Motivational Interviews: Everything You Need to Know

Motivational Interviews: Everything You Need to Know

I was lucky enough to be one of the first people in the UK to be supported by the originators of this counseling approach, Drs. Bill Miller and Dr. Steve Rollnick, trained in motivational interviewing. It is difficult to explain now, thirty years later, how exciting it was to be at the beginning of something that was so important in the world of psychotherapy. It changed my life.

Anyway, this little article contains everything you really need to know about the mysterious art of Motivational Interviewing and why it's so important in the world of counseling and psychotherapy.

Motivational Interviewing was originally developed by Dr. Bill Miller, an American university lecturer and psychotherapist, conceived it in a seminal 1983 article on changing the health behavior of problem drinkers. His ideas developed and other people, especially Dr. Steve Rollnick, worked together until a brand new therapeutic discipline called Motivational Interviewing emerged in the late 1980s and early 1990s.

MI (as it is known) is important because it is one of only two complete types of counseling. The other is what is referred to interchangeably as humanistic counseling or Rogerian counseling or, most commonly, person-centered counseling. This style was developed by Carl Rogers in the 1950s as an alternative to medical help and medication for emotional problems.

Why is MI important?

Before MI came along, the world of psychological intervention was really dominated by just three forms of help. At one end of the spectrum were doctors, psychiatrists, and medications, and at the other end was "counseling," and somewhere in the middle were clinical therapies like cognitive behavioral therapy (along with several other hundred variations) that believed that change was dependent on one or more assumptions, such as: B. Change, depend on education or behavioral training or insight etc.

MI changed all that. A central tenant of MI is that we change when we want to, and often counseling, medication, doctors, therapy, counseling don't really work because deep down we just haven't really decided to change! MI seeks to resolve this ambiguity and believes that if we are truly determined to change, we will. It's that simple.

To give the approach some form, Bill and Steve developed what they call the 4 Principles of MI. These are:

• develop discrepancy

• Roll with resistance

• Express empathy

• Support self-efficacy

A little later in development they added:

• Avoid arguments (which is always a good idea in therapy!)

Along with these guiding principles, they also quite helpfully created a list of strategies for MI practitioners. These are:

1. Reflective Listening (which is actually a huge and very skillful area of ​​MI)

2. affirmation

3. Open questioning

4. Summarize

5. Making self-motivation statements (i.e. talking about change)

Aside from these nuts and bolts, there is what has become known as the Spirit of MI. This includes anything else that cannot be easily listed or labeled. As Bill said, “MI is mostly just a way of being with people.”

What interests people about MI is that there are no preconceived ideas about why or how people should change or what should or shouldn't work. It is also a very short therapy. It doesn't take long and tends to get "to the point" (as Bill would often say). Standard motivational enhancement therapy (the therapy version of MI) for people with alcohol problems consists of just four sessions and one assessment. Compared to CBT or most other forms of help, which typically last at least 16 sessions and sometimes much, much more, this is wonderfully short and just as effective.

I hope this article was useful and summarizes the main elements of MI and puts it in context.

Thanks for reading.

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