Implements plan for change.
5. Maintenance – Successfully maintains behavior changes over time.
6. Termination – No longer tempted by old, destructive behaviors and has confidence in ability to cope.

What to Expect
Motivational interviewing involves the therapist asking the client thoughtful, open-ended questions, which helps the person identify reasons they are resistant to change, what life might be like when the change(s) take place and the discrepancies between their current life and the identified goal(s). This process gives the person an understanding of their own values and the self-confidence necessary to continue working towards change. Therapists using motivational interviewing follow these four core principles:

1. Express Empathy – The therapist understands the person’s struggles and barriers for change; they will not judge the person or the situation.

2. Develop Discrepancy – The therapist will ask questions that will lead the person to realize what is standing in the way of the goal(s). For example, if a person with alcoholism says they want to have a successful career, the therapist will ask questions that will lead the individual to come to the conclusion that their drinking is standing in the way of career success.

3. Work Through Resistance – The therapist will not try to force change when a person is resisting, but they will continue to offer alternative ways of thinking for the person to consider.

4. Support Self-Efficacy – Some people have tried to make changes in the past and failed, so they don’t have much faith that the change will stick this time around. For example, a person may have stayed sober for two years and then relapsed. They may not believe this time will be any different. It’s the therapist’s job to point out the person’s strengths and ways they are achieving their goal. Essentially, they work to boost the person’s confidence that they have the power within to maintain the change.