Motivational interviewing (MI) is a counseling style designed to help people resolve ambivalent feelings and increase their motivation to change. The key elements of motivational interviewing include expressing empathy, avoiding argumentation, and providing support and encouragement. The aim is to help people explore their reasons for change and to find the intrinsic motivation to make positive changes in their lives. Motivational interviewing effectively treat various issues, including substance use disorders, eating disorders, and chronic pain.

Motivational Interviewing Processes

The MI intervention employs four main processes or ways the facilitator structures the communication. These processes are detailed below.

Engaging

The MI process of engagement is based on the premise that ambivalence is generally a normal and healthy part of the change process. The counseling relationship is one of the most critical elements of this process, as it provides a safe and supportive space for exploration and growth. MI is a collaborative, non-judgmental process that respects the client's autonomy and encourages them to participate actively in their change process.

Focusing

Ultimately, the focus is on helping the client develop a clear plan for change with a commitment to follow that plan. The focus on creating a shared purpose between the health care professional and the client makes this process effective. It ensures that both parties are working together towards a common goal and that there is a mutual understanding of what needs to be done for changes to occur.

Evoking

This process involves asking open-ended questions and reflecting on what the individual has said to help them explore their motivations for change or the "client's why." This technique can help individuals to articulate their reasons for wanting to make a change and can also help to identify any ambivalence or resistance to change. This technique ultimately aims to help the individual build motivation and commitment.

Planning

This process is the "how" of change. First, the counselor and client work together to create a sustainable plan. This plan should reflect the individual's unique needs and situation and include regular accountability checks.

Stages of Change

Motivational interviewing employs a transtheoretical model, which includes assessing which stage of change the individual is in and working to move the individual from one stage to the next. Five stages of change have been identified.

#1 Precontemplation

In the pre-contemplation stage of change, individuals are not yet considering changing their behavior. They may be unaware of the problem or unwilling to admit that there is a problem. As a result, they are not actively looking for solutions or engaging in any change process. 

MI is designed to help move people from pre-contemplation to contemplation by increasing their awareness of the problem and exploring their willingness to change. This typically involves open-ended questions, reflective listening, and providing information about the consequences of continued inaction. Helping individuals see the problem in a new light can be an essential first step in initiating behavior change.

#2 Contemplation

According to the MI technique, the contemplation stage of change is when an individual begins recognizing that they have a problem and starts considering making a change. This usually happens after a trigger event, such as receiving a poor medical diagnosis, realizing that their current behavior is not sustainable, or experiencing negative consequences due to their behavior. 

During this stage, individuals often swing back and forth between feeling motivated to make a change and feeling ambivalent or resistant. Ultimately, what will determine whether someone moves on to the next stage is their commitment to change and confidence in their ability to succeed.

#3 Preparation

 In the preparation stage, the individual has decided that the negatives of continuing with the harmful behavior outweigh the positives. The individual is planning to change but has not yet moved forward with the plan.

#4 Action

The action stage of change is when an individual starts to take steps to achieve their goal. This is the stage where people are most likely to succeed because they are highly motivated. It is also helpful to have support from others going through the same process during this stage. The action stage of change can be challenging, but it is possible to succeed if the individual is motivated and has a plan.

#5 Maintenance

This stage of change is when an individual has successfully made a behavior change and is working to prevent relapse. This stage requires ongoing effort and may be challenging, but it is important to remember that slips may be a part of the process. To successfully navigate the maintenance stage, individuals must develop a support network, find effective coping mechanisms, and establish a healthy routine. 

An Effective Treatment Technique

MI is an effective technique in substance use disorder (SUD) treatment and recovery. This type of counseling helps the individual identify their motivational factors for change and then work through any ambivalence they may have regarding the change. Motivational interviewing is a client-centered approach that builds on the strengths and resources of the individual. 

Motivational interviewing (MI) is a counseling approach that helps people resolve ambivalent feelings and insecurities to find the motivation they need to change their behavior. The process of MI begins with building rapport with the client. Once rapport is established, the counselor then works to assess the client's level of motivation and explore any ambivalence they may have about changing their behavior. From there, the counselor works with the client to develop a plan of action and set goals for change. Once the change is made, the individual makes a plan for maintaining what they have accomplished. Ultimately, the goal of MI is to help the client find the intrinsic motivation they need to make lasting changes in their life. For more information on how MI can help you or someone you know who is struggling, contact Next Level Recovery Associates at consult@nextlevelra.com.