What is Motivational Interviewing?
A brief overview of Motivational InterviewingMotivational interviewing is a form of collaborative conversation for strengthening a person's own motivation and commitment to change (Miller & Rollnick, 2013).
It is a person-centered counseling style for addressing the common problem of ambivalence about change by paying particular attention to the language of change. It is designed to strengthen an individual's motivation for and movement toward a specific goal by eliciting and exploring the person's own reasons for change within an atmosphere of acceptance and compassion. William Miller and Stephen Rollnick offer three levels of definitions of MI in their book, Motivational Interviewing: Helping People Change (3rd edition, 2013).
Miller and Rollnick went some way to clarify what MI is, by defining what it isn’t in their 2009 paper, Ten Things MI is Not:
The approach invites clinicians to step out of the expert, directive role into one characterized more by guiding. The way of relating is captured by the spirit:
It takes time and practice to bring all three components together in an increasingly flowing and flexible way, that continually tunes in to where the client is at and what would be most helpful to them at that point conversation. However, the individual elements can in themselves be helpful, even if they are not always being combined in a focused conversation that attends to the client’s language about change. |
Every year Member of the Motivational Interviewing Network of Trainers (MINT) attend an in-person or virtual meeting. Here is the Plenary from 2021
Stephen Rollnick explores what might make MI easier to learn, by looking at the implications for "me", "my skills" & "my setting".
Helen Mentha (MINT) talks about the edge of motivational interviewing and where it intersects with other interventions.
Ken McMaster - Discord is by its very nature, often the starting point for conversations when men are mandated to address issues of abusive behaviour within their relationships.
Bill Miller and Steven Rollnick answer the question "What is MI?"
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Clinical application
MI is being increasingly applied to a broad range of presenting issues. If there is a change to be made, and especially if ambivalence is involved, MI may be of value.
For the clinician learning MI, the stages (or tasks) of learning MI identified by Miller and Moyers (2006) can be a helpful guide:
For the clinician learning MI, the stages (or tasks) of learning MI identified by Miller and Moyers (2006) can be a helpful guide:
- Overview: Spirit of MI
- OARS: Client-centred counseling skills, including elicit-provide-elicit and resisting the Righting Reflex
- Recognising change talk and resistance (now conceptualized as sustain talk and discord)
- Eliciting and strengthening change talk
- Developing a change plan
- Consolidating commitment
- Transition and belonging: Integrating MI with other approaches
Training
For those training MI, there is also a body of research investigating what works in training. MINT offers some considerations on what MI training might consist of and what to expect. Click here for more information
MINT is committed to high standards of training and those of us who offer professional development in MI would be expected to:
A range of practical exercises for teaching MI can be found here.
For organisations seeking training for their staff in MI, it is important to consider that MI as a fully utilized, skillful approach cannot easily be acquired in a two day workshop, although some core elements may be. The preparation leading up to training and support for ongoing practice and development of the skills are important factors in effective acquisition of MI skills.
Implementation research: a synthesis of the literature offers an indepth overview of the opportunities and challenges of implementation of treatments into practice.
MINT is committed to high standards of training and those of us who offer professional development in MI would be expected to:
- Model the spirit throughout the workshop
- Be skilled in MI and be able to demonstrate these skills as appropriate
- Be up to date in content and methodology
- Use adult learning principles and multiple modes of teaching
- Offer opportunities for skill development and interaction
- Be realistic and informed about the potential and limitations of MI
- Respect participants’ autonomy, existing skills and experience, and the nature of individual work settings.
A range of practical exercises for teaching MI can be found here.
For organisations seeking training for their staff in MI, it is important to consider that MI as a fully utilized, skillful approach cannot easily be acquired in a two day workshop, although some core elements may be. The preparation leading up to training and support for ongoing practice and development of the skills are important factors in effective acquisition of MI skills.
Implementation research: a synthesis of the literature offers an indepth overview of the opportunities and challenges of implementation of treatments into practice.
Research
Research into MI and its potential applications is growing at a significant pace with well over 1000 clinical trials. The growing body of evidence indicates that the approach is of value and can facilitate change.
However, it can be hard to navigate the research literature, especially when the term “Motivational Interviewing” has been used to describe a wide range of practices, many of which are not MI. Even where the description of MI was accurate, the fact that MI itself has evolved over the past thirty years can make it hard to compare findings across studies.
Further, even where the description of MI is sound, many studies offer no or insufficient fidelity measures that check whether what was delivered was actually MI. Add to this the challenge of determining meaningful outcome measures that could be considered to originate within the client, rather than the research team, and it can be difficult to draw firm conclusions.
What is MINT?
However, it can be hard to navigate the research literature, especially when the term “Motivational Interviewing” has been used to describe a wide range of practices, many of which are not MI. Even where the description of MI was accurate, the fact that MI itself has evolved over the past thirty years can make it hard to compare findings across studies.
Further, even where the description of MI is sound, many studies offer no or insufficient fidelity measures that check whether what was delivered was actually MI. Add to this the challenge of determining meaningful outcome measures that could be considered to originate within the client, rather than the research team, and it can be difficult to draw firm conclusions.
What is MINT?
"The bird is powered by its own life and by its motivation."
- A. P. J. Abdul Kalam -