Motivational Interviewing Theory

Psychologists William Miller, PhD. and Stephen Rollnick, PhD. developed the counseling approach known as Motivational Interviewing (MI). Motivational Interviewing evolved out of experience in the treatment of persons who were problem drinkers, and was first described by Miller in 1983. In 1991 Miller and Rollnick provided these techniques as a method that promotes and engages intrinsic motivation within the client in order to change behavior. MI is a client-centered counseling style that is goal -directed and brings about behavior change by helping clients to explore and resolve ambivalence. Traditional Rogerian client-centered therapy does not guide or direct or focus in the way that MI therapists do to influence individuals to consider making changes, instead of non-directively explore themselves.

Motivational interviewing is a way of conducting and occupy the essential motivation within the client in order to change behavior. It is “an efficient and collaborative style of clinical interaction that can boost the effectiveness of the therapeutic alliance” (Jellinek, Henderson, Dilallo, & Weiss, 2009, p.108). Motivational

The idea of motivational interviewing builds on Rogers' theories about people having freedom of choice and changing through the process of self-actualisation (Davidson, 1994). Miller and Rollnik (1991) describe it as a technique in which the heath practitioner becomes a helper in the change process while expressing acceptance of their client. A central goal of motivational interviewing, says Geldard & Geldard (2012), is to help resolve the ambivalence which prevents clients from realising their personal goals and to facilitate positive change. Motivational interviewing is mostly utilised to counsel those troubled by addiction (not just substance, but also behaviours).

The spirit of motivational interviewing (MI), which entails collaboration, evocation and autonomy, is the fundamental approach to elicit intrinsic motivations (1, 2). Throughout the video, the therapist appears to have applied the MI spirit in accordance with Miller and Rollnick (2). The therapist firstly created an encouraging atmosphere for change by monitoring and accommodating the client’s aspirations (collaboration). The therapist then evoked the client’s motivation through their perceptions, goals and values (evocation) and also informed about the right for self-direction leading to commitment to change (Autonomy). However, to sustain the MI spirit, a breakdown of the requirements will be discussed below.

Afterwards, the essential concepts and methods were later particularized by Miller and Stephen Rollnick, Ph.D., in 1991. This involved a more comprehensive description of the clinical procedures of motivational interviewing. Motivational Interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence (Miller & Rollnick, 1991). Motivational Interviewing is goal directed and more focused when compared with nondirective therapies. The central purpose is to examine and resolve ambivalence, with an intentionally directive therapist to carry out this goal (Miller & Rollnick, 1991).

This closely simulated a patient interaction with candid answers and the presence of other family members. It was most challenging to calculate the responsive statement to use while maintaining the direction of the interview. Motivational interviewing techniques employed in this interaction include the use of open ended questions to encourage change talk from the patient, affirmation of the patient’s honesty and accountability, reflective statements to show active listening and to illicit further change talk from the patient, and the use of summarization to communicate the patient’s identified growth (Miller & Rollnick, 2013). Transcending these techniques was the spirit of motivational interviewing that communicated acceptance to the patient, guiding versus directing communication, and the support of self-efficacy (Miller & Rollnick, 2013). This was done by first asking permission to discuss the topic and was then carried through the

The process of motivational interviewing is essentially about creating "intrinsic motivation to change" within the client (Moyers, 1998). The choice to change must originate with the client and the process for helping this occur begins with motivational interviewing. There are two phases within motivational interviewing, the first focuses on increasing the client’s motivation to change and the second phase is negotiating a plan and consolidating commitment. It is important to understand the traps that can be encountered within this process, such as the question/answer trap. In this trap the client is led by the counselor with little chance to have free speech to explain themselves because the counselor is just focused on the next question instead of focusing on where the client is leading them. This trap is very similar to the expert trap in the fact that the client is left to believe they cannot find answers for themselves; they instead must listen to the expert who is giving them the answers. This is most definitely not the way to motivate a client to make changes for themselves. Other traps include premature focus, denial, labeling, and blaming; all of which can prevent the client from opening up in the treatment process.

Motivational interviewing recognizes and accepts the fact that clients who need to make changes in their lives approach counseling at different levels of readiness to change their behavior. During counseling, some patient may have thought about it but not taken steps to change it while some especially those voluntarily seeking counseling, may be actively trying to change their behavior and may have been doing so unsuccessfully for years. In order

(Rollinick et al. 2010). This technique isn’t considered to be a form of psychotherapy but rather a formalized therapeutic relationship that engages the assessment and intervention steps of the nursing process (Moller & Potter 2016b). Motivational interviewing is focused on activating the client’s capability to make a beneficial change regarding one’s health (Easton, Swan & Sinha 2000).

