Table of ContentsView AllTable of ContentsKey ConceptsPrinciplesTechniquesUsesBenefitsEffectivenessThings to ConsiderHow to Get Started
Table of ContentsView All
View All
Table of Contents
Key Concepts
Principles
Techniques
Uses
Benefits
Effectiveness
Things to Consider
How to Get Started
Motivational interviewing is a counseling approach designed to help people find the motivation to make a positive behavior change. This client-centered approach is particularly effective for people who have mixed feelings about changing their behavior.
It’s possible to experience to have conflicting desires, such as wanting to change your behavior, but also thinking that you’re not ready to change your behavior. The motivational interviewing approach holds that resolving this ambivalence can increase a person’s motivation to change.
The 6 Stages of Change
The Spirit of Motivational Interviewing
Motivational interviewing should always be implemented with a particular “spirit.” According to Miller and Rollnick, the “spirit” is collaborative, evocative, and honors client autonomy.
In order for motivational interviewing to be effective, the therapist must maintain this overall “spirit.”
Collaboration Instead of Confrontation
Collaboration is a partnership formed between the counselor and the client. In motivational interviewing, this relationship is based on the point of view and experiences of the client.
This approach contrasts with some other therapeutic approaches, specifically those in which the counselor is confrontational and imposes their own point of view about their client’s behavior.
Collaborationbuilds rapportbetween the therapist and the client. It allows the client to develop a trusting relationship with their counselor, something that is difficult to do in a more confrontational environment.
Evocation Rather Than Education
The notion of the counselor drawing out a client’s ideas rather than imposing their own opinions is based on the belief thatmotivationto change comes from within. As such, it cannot come from the counselor.
No matter how much the counselor might want a person to change their behavior, it will only happen if the individual also wants to change. So, it is the counselor’s job to “draw out” their client’s true motivations for this change. Once these motivators are identified, the client can use them to make therecovery processeasier or to help them keep going when they want to give up.
Unlike treatment models that emphasize the counselor as an authority figure, motivational interviewing recognizes that the true power for making changes rests within the client. The counselor cannot demand this change.
Put another way, it is up to the client to take the actions necessary to change their behavior. They must put in the work. This is self-empowering to the individual, but also gives them personal responsibility over their actions.
Principles Behind Motivational Interviewing
Althougheach person’s journey is different, counselors who use motivational interviewing hold true to four principles throughout the recovery process. These principles are vital to establishing trust within the therapeutic relationship.
Express Empathy
Instead of judging, counselors focus on understanding the situation from their client’s point of view. This is known asempathy.
A counselor doesn’t have to agree with their client to show empathy. Empathy is about surrendering your own opinions in order to understand someone else. This practice creates a safe space where clients feel comfortable being themselves and sharing their concerns.
Develop Discrepancy
Developing discrepancy is based on the belief that a person becomes more motivated to change once they see the mismatch between where they are and where they want to be.
It is a counselor’s job to help clientsidentify their core valuesand clarify their personal goals. Goals and actions are developed in a trusting, collaborative atmosphere free from pressure. This offers an environment that is based on the person’s needs, wishes, goals, values, and strengths.
Roll With Resistance
Motivational interviewing understands that change doesn’t always happen just because you want it. It’s natural to change your mind many times about whether you want to change your behavior and what that process or new lifestyle looks like.
For example, if a client reveals that they started drinking to cope with a partner’sinfidelity, the counselor might help them reframe the situation. Instead of the client blaming themselves, they may begin to see that the person cheated because of their own issues.
Support Self-Efficacy
In the beginning, the therapist may have more confidence in the individual than they have in themselves, but this can change with ongoing support. Soon, the client starts to recognize their strengths and ability to change their behavior for the better.
Self Efficacy and Why Believing in Yourself Matters
In motivational interviewing, counselors help people explore their feelings and find their own motivations. They do this using four basic techniques.
Open-Ended Questions
Open-ended questionsare questions you can’t answer with a simple “yes” or “no.” These types of questions encourage you to think more deeply about an issue.
Such questions often start with words like “how” or “what,” and they give your therapist the opportunity to learn more about you. Examples of open-ended questions include:
Affirmations
Affirmations are statements that recognize a person’s strengths and acknowledge their positive behaviors. Done right, affirmations can help build a person’s confidence in their ability to change.
