Motivational Interviewing is a particular style of strategic communication. It serves to bolster the internal motivation of clients to engage in the process of initiating a specified change. Developing skillfulness with the approach requires some initial training, followed by many hours of practice (and feedback)! MI is not a “therapy” technique (although it is often misconstrued in that way). Rather, MI is an evidence-based way of hosting, or providing structure for a conversation, where the intent is to help the interviewee activate motivation for a specific change. For a simple and fun explanation of what MI is, provided by our puppet “Marco The MI Guy” – click here
The word “motivation” stems from the word “motive” (aka “a reason”). Thus, MI involves helping clients identify their own, internal reasons for pursuing a particular change. Then, once such internal reasons for change begin to surface, MI serves to enhance or strengthen the person’s motives (reasons) for making positive changes. To state the process in an overly simplified way, MI is all about helping the client find his/her own reason(s) to change and then helping to “grow” such reasons into an internal desire and need for change. Client speech that indicates awareness of one’s own desire, reason, need and ability to change is often referred to in MI work as “Preparation Language”.
Finally, when there is sufficient motivation for change, MI providers work to help their client shift from preparation for change into a commitment and to an action plan for change. Language related to client commitment and action planning is discussed as “Change Talk” in MI training.
There are three primary ingredients required to fuel the capacity to engage with any particular change. These are:
The client’s perception that the change is important (which influences READINESS to change)
A sense that the advantages of pursuing the change outweigh the disadvantages (from the client’s point of view). Working to tip the scales in favour of a specified change serves to affect client WILLINGNESS to change
The client’s perception that change is possible for him or her. When client confidence in their ability to change is low, the motivational enhancement process involves bolstering the client’s ABILITY to pursue the change – and also their perception that they have the capacity to change.
MI work is structured in a way that helps the interview begin by engaging with his/her client’s point of view on the change topic being discussed. Then, using a number of specialist skills, MI interviewers help clients to hear important elements in their thinking that will serve to activate more talk, and thought, about internal reasons, needs, desires and hopes around the targeted change
MI work is done by purposefully investing in the development of an interpersonal environment between interviewer and client. Specifically, MI work is done by setting up opportunities to: a) demonstrate a partnership process where possible changes are explored, accepted or rejected b) evoke the client’s own ideas, hopes, goals, reasons, and perceived need for change (rather than attempting to “implant” such motivation) c) demonstrate respect for the fact that the client has autonomy in decision-making throughout an MI conversation d) test the accuracy of the interviewer’s ability to understand and empathize with what the client is thinking and feeling as the conversation unfolds e) offer and express compassion for the best interests of the client so that the work is not conducted in a “technical” way, but rather in a spirit of caring, respect, and genuine positive regard for the client and the outcomes sought
Much of MI work involves learning to overcome a reflex-type reaction that can flare up in an interviewer as soon as one has a sense of what the client could (or should) do to address the concern that is under discussion. MI work is often impeded by giving information and advice (when it is not wanted or asked for by the client). MI involves developing some new skills and strong self-discipline – so that we can learn to “evoke” motivation for change. This requires that interviewers learn to thwart their best intentions of “changing the client” by directing, advising, telling, and informing. Conducting MI conversations involves “tweaking” a number of core communication competencies – so that they can be employed in a new way (and one that doesn’t always feel natural at first!) If you’d like more clarification about what MI is, and what it is not, please feel free to call us anytime – or have a look at a few of our T.I.P.s documents here
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