What Is Motivational Interviewing?

Motivational interviewing (MI) is a technique that we’ve been talking about in pharmacy for years (e.g., study re: MI and adherence), and care management has also been using this approach (e.g., CV study and chronic kidney study).  As we all know, getting consumers to engage is difficult.  It’s even more difficult to get them to engage and actually change behavior.

As I understand it, this technique is focused on using open ended questions to understand a patient’s barriers to change as expressed in their own words.  It seems to be based on the traditional concept of active listening.  In healthcare, this changes the paradigm from a prescriptive approach to more of an enablement apporach.  Just like health literacy, I think of motivational interviewing as another leg of stool in creating an effective program for care management.  (article on nurse training)

Definition from Wikipedia:

Motivational interviewing (MI) refers to a counseling approach in part developed by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D. The concept of motivational interviewing evolved from experience in the treatment of problem drinkers, and was first described by Miller (1983) in an article published in Behavioural Psychotherapy. These fundamental concepts and approaches were later elaborated by Miller and Rollnick (1991) in a more detailed description of clinical procedures. Motivational interviewing is a semi-directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with non-directive counseling, it is more focused and goal-directed. Motivational Interviewing is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior. The examination and resolution of ambivalence is a central purpose, and the counselor is intentionally directive in pursuing this goal.

Motivational interviewing recognizes and accepts the fact that clients who need to make changes in their lives approach counseling at different levels of readiness to change their behavior. If the counseling is mandated, they may never have thought of changing the behavior in question. Some may have thought about it but not taken steps to change it. Others, especially those voluntarily seeking counseling, may be actively trying to change their behavior and may have been doing so unsuccessfully for years. In order for a therapist to be successful at motivational interviewing, four basic skills should first be established. These skills include: the ability to ask open ended questions, the ability to provide affirmations, the capacity for reflective listening, and the ability to periodically provide summary statements to the client.

Here’s a video on motivational interviewing: