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What is Motivational Interviewing (MI)?

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Reviewed by Bill Wilson, Chief Program Officer at Gaudenzia

Gaudenzia’s treatment model incorporates evidence-based techniques like Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI). In this post, we’ll discuss MI—an evidence-based, collaborative style of communication that helps individuals resolve ambivalence and strengthen their intrinsic motivation to change.

As a person-centered, directional approach, MI provides an effective framework for communicating about change. This includes supporting individuals in their process of coping with behavioral health concerns like substance use and co-occurring disorders, housing insecurity, behaviors connected to justice-involvement, and the impact of trauma on a person.

Looking for “rehab facilities near me” that use Motivational Interviewing? If you or someone you love needs help with substance use and co-occurring disorders, please call our 24-hour Treatment and Referral HelpLine at 833.976.HELP (4357) or email [email protected]

How Does Motivational Interviewing Work?

Developed by William R. Miller and Stephen Rollnick in the 1980’s, MI has two primary goals — to strengthen an individual’s internal motivation to change and to elicit an external commitment to making the change. The spirit of MI naturally creates an equal partnership between a client and their counselor by making the following distinctions:

  • Collaboration vs. Confrontation — An MI approach focuses on the perspective and experiences of the client. Rather than confronting an individual about their behavior, this collaborative style of communication helps foster an understanding of what drives a client’s behaviors and what barriers to change they encounter. This intentional letting go of the “expert” role helps to create an equal partnership where both parties are seen as equally bringing something to the counseling intervention.
  • Evocation vs. Education — A primary goal of MI is to elicit or evoke an individual’s own internal motivation, rather than imposing threats or ultimatums in attempts to force change. Evocation allows the counselor to see the reasons to make a change are already inside the client. By evoking change talk from the client, as opposed to educating clients about why they should make changes, the counselor helps create a space for the client to experience shifts towards change.
  • Autonomy vs. Authority — MI emphasizes the power and autonomy an individual has over their own life, rather than placing a counselor in an authoritative hierarchy above the individual. Supporting self-autonomy and emphasizing personal control helps clients take ownership of their decision regarding change.
  • Compassion vs. Self-Interest —The spirit of MI includes a focus on compassion for the client and a constant attention towards their individual reasons for and against change, without the distraction of the interests of other systems.

An underlying principle of MI is that a person’s motivation to change should come from within, rather than an external source, such as a counselor, family member, or court system.

Motivational Interviewing and Substance Use Disorder

MI takes into consideration how difficult it is to make significant life changes. This is especially true for changing learned behaviors that were, at one point, useful — or even essential — to an individual’s survival, but no longer serve in their best interest.

As an example, an individual with a co-occurring anxiety disorder may turn to drugs or alcohol to calm their nerves before a stressful event. While this behavior seems to help the individual cope during the event, it is not a healthy or sustainable coping mechanism. With repetition, this learned behavior becomes destructive, putting the individual at risk of developing or exacerbating substance use disorder.

Even when the harmful effects of drug and alcohol use are apparent, the individual may still feel ambivalent about changing their behavior, as it is the only way they know how to cope with their anxiety. MI provides a safe, nonjudgmental context for the individual to explore their ambivalence and take part in the process of finding alternate, healthier solutions.          

Motivational Interviewing and The Stages of Change

Ambivalence, or feeling conflicted about making a change, is a common barrier to change. An MI treatment approach can help individuals navigate the process of making significant life changes. The process of change is outlined by Dr. James Prochaska and Dr. Carlo DiClemente’s transtheoretical model of behavior change, commonly known as the Stages of Change.

Stages of Change co-developer Dr. Carlo DiClemente speaks at Gaudenzia’s 28th Annual Women and Children’s Conference (Nov 2022)

The Stages of Change model illustrates the incremental stages an individual may encounter as they confront destructive behaviors and set out to make lasting changes.

The Five Stages of Change are outlined as follows:

  • Precontemplation — At this stage, an individual may be unaware that a problem exists and/or has no intention to change their behavior.
  • Contemplation — An individual is aware that a problem exists and is exploring both sides of the ambivalence about making a change but has not yet committed to it.
  • Preparation — During the preparation stage, an individual has made a commitment to change and intends on acting soon.
  • Action — During the action stage of change, the individual modifies their behavior and/or circumstances with the intention of overcoming their problems.
  • Maintenance — During the maintenance stage, individuals work to prevent returning to old, unhelpful thought patterns and behaviors and focus on sustaining long-term change.

Some professionals consider a “relapse” stage as part of the change cycle and view it as an opportunity to learn and make adjustments that support long-term success.

Counselors can tailor Motivational interviewing techniques to the stage of change an individual is in, helping them process their ambivalence and build the necessary confidence levels to progress to the next stage.

Motivational Interviewing at Gaudenzia

Gaudenzia uses an evidence-based, person-centered treatment model to help break the cycle of substance use and co-occurring disorders.

Our treatment approach integrates Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI) and Relapse Prevention Therapy with care that is gender-responsive, trauma-informed, and culturally responsive.

If you or someone you love needs help with substance use and co-occurring disorders, please call our 24-hour Treatment and Referral HelpLine at 833.976.HELP (4357) or email [email protected] today.

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