Motivational interviewing
Motivational Interviewing, or MI therapy, is like a guiding compass for you when you’re navigating the challenging process of change. Have you ever felt the struggle of trying to make a significant shift in your life, knowing deep down its importance for your mental health and well-being, yet finding it tough to turn that knowledge into action? That’s where this evidence-based counseling approach steps in–helping you tap into your intrinsic motivation, empowering you to make positive changes in your life, whether it’s in health, behavior, or breaking free from addictive patterns.
What are the origins of motivational interviewing?
Developed by William R. Miller and Stephen Rollnick in the ’80s, MI Therapy emerged as a beacon of hope in the realm of transformative counseling practices. Miller and Rollnick originally wanted to address issues like substance misuse.
Since then, MI has evolved to touch various aspects of life, from supporting adolescents in behavioral health to helping people change and aiding individuals in their journey towards freedom from addictive behaviors. Picture MI as a nurturing space where you can explore your ambivalence, discover your own reasons for change, and collaboratively pave the way to a more empowered and fulfilling life journey.
When is motivational interviewing used?
Motivational Interviewing is a versatile approach that supports and expresses empathy for individuals, groups, and families in making positive behavior changes. It is commonly used across diverse populations, and conditions where it is commonly used include: substance use disorder (SUD), alcohol use disorder (AUD), unsafe sex practices, and risky behavioral reduction.
Motivational interviewing is also used in combination with CBT for anxiety treatment, including generalized anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and anxiety caused by traumatic brain injuries.
How does motivational interviewing work?
In MI therapy, the focus is on understanding your feelings, thoughts, and goals related to change and to support self-efficacy. By discussing your motivations and exploring the benefits and risks of change — as well as the benefits and risks of not changing — you can start to build your own pathway towards a healthier and more fulfilling lifestyle.
Although motivational interviewing is a therapeutic technique employed by licensed professionals, it’s meant to feel like you’re having a supportive chat with a friend. The other person — in this case, a therapist — helps you explore your reasons for wanting to make a behavior change. The therapist doesn’t necessarily see change as the goal; they’re more like a sounding board who asks insightful questions to help you uncover the right next steps for you.
Four main principles make up the spirit of motivational interviewing. They are:
- Partnership – A therapeutic collaboration between you and your therapist. Instead of telling you what to do, the therapist guides you to find your own desires and confidence to make positive changes in your life.
- Acceptance – Respecting your individual needs and autonomy
- Compassion – Respecting, promoting, and acknowledging your needs and feelings
- Evocation – Creating space to explore motivations, strengths, and values that you already possess to drive change
In addition, motivational therapy involves four processes during therapy:
- Engagement – Empathetic, client-centered listening
- Focusing – Naming of a target goal for change
- Evoking – Supporting your own intrinsic motivation
- Planning – Using your own knowledge and expertise to generate life changes
A main goal of motivational interviewing is to assess where you are in the “stage of change.” Many therapists use Prochaska and DiClemente’s transtheoretical model “stages of change” theory to assess their clients. The five stages of change, according to the transtheoretical model are:
- Precontemplation stage
- Contemplation stage
- Preparation stage
- Action stage
- Maintenance stage
What is motivational interviewing like?
When you begin MI therapy, you can expect a collaborative and conversational style of therapy where your therapist will work with you to explore and resolve ambivalence towards change you’re considering making. The spirit of motivational interviewing is person-centered, using a counseling style that maintains a gentle, collaborative tone throughout, allowing you to voice your reasons and motivations for change rather than being directed.
Your therapist may ask you questions like “Can you tell me more?”, “What does that mean to you?”, or “How do you feel about that?” In MI therapy, sessions may involve reflective listening, exploring your motivations, values, and goals, as well as discussing potential strategies for change. After sessions, you may be encouraged to reflect on your thoughts, feelings, and actions, possibly through homework assignments or journaling activities tailored to support your progress.
How long does motivational interviewing take?
The number of sessions needed can vary depending on your goals and progress. This typically ranges from a few sessions to several months, with a frequency that suits your needs and schedule as agreed upon by you and your therapist. Initially, your therapist may ask you open-ended questions to understand your perspective on change, your goals, and any barriers you may face.
Is motivational interviewing effective?
A systematic review of reviews from 2018 in the UK looked at over 5,000 records, and over 100 reviews, including close to 40 meta-analyses, to gauge the effectiveness of motivational interviewing. The researchers found that motivational interviewing therapy is overall effective, but the degree of efficacy depends on the issue you’re trying to address.
For example, according to the researchers, motivational interviewing is most effective at managing and preventing behaviors like binge drinking, decreasing drinking frequency, smoking, and substance abuse. But, it seems to be less effective for people with gambling issues. Not surprisingly, MI therapy appears to be less effective for people who do not have a desire to change.
Other studies have shown that MI therapy is more effective in a one-on-one format than in groups, and one of the benefits of MI therapy is that it works well in combination with other types of therapy. One 2016 study demonstrated that combining MI Therapy with CBT was particularly effective at treating generalized anxiety disorder.
How to find a clinician who practices motivational interviewing
If you think motivational interviewing therapy might be right for you, it’s important to speak with a licensed and experienced clinician trained in this model. Since MI therapy can involve digging deep to look at motivations and breaking old patterns, you’ll want a therapist who is not only compassionate and patient but also experienced in creating a supportive environment. Don’t hesitate to ask about their background to make sure their clinical practice is the right fit for your specific needs.
There are many types of mental health care providers who practice MI therapy, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.
On top of finding someone specializing in MI therapy, you want to make sure they meet your other needs. For example, if you’re struggling with a specific behavioral addiction, like sex, you’ll want to find a therapist who can practice MI therapy and also has experience treating sex addiction. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.
You can find a therapist who accepts your insurance and specializes in motivational interviewing by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Motivational Interviewing” from the “Treatment methods” drop-down.