Combined Motivational Interviewing and Cognitive-Behavioral Therapy with Older Adult Drug and Alcohol Abusers is an article written by Lyle Cooper concerning the abuse or misuse of illicit drugs, prescription medications, and alcohol in older populations. Due to lack of knowledge or resources, elderly individuals are falling victim to substance use problems and the numbers are projected to rise. Therefore, an assistance program called HeLP was created to provide evidence-based treatment to the specific cohort of 50 and up age range. Motivational interviewing is used to eliminate internal uncertainties clients may have concerning their treatment; hence, opening themselves up to behavioral changes. Clients who decide to move on to the next stage and if HeLP workers deem it necessary, cognitive-behavioral therapy is implemented to promote changes in thoughts, behaviors, and prevention of future relapse.

The purpose of the following health history interview is to obtain a complete picture of a person’s past and present health (Jarvis, 2012). This type of assessment provides subjective data provided by the client through a series of questions that can determine if the client’s lifestyle is appropriate for their well-being. In order to build trust between interviewer and client a rapport has to be built. Trust and rapport develop between the nurse and patient when the nurse has empathy or insight, and must emphasize to the patient that the information will remain confidential (Jones, 2009). This interviewer must use therapeutic communication with the client so that accurate information can be attained. Therapeutic communication involves careful listening to understand the client, using open ended questions to elicit complete responses, establishing a good rapport, and

Motivational interviewing is a counseling approach that was studied and understood as an applicable theory of practice that would be beneficial in the environment where I currently work which is an alcohol treatment facility. Whereas, it is understood that clinical and applied aspects of Motivational Interviewing (MI) have shown effective as a relatively brief intervention (Levensky, Cavasos, & Brooks, 2008), especially those dealing with an alcohol dependency. According to Miller and Roderick, MI, has been defined mostly as a directive, client centered counseling approach for eliciting behavior change by helping clients to explore and resolve ambivalence. In addition, with its goal-orientated approach it can help break down resistance to change (Corey, 2013, pp. 191-194). This theoretical approach is the most favored for the environment in my profession of choice, in addition, integrating it with the practice of Cognitive Behavioral Therapy (CBT) which is already in use.

According to Miller and Rose (2009), Motivational Interviewing is an evidence-based psychotherapeutic method that was developed by Dr. William R. Miller following unexplained outcomes that emphasized the impact of interpersonal processes on behavior change after Miller trained counselors on techniques of behavioral self-control and accurate empathy. The clinical method has been defined by Lewis Dana and Belvins (2015) and Miller and Rollnick (2002) as goal-directive, client-centered counseling method for eliciting behavior and enhancing intrinsic motivation to change by helping clients explore and resolve their ambivalence (Lewis, Dana & Belvins, 2015; Miller & Rollnick, 2002). While composed of general principles and early methods, Miller and Rollnick (2002), Miller and Rose (2009), and Lewis et al (2015) all discuss the basic practice of Motivational Interviewing is underlined by the Motivational Interviewing spirit, which focuses on collaboration, and evocation between the counselor and the client, and the autonomy of the client (Lewis et al, 2015; Miller & Rollnick, 2002; Miller and Rose, 2009). Although originally developed to address substance abuse disorders, as published by Miller and Rose (2009), Motivational Interviewing is effective in reducing maladaptive behaviors and promoting adaptive health behavior changes. Additionally, the relatively brief intervention is easily learned by a broad range of helping professionals, compliments other forms of active treatment

Motivational Interviewing is a set of interpersonal techniques that allow patients to recognize harmful, self-engaging behaviors through a non-confrontational approach that is focused on self-motivation to facilitate a behavior change. Through motivational interviewing, it is the patient’s responsibility to determine if a change is required, and if so, he decides the course of action. The healthcare provider’s role throughout this process is to refine the patient’s motivation for change, provide him with the appropriate

Motivational Interviewing (MI) refers to a client centred counselling approach, which is directed to enhance motivation in an individual for behaviour change Miller & Rollnick (as cited in Christopher & Dougher, 2009). MI as a method understands and accepts that the clients are at different levels of readiness to change their behavior. It consistently focuses on goals to prepare the client for transformation by providing motivation for commitment to change (Bricker & Tollison, 2011) in the domains of substance abuse, addiction and risky health problems. It proceeds to make the client aware of the causes, consequences and risks that could be a result of the behavior. Through this, the client foresees the possibilities of enhancement and becomes motivated to achieve it (Jenson, Cushing, Aylward, Craig, Sorell & Steel, 2011). MI is coherent with the