What is Motivational Interviewing (MI)?

Motivational Interviewing, or MI, was developed by William Miller and Stephen Rollnick as a counseling technique that motivated individuals for change. They define MI as "...a collaborative, person-centered form of guiding to elicit and strengthen motivation for change." MI is considered an evidence based practice for addressing and treating persons with substance use disorders.

 

The "Spririt of MI" is based on three key elements:

  • Collaboration, not confrontation, between the counselor and client
  • Evocation, or drawing out, the client's ideas about change
  • Emphasizing the Autonomy of the client, versus being authoritative with them

 

The Principles of MI are:

  • Express Empathy with the client
  • Support Self-Efficacy
  • Roll with Resistance, or avoid enhancing a client's resistance to change by not confronting it
  • Develop Discrepancy between where the patient is and where they want to be

 

MI Skills and Strategies

There are many skills and strategies related to MI, but the OARS are one of the most basic skills sets to learn for MI. The OARS are types of responses to use with the client to elicit more change talk.

 

  • Open-ended Questions: Ask questions that cannot be answered with a yes or no response
  • Affirmations: Affirm the clients strengths by reframing behaviors or concerns expressed by the client that reinforce positive client qualities
  • Reflections: Make genuine statements back to the client to let them know they are heard and that you are empathetic to their situation
  • Summaries: Make summarizing statements that demonstrate interst, understanding, and highlight the important aspects of the conversation

 

What is Change Talk?

 

Change talk is defined as statements made by the client that show consideration of, motivation for, or a commitment to change. The goal of MI is to get the client to express change talk, because the more an individual talks about change, the more likely they are to change. When you hear change talk from a client, use your OARS to reinforce the change.

 

Resources

Motivational Interviewing

Motivational Interviewing Network of Trainers

National Institute on Drug Abuse (NIDA): Blending Initiative Motivational Interviewing CME/CE and Patient Simulation