Among the approaches to one-on-one therapy in Orange County used at SoCal Mental Health is motivational interviewing (MI). Through the use of MI, individuals can work through their fears and ambivalence to discover the inner drive to make a change in their behavior. Changing one’s life is hard enough as it is, and this method is practical, compassionate, and short-term in nature.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MI’s central principle is “motivation to change should be elicited from people, not imposed on them,” according to S. Rollnick and J. Allison in The Essential Handbook of Treatment and Prevention of Alcohol Problems. In a 2009 article, Rollnick later suggested that MI is “a person-centered form of guiding to elicit and strengthen motivation for change.”
Principles of Motivational Interviewing
MI is a method that operates on some central assumptions that speak to the core of many harmful habits and behaviors:
- When it comes to altering one’s habits, such as substance use disorder (SUD), ambivalence about change is common and significant.
- Ambivalence can be resolved by exploring the client’s intrinsic motivations and values.
- The therapist’s relationship with the client is a collaborative partnership to which each party brings important expertise.
- An empathic, supportive counseling style provides conditions under which change can occur.
As a result of motivational interviewing, clients are more likely to make positive changes in their lives. Resolution of clients’ ambivalence regarding harmful habits is a crucial MI emphasis, and targeting this is vital when working with a client. When doubts and reservations are addressed, real progress is possible.
Indications for Motivational Interviewing
MI is often used when it comes to treating addiction and health problems, including SUD, diabetes, heart disease, and more. Using MI, individuals will become more motivated to make better lifestyle choices. It can also help people become ready for more specialized forms of treatment. This intervention has been proven to be effective with people who are uninspired or unprepared to change at first. People who are enraged or aggressive may benefit from motivational interviewing.
MI can also assist people who are not ready to commit to treatment. According to the previously mentioned SAMHSA resource on MI, alcohol, and drug use problems are more common among those who are homeless. The positive outcomes specific to using MI in homeless services have been beneficial in motivating individuals through one-on-one interviewing. MI reflects a longstanding tradition of humanistic counseling and the person-centered approach.
Client-Counselor Relationship and P.A.C.E.
MI is a treatment that emphasizes teamwork between the therapist and the patient. In a compassionate therapy approach, clients learn about their internal inconsistencies in harmful behaviors, and they work with the therapist on resolving their doubts so that they are more motivated to make positive changes. This strategy is based on the idea that real emotional progress requires a client’s desire to change.
MI is a unique counseling method that uses specialized therapeutic abilities to promote the client’s desire to stop using substances or other harmful habits. Providers must reflect the spirit of MI–the underlying view that a partnership exists between the provider and client that promotes a collaborative approach to change–to be successful with MI. At SoCal Mental Health, our providers have studied MI and are proficient in the skills and techniques required.
According to SAMHSA, Partnership, Acceptance, Compassion, and Evocation (PACE) are all components of MI:
- Partnership is a joint effort between the service provider and the client. When a provider demonstrates empathy and genuine interest in the client’s viewpoint, a client is more likely to voice concerns.
- Acceptance is the act of showing respect and esteem for the client. It demonstrates the provider’s desire to comprehend the client’s problems and points of view. Providers may utilize the four acceptance components of MI—absolute worth, correct empathy, autonomy support, and affirmation—to better understand the client’s circumstances and choices.
- Compassion refers to the provider actively promoting the client’s welfare and prioritizing the client’s needs.
- Evocation is the process of eliciting and exploring a client’s existing motivations, values, strengths, and resources.
How Does Motivational Interviewing Work?
MI occurs between a counselor or therapist and a client as they discuss a negative aspect of an individual’s life regarding mental health and lifestyle. The process is a person-centered, or client-centered, approach to counseling and therapy influenced the development of MI as a technique. The primary goal is to encourage individuals to engage in the sometimes arduous change process by identifying the person’s own goals and desires.
The process has two stages: 1) increasing someone’s motivation and 2) committing to action. Hearing one’s commitment spoken aloud has been proven to assist clients in making changes instead of merely expressing a need or wish for them to change. The therapist’s job is more about listening than it is about making suggestions or taking action. In addition to cognitive therapy, support groups like Alcoholics Anonymous (AA) and stress management training programs often use motivational interviewing in conjunction with or after other treatments.
Historically, clients’ reluctance to comply with treatment and therapy has been seen as a difficult problem to overcome. MI’s approach to resistance to change has evolved as the method has grown. MI sees resistance as a natural response to the counselor’s approach in the present rather than as a pathological defensive mechanism on the part of the client.
Better outcomes are associated with MI due to the consistent counselor conduct that focuses on eliciting desires for a better life. Empathy and a warm demeanor are critical for the interviewer. The more client can work with a MI counselor to talk through any internal or external roadblocks that they may be feeling, the more likely they will be able to commit to making positive changes that support their recovery goals.