Motivational Interviewing: What Is It?

Motivational Interviewing is a counselling technique used to help people achieve desirable behaviour change.

It was originally developed in the context of substance use, but is equally applicable for any health behaviour such as exercise, diet, etc. The main features of this approach are:

• It is collaborative, rather than coercive, exploring a person’s ambivalence about change in an empathic way. This can involve ‘rolling with resistance’, avoiding directing or confronting the person (who might then become defensive and ultimately reinforce their current maladaptive behaviour).
• It is based on evocation rather than instruction. The aim is to give the person room to identify for themselves the costs of their current behaviour and the benefits of change. Of course, some form of education is necessary at times, but it is a matter of striking a balance between information and patient self-efficacy.
• Working towards a commitment to a specific goal from the person (e.g., four alcohol-free days per week). The important point to note here is that person asking the questions has to be on the same page as the person being asked. In order to set a goal that the person is genuinely motivated to achieve, we must first recognise which stage of change they are at: for example, Pre-contemplation (or ‘not ready to change’) vs Contemplation (‘getting ready to change’).

An excellent reference for further reading is this RACGP article:
https://www.racgp.org.au/afp/2012/september/motivational-interviewing-techniques/

See also: Miller & Rollnick (2012): ‘Motivational Interviewing, Helping People Change’, 3rd ed. New York: Guilford Press.

By David Warmington, Clinical Psychologist at Seed Psychology