Motivational Interviewing

Motivational Interviewing (MI) is a style of working with a client that focuses on allowing the client to direct the change rather than telling the client what they need to do. It is about having a conversation about change. MI is considered to be an evidence-based practice that has proven to be successful.

 t3 (think. teach. transform.) – a Seattle-based company that is affiliated with the Center for Social Innovation in Needham, MA describes MI as “a person-centered, goal-oriented, guiding method to enhance motivation to change.”

Mark Howarth from Invisible People interviewed Ken Kraybill from t3 in this short video which explains some of the highlights of Motivational Interviewing.

Ken says we try to have a conversation that draws out from the person what their own needs/desires are, what kind of life they really want to have, how that’s dissonant from the life they’re living. Not to guilt trip them but to just to help them shine a light on it.

A longer video from Bill Matulich who is part of the Motivational Interviewing Network of Trainers provides descriptions of some of the MI concepts. In the video he explains that the Spirit of MI is described as:

  • Partnership – Work collaboratively and avoid the “expert” role.
  • Acceptance – Respect the client’s autonomy, potential, strengths and perspective.
  • Compassion – Keep the client’s best interests in mind.
  • Evocation – The best ideas come from the client.

Bill also says that there are Four Key Skills (known as the OARS) that must be mastered by the counsellor:

  • Open Questions – these are questions that call for more than a short, yes/no answer. Rather than saying “Don’t you want to move to a safer place?” the counsellor would say “What are the advantages you see in moving to a safer place?”
  • Affirmations – these are positive comments that a counsellor can make about their life (awards, attempts, achievements, accomplishments ) i.e. “You were successful in changing in the past” or “You care a lot about your family.”
  • Reflections – this means understanding what the client is thinking and feeling and then saying it back to the client. Rather than asking the client a question you rephrase and summarize what the client said. (This stage is also a key component of Active Listening).
  • Summaries – are longer reflections that encapsulate more than one client statement. This includes summing up the entire direction of the conversation.

Bill also outlines the Four Processes involved in Motivational Interviewing. These steps usually need to go in order (i.e. you need to become engaged with your client before you can start focusing on the client’s issues.)

  • Engaging – “The process of establishing a trusting and mutually respectful relationship.”
  • Focusing – “An ongoing process of seeking and maintaining direction.”
  • Evoking – “Eliciting a client’s own motivation for change.” You’re “eliciting change talk” which can be defined as “Client speech that favours movement in the direction of change.”
  • Planning – “Developing a specific change plan that the client agrees to and is willing to implement.” When you develop a plan with a client it must be a “SMART” plan – “Specific, Measurable, Achievable, Relevant and Timed”.