Imagine you’ve been struggling with your mental health lately.
You’ve been sleeping in late, skipping the gym, not eating how you’d like to, spending too much time scrolling on social media…
And you decide you want to make a change.
But you find yourself stuck in a cycle of trial and error and realize, the decision to change these habitual behaviors alone is not enough.
Sometimes we need to dig deeper to find the motivation to change and ensure that we are ready, willing, and able to commit to that change.
This is where Motivational Interviewing (MI) may be useful.
Healthcare professionals play a large role, not only providing patients with the equipment to change (whether that be a drug, medical device, etc.) but also ensuring patients feel understood, prepared, and motivated to endure the sometimes-intimidating path towards change.
MI can help with this – not only in the healthcare and life science fields, but in many other fields where a longstanding behavior needs to be changed.
In our three-part article series, we take a closer look at how MI works. The first segment begins below.
When people want to change a behavior, whether it be a bad habit, a psychological response, or disordered patterns, they need to be motivated to do so.
One of the greatest challenges for mental health practitioners is helping patients change longstanding behaviors that pose significant health risks.² To improve patients’ mental health care and treatment quality, many counselors, behavioral health specialists, and other healthcare professionals (HCPs) have turned to Motivational Interviewing (MI).
MI is a counselling method that focuses on enhancing a patient’s individual motivation to change a longstanding behavior for a better quality of life.² In this series of articles, we will take a look at MI, how it works, and how to use it in practice.
Background
MI was developed in the 1980s by William R. Miller and Stephen Rollnick to support patients with substance use disorders. Alongside its usefulness in alcohol and drug abuse treatments, MI is now often used to support patients in making positive life changes across a variety of fields. These include public health, medical care, criminal justice, education, sports, and parenting.²˒³˒⁴
By using MI in these fields and others, patients can experience many benefits, such as⁵:
Reduced risk of relapse
Increased patient self-confidence and self-trust
Improved receptiveness to treatment
Responsibility for actions
Empowerment for positive changes
The effectiveness of MI is supported by overwhelming research, regardless of whether it’s used as an alternative to intervention, on its own, or alongside other treatment approaches. Over 90 clinical trials have proven its efficacy, spanning populations varying in culture, ethnicity, age, and professions.³ In one of the largest analyses conducted for MI, researchers reviewed over 115 studies and concluded that MI was effective for 75% of all participants.⁶
But the high efficacy of MI to change behavior isn’t just as simple as using specific techniques – the right environment must first be created to foster open discussions between counselors and patients.
The “Spirit” of MI
Successful MI techniques require counselors to dig deep with patients to uncover their underlying motivations to change a behavior. This can be a tough and multi-layered conversation. Because of this, patients need to feel safe and respected.
This type of environment, where patients feel safe, accepted, and respected, is referred to as the “spirit” of MI.⁵ At the core of MI lies an underlying “spirit”, or way of conversing and interacting with people.⁴
To create the “spirit” of MI, counselors should approach discussions with patients in a person-centered manner.¹ This concept is grounded in the idea that patients are inherently motivated. By this notion, in person-centered therapy, patients often lead the general direction of therapy, while the counselor takes a non-directive role.⁷
When the “spirit” of MI is created and person-centered discussions are used, the kind of dynamic between counselor and patient can be described by the following elements⁴:
Partnership: The counselor has expertise in facilitating change, but the patient has expertise in their own perspective.
Evocation: The counselor draws out the patient’s values, priorities, and motivations for change.
Acceptance: The counselor is nonjudgemental and seeks to understand the patient and is empathetic.
Compassion: The counselor actively promotes and prioritizes the patient’s wellbeing.
The effectiveness of MI is driven by forming a collaborative counselor-patient relationship through person-centered therapy techniques. Patients are more likely to change when the counselor is genuine and warm, expresses unconditional positive regard and reflective listening, is non-judgmental, and shows empathy.¹
When the right environment is created for patients to feel safe and explore their deepest motivations, MI can be a highly effective tool to change patient behavior. Once the “spirit” of MI is created, the stage is set for patients to work on moving forward towards change.
In the next segment of this article series, we’ll take a closer look at the goal of MI and its processes.
"Motivational interviewing is a person-centered counseling style for addressing the common problem of ambivalence about change.¹"
– Miller and Rollnick, 2013
References
Substance Abuse and Mental Health Services Administration. Chapter 3 - Motivational interviewing as a counseling style. In: Enhancing motivation for change in substance use disorder treatment. 2019.
D. I. Lubman, K. Hall,T. Gibbie. Motivational interviewing techniques facilitating behavior change in the general practice setting. Australian Family Physician - The Royal Australian College of General Practitioners (RACGP). 2012;41(9).
Center for Care Innovations. What exactly is motivational interviewing? Careinnovations.org. Accessed January 19, 2024.
Motivational Interviewing Network of Trainers. Understanding motivational interviewing. motivationalinterviewing.org Updated 2021. Accessed January 19, 2024.
Free by the Sea. Motivational interviewing for substance abuse,. Free by the Sea webpage. Updated 2024. Accessed February 15, 2024.
Butler Center for Research. Motivational interviewing. Hazelden Betty Ford Foundation. Updated 2017. Accessed February 14, 2024.
L Yao,R. Kabir. Person-centered therapy (rogerian therapy). StatPearls; 2023.