Examples of affirming responses include:
Reflective Listening
Reflection or reflective listening is perhaps the most crucial skill therapists use. Reflection lets a client know that their therapist is listening and trying to understand their point of view. It also gives the client the opportunity to correct any misunderstandings and to elaborate on their feelings.
Reflection is a foundational skill of motivational interviewing and how therapists express empathy.
Summaries
Summaries are a special type of reflection. They show that the therapist has been listening and understand what the client has been saying.
Therapists can use summaries throughout a conversation. Some examples of summarizing techniques include:
What Motivational Interviewing Can Help With
Motivational interviewing can also be used as a supplement tocognitive behavioral therapy (CBT)for anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD).This approach has even been used to reduce the fear of childbirth.
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Benefits of Motivational Interviewing
There are several reasons why motivational interviewing is a widely used form of mental health therapy, including:
Motivational interviewing is especially beneficial to people who are initially resistant to starting a treatment program or who are unprepared to make the necessary life changes.
Since motivational interviewing was first introduced in the 1980s, studies have shown that it can effectively treat a range of psychological and physical health conditions.
One meta-analysis of 72 clinical trials found that motivational interviewing led to smoking cessation, weight loss, and cholesterol level control.
Research also reveals that motivational interviewing can aid inaddiction treatment. Another review showed that, of the 39 studies reviewed, two-thirds found that motivational interviewing was associated with significant reductions in adolescent substance use.
Yet another review indicates that motivational interviewing can effectively reducebinge drinkingas well as the frequency and quantity of alcohol consumed.
Motivational interviewing can effectively treat a variety of conditions. But keep in mind that there is no one form of therapy that is appropriate for everyone and works in every instance.
Although motivational interviewing has helped many people find the motivation to make both small and major behavior changes, it’s not the ideal course of treatment for everyone.
Motivational interviewing works best for people who havemixed feelingsabout changing their behavior. If you have absolutely no desire to change your behavior, or are already highly motivated to change, you may not reap the benefits of this approach.
If you feel that you or someone you love might benefit from this counseling approach, consider the following first steps:
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7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Miller WR, Rollnick S.Motivational interviewing: Helping people change. 3rd ed. Guilford Press; 2013.Bandura A.Self-efficacy: Toward a unifying theory of behavioral change.Psychol Rev. 1977;84(2):191-215. doi:10.1037/0033-295X.84.2.191Randall CL, McNeil DW.Motivational interviewing as an adjunct to cognitive behavior therapy for anxiety disorders: A critical review of the literature.Cogn Behav Pract. 2017;24(3):296-311. doi:10.1016/j.cbpra.2016.05.003Abdollahi S, Faramarzi M, Delavar MA, Bakouei F, Chehrazi M, Gholinia H.Effect of psychotherapy on reduction of fear of childbirth and pregnancy stress: A randomized controlled trial.Front Psychol. 2020;11:787. doi:10.3389/fpsyg.2020.00787Rubak S, Sandbaek A, Lauritzen T, Christensen B.Motivational interviewing: A systematic review and meta-analysis.Br J Gen Pract. 2005;55(513):305-312.Barnett E, Sussman S, Smith C, Rohrbach L, Spruijt-Metz D.Motivational interviewing for adolescent substance use: A review of the literature.Addict Behav. 2012;37(12):1325-1334. doi:10.1016/j.addbeh.2012.07.001Frost H, Campbell P, Maxwell M, et al.Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews.PLoS One. 2018;13(10):e0204890. doi:10.1371/journal.pone.0204890Additional ReadingRollnick S, Miller WR.What is motivational interviewing?Behav Cogn Psychother. 1995;23(4):325-334. doi:10.1017/S135246580001643X
