Helping people change © Miller & Rollnick
What is it? Put simply, Motivational Interviewing (MI) helps us to have conversations that promote change and hope. One way to think about whether you are using this approach is to ask whether you feel like you are wrestling with the person you are speaking with, or dancing. MI helps us to feel like we are dancing together in step rather than fighting or struggling. The following is another definition. Motivational Interviewing is a ‘collaborative conversation style for strengthening a person’s own motivation and commitment to change’(Miller 2013). Professor William Miller began to develop Motivational Interviewing (MI) in 1983. He was seeking a more effective and compassionate way to treat substance use problems in an era when treatment was directive and confrontational, and as a result was increasing people’s resistance to change. Motivational Interviewing is a person-centred counselling style that recognises the common issue of ambivalence when making changes of any kind. It is particularly helpful when a person has experienced problems or behaviours for many years which may then result in them or others feeling ‘stuck’, or afraid of change, or lacking in confidence or hope around making a change. How does it work? MI is designed to strengthen a person’s personal motivation and commitment to their goal by exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. Motivational Interviewing pays particular attention to the language of change, including ‘change talk’ and ‘sustain talk’. It offers a range of practical skills involving engaging, listening, reflection, affirmations, focusing, evoking and planning to support a person to successfully make important changes. MI also provides effective strategies for dealing with common problems such as resistance to change and discord between a person and family, carers or health workers around goals and progress and how best to achieve what is important to the person. What are the potential advantages? MI has a strong evidence base with over 200 Randomized Controlled Trials internationally demonstrating its effectiveness in a wide range of areas. These include: mental health - including anxiety, trauma, anger, eating disorders addictions - including smoking, alcohol, cannabis, stimulants, gambling physical health - such as weight loss, diet, exercise, lifestyle, diabetes, oral health, pain management, rehabilitation education - including approaches for adolescents, parents, teachers, disability, health care employment - including performance improvement, physical and mental health, supervision, coaching, culture change correctional services - prison and community based, forensics MI has been effective in supporting particular populations such as veterans and minority indigenous groups. It is also the intervention with the strongest support for helping people with complex dual diagnoses. MI is relatively brief, is grounded in theory and actions which can be verified, is learnable by a broad range of providers, and produces best results when used in conjunction with the approaches or interventions already used in a service so can be easily incorporated into programs. It promotes clients’ expertise in recognizing that they are the best judges of their lives and goals but does not take away from the provider or family and carers’ skills in providing support – instead it offers an alternative way of having conversations so that agreed goals are more likely to be enabled. It is strengths based and solution oriented and focuses on hope, empathy, engagement, personal values and preferences and future possibilities rather than other’s agendas for change or the person’s past unsuccessful attempts.
How do I learn more?
Mudanca provides consultation, training and supervision in Motivational Interviewing.
Mudanca also has a clinic where we use this approach to support clients.
Visit motivationalinterviewing.org for resources and latest research