Motivational Interviewing (MI) In Vancouver, BC
Facilitating Change through Guided Conversation
Motivational Interviewing (MI) is a client-centered, directive therapeutic approach developed in the 1980s by William R. Miller and Stephen Rollnick. It’s specifically designed to enhance an individual’s motivation to change by resolving ambivalence. While it was initially created to address problematic drinking, its applications have expanded to include a range of behaviors and settings.
Key Points about Motivational Interviewing
Client-Centered
MI emphasizes a collaborative relationship between therapist and client, wherein the therapist acts as a guide, helping the client explore and resolve ambivalence about change.
Ambivalence and Change
MI recognizes that ambivalence (having mixed feelings or contradictory ideas about something) is a natural part of the change process. The approach aims to help clients navigate this ambivalence and move toward positive change.
Core Principles
There are four foundational principles in MI:
Express Empathy: Through reflective listening, therapists show understanding and validation.
Develop Discrepancy: Therapists help clients see the mismatch between their current behavior and their broader life goals or values.
Roll with Resistance: Instead of confronting or opposing resistance, therapists acknowledge it and work with the client to explore its sources.
Support Self-Efficacy: Therapists believe and affirm that clients have the ability to change, enhancing their confidence in their capacity to do so.
Develop Discrepancy: Therapists help clients see the mismatch between their current behavior and their broader life goals or values.
Roll with Resistance: Instead of confronting or opposing resistance, therapists acknowledge it and work with the client to explore its sources.
Support Self-Efficacy: Therapists believe and affirm that clients have the ability to change, enhancing their confidence in their capacity to do so.
OARS Technique
Often used in MI sessions, this stands for:
Open-ended questions: Encourages clients to share more about their experiences and feelings.
Affirmations: Positive reinforcement that strengthens the client’s motivation.
Reflective listening: Echoing back the client’s words to show understanding.
Summaries: Providing concise and coherent recaps of the client’s expressed thoughts and feelings.
Open-ended questions: Encourages clients to share more about their experiences and feelings.
Affirmations: Positive reinforcement that strengthens the client’s motivation.
Reflective listening: Echoing back the client’s words to show understanding.
Summaries: Providing concise and coherent recaps of the client’s expressed thoughts and feelings.
Stages of Change
MI integrates the concept of “stages of change” from the Transtheoretical Model, recognizing that individuals move through different stages when considering, initiating, and maintaining behavior change.
Evoking Change Talk
A key component of MI is to evoke “change talk” from clients—statements that indicate a desire, ability, reason, or need to change. The more a person articulates reasons for change, the more likely they are to take action..
Resistance as Feedback
Instead of viewing resistance as a barrier, MI considers it valuable feedback. It signifies that the current conversation isn’t resonating with the client, prompting the therapist to adjust their approach.
Elicit-Provide-Elicit
In situations where the therapist needs to provide information, they first elicit the client’s knowledge or perspective, provide new information, then elicit a response to the new information. This ensures that the conversation remains collaborative.
Applications
While MI was initially developed for addiction counseling, its principles and techniques have been successfully applied in various settings, including health care, mental health, corrections, and social work.
Evidence-Based
Multiple studies have highlighted the efficacy of MI in enhancing motivation and prompting behavior change, especially in the realms of substance abuse, health behaviors, and treatment adherence.
In Short
Motivational Interviewing is a powerful tool in the therapeutic toolkit. By emphasizing collaboration, drawing out client-driven motivations for change, and handling resistance with grace, MI provides a robust framework for facilitating meaningful and lasting change.