7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Miller WR, Rollnick S.Motivational interviewing: Helping people change. 3rd ed. Guilford Press; 2013.Bandura A.Self-efficacy: Toward a unifying theory of behavioral change.Psychol Rev. 1977;84(2):191-215. doi:10.1037/0033-295X.84.2.191Randall CL, McNeil DW.Motivational interviewing as an adjunct to cognitive behavior therapy for anxiety disorders: A critical review of the literature.Cogn Behav Pract. 2017;24(3):296-311. doi:10.1016/j.cbpra.2016.05.003Abdollahi S, Faramarzi M, Delavar MA, Bakouei F, Chehrazi M, Gholinia H.Effect of psychotherapy on reduction of fear of childbirth and pregnancy stress: A randomized controlled trial.Front Psychol. 2020;11:787. doi:10.3389/fpsyg.2020.00787Rubak S, Sandbaek A, Lauritzen T, Christensen B.Motivational interviewing: A systematic review and meta-analysis.Br J Gen Pract. 2005;55(513):305-312.Barnett E, Sussman S, Smith C, Rohrbach L, Spruijt-Metz D.Motivational interviewing for adolescent substance use: A review of the literature.Addict Behav. 2012;37(12):1325-1334. doi:10.1016/j.addbeh.2012.07.001Frost H, Campbell P, Maxwell M, et al.Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews.PLoS One. 2018;13(10):e0204890. doi:10.1371/journal.pone.0204890Additional ReadingRollnick S, Miller WR.What is motivational interviewing?Behav Cogn Psychother. 1995;23(4):325-334. doi:10.1017/S135246580001643X
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Miller WR, Rollnick S.Motivational interviewing: Helping people change. 3rd ed. Guilford Press; 2013.Bandura A.Self-efficacy: Toward a unifying theory of behavioral change.Psychol Rev. 1977;84(2):191-215. doi:10.1037/0033-295X.84.2.191Randall CL, McNeil DW.Motivational interviewing as an adjunct to cognitive behavior therapy for anxiety disorders: A critical review of the literature.Cogn Behav Pract. 2017;24(3):296-311. doi:10.1016/j.cbpra.2016.05.003Abdollahi S, Faramarzi M, Delavar MA, Bakouei F, Chehrazi M, Gholinia H.Effect of psychotherapy on reduction of fear of childbirth and pregnancy stress: A randomized controlled trial.Front Psychol. 2020;11:787. doi:10.3389/fpsyg.2020.00787Rubak S, Sandbaek A, Lauritzen T, Christensen B.Motivational interviewing: A systematic review and meta-analysis.Br J Gen Pract. 2005;55(513):305-312.Barnett E, Sussman S, Smith C, Rohrbach L, Spruijt-Metz D.Motivational interviewing for adolescent substance use: A review of the literature.Addict Behav. 2012;37(12):1325-1334. doi:10.1016/j.addbeh.2012.07.001Frost H, Campbell P, Maxwell M, et al.Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews.PLoS One. 2018;13(10):e0204890. doi:10.1371/journal.pone.0204890
Miller WR, Rollnick S.Motivational interviewing: Helping people change. 3rd ed. Guilford Press; 2013.
Bandura A.Self-efficacy: Toward a unifying theory of behavioral change.Psychol Rev. 1977;84(2):191-215. doi:10.1037/0033-295X.84.2.191
Randall CL, McNeil DW.Motivational interviewing as an adjunct to cognitive behavior therapy for anxiety disorders: A critical review of the literature.Cogn Behav Pract. 2017;24(3):296-311. doi:10.1016/j.cbpra.2016.05.003
Abdollahi S, Faramarzi M, Delavar MA, Bakouei F, Chehrazi M, Gholinia H.Effect of psychotherapy on reduction of fear of childbirth and pregnancy stress: A randomized controlled trial.Front Psychol. 2020;11:787. doi:10.3389/fpsyg.2020.00787
Rubak S, Sandbaek A, Lauritzen T, Christensen B.Motivational interviewing: A systematic review and meta-analysis.Br J Gen Pract. 2005;55(513):305-312.
Barnett E, Sussman S, Smith C, Rohrbach L, Spruijt-Metz D.Motivational interviewing for adolescent substance use: A review of the literature.Addict Behav. 2012;37(12):1325-1334. doi:10.1016/j.addbeh.2012.07.001
Frost H, Campbell P, Maxwell M, et al.Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews.PLoS One. 2018;13(10):e0204890. doi:10.1371/journal.pone.0204890
Rollnick S, Miller WR.What is motivational interviewing?Behav Cogn Psychother. 1995;23(4):325-334. doi:10.1017/S135246580001643X
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