Motivational Interviewing & Mental Health
When attempting to create a behavior change on your own you may have mixed feelings about how to proceed, it may be beneficial to have a supportive network of friends, family, and professionals to support you, such as a motivational counselor who can provide motivational therapy to help keep you on track. Some motivational counselors devote their careers to studying how people commit to making healthy life changes. Psychologists trained in motivational interviewing (MI) may be able to help by facilitating behavior change through resolution of the client’s ambivalence. They tend to pay particular attention to finding intrinsic motivators for making behavioral changes.
Motivational interviewing changes can occur, whether ambitious, minor, or somewhere in between. If you're in a season of personal development, motivational interviewing might inspire you to make healthier changes in the present and transform your future.
Motivational interviewing
Motivational interviewing was a process initially developed by clinical psychologist William R. Miller and later expanded on with Stephen Rollnick as an option in clinical practice for those experiencing a substance use disorder. The motivational interviewing process itself is based on the humanistic values of Carl Rogers in which patients are treated with empathy and unconditional positive regard. Miller and Rollnick developed a guide printed by Guilfold Press that serves as a foundation for helping patients change behavior using motivational interviewing principles. The theory and practice of MI in clinical psychology have evolved over subsequent decades, and it's now used in behavioral and cognitive psychotherapy for various conditions.
In a motivational interviewing session, the motivational interviewing therapist often engages a person in a candid discussion to assess whether they’re genuinely interested in change. Client autonomy is typically a key component of motivational interviewing. Motivational behaviors can differ greatly—and people use motivational interviewing for many reasons. The motivation to change may originate in the patient, not the motivational interviewing therapist, which makes it important to consider a client’s ideas in the motivational interviewing process.
Who can benefit from motivational interviewing?
- Healthy nutrition and physical activity levels
- Abstinence from smoking, gambling, unsafe sex, or other behaviors
- Stress management
- Engagement in management programs for diabetes, cardiovascular health, or other health concerns
Principles of motivational interviewing
- Willingness: How open a client is to change
- Ability: The confidence a client has to change
- Readiness: Whether the change is an immediate priority
- Listen with empathy: As a foundational skill, Therapists trained in MI learn to take an active interest in a client's internal perspective and express empathy by showing genuine curiosity and using reflective listening.
- Understand the client's motivations: If the client isn't motivated, change may not occur, regardless of how much a therapist cares for the client's well-being. Instead, the therapist honors client autonomy and strives to support their client’s self-efficacy by reflecting on the their strengths and past successes and restoring confidence in their capacity for change.
- Resist the righting reflex: Counselors may feel inclined to prescribe the "right path" for healthy change, but this can defeat the purpose of MI, as clients may resist change when therapists propose a strict plan of action. A well-trained MI counselor may roll with resistance and emphasize a client's decision to make changes independently, using reflective phrases.
- Empower the patient: Research shows that when clients are primary and active collaborators in their healthcare, the treatment outcomes tend to improve. In MI, empowerment may look like collaboration that boosts a client’s ability to change.
Common motivational interviewing strategies
To build a client's motivation, motivational interviewing counselors use several research-backed strategies to give clients confidence in their ability. There are many motivational, therapeutic techniques that may promote change and support a healthy client-therapist relationship and productive conversation in motivational interviewing. Motivational interviewing strategies include:
Open-ended questions
Affirmations
Reflective listening and phrasing to express empathy
A collaborative "change plan"
- Where do we go from here?
- What do you want to do at this point?
- After reviewing this plan, what's the next step for you?
The client is the change leader in this plan (and in all motivational interviewing strategies). Their motivational interviewing therapist can be a collaborative, trusting professional who recognizes their strengths, autonomy, and vision for the future.
Online motivational interviewing
Takeaway
Motivational interviewing is typically a practical, non-confrontational counseling style that may appeal to diverse people and personalities. If you're experiencing difficulty with behavior change and believe you could benefit from MI, consider reaching out to a counselor. A licensed mental health professional can help you see your full potential, embrace your strengths, and implement changes for a healthier, more fulfilling life. If you feel hesitant about in-person therapy, you might consider online therapy. With BetterHelp, you can be matched with a therapist who has experience using MI as a way of enhancing motivation to make meaningful change. Take the first step toward getting support and contact BetterHelp today.
What're the 5 motivational interviewing principles?
The principles of motivational interviewing can guide motivational interviewing practitioners as they interact with clients. The five motivational interviewing principles are:
- Develop discrepancy
- Express empathy
- Amplify ambivalence
- Roll with resistance
- Support self-efficacy
What're the interviewing for motivation stages of change?
According to the American Addiction Centers, there are six stages of change in motivational interventions like motivational interviewing. These motivational interviewing stages are:
- The precontemplation stage
- The contemplation stage
- The preparation stage
- The action stage
- The maintenance stage
- The termination stage
A motivational interviewing counseling session typically revolves around building a collaborative relationship between the therapist and the client. Motivational interviewing is focused on finding ways to enhance motivation that accurately reflect the client’s experience and goals in their own words. For example, a client might engage in motivational interviewing as a normal part of the process to quit smoking, stop alcohol use, or quit the use of other drugs to improve their lives and reduce risk of heart disease, lung cancer, or other complications.
Can motivational interviewing be used to manipulate someone?
In general, motivational interviewing techniques are used to help someone make decisions and engage in the change process in general rather than to motivate them to make one decision in particular. So while it is possible that someone could use motivational interviewing techniques to manipulate another person, this application would not be in line with the aim of this person-centered form of motivational interviewing nor the ethical standards of the field of motivational interviewing.
What's the motivation for “change talk" in motivational interviewing?
“Change talk” is a term that refers to when a motivational interviewing client starts expressing interest in changing some of their habits or behaviors, such as health-risk behaviors. Motivational interviewing "change talk" in contrast to “sustain talk,” which is talk related to keeping one’s behaviors in line with the current status quo.
Motivational interviewing providers are typically trained in eliciting change talk and to emphasize change talk to encourage clients to reach their goals. In fact, finding a way to elicit change talk is often a core goal of motivational interviewing. The motivation for change talk occurring from the client’s perspective can vary significantly depending on the individual, their goals, and other elements of their journey.
What's the "spirit" of motivational interviewing?
The underlying “spirit of MI” is a term coined by researchers Miller and Rolnick in a 2013 article. In it, they outline four components of the spirit of motivational interviewing, which are:
- Partnership
- Acceptance
- Compassion
- Evocation, or the evoking process
What type of therapy is similar to MI?
MI, or motivational interviewing, is a therapeutic approach that's used across many settings to support those experiencing substance use disorder or related challenges. Acceptance and commitment therapy (ACT) is another approach that may be used instead of or in tandem with motivational interviewing for substance use challenges. Although the two have different foundations and techniques, some older research suggests that they can be similar in their end goals and therefore complementary in many cases.
What is absolute worth?
Absolute worth is a core concept associated with the motivational interviewing (MI) clinical experience and approach. It states that all human beings have inherent worth that should be prized. It falls under the broader concept of acceptance, which is one of the four key components of the spirit of motivational interviewing according to Miller and Rollnick, 2013. Miller & Rollnick also wrote a guide published by Guilford Press to help practitioners guide clients through the motivational interviewing process, the most current version of which was published in 2023.
What is motivational interviewing for substance misuse (formerly “substance abuse”)?
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), motivational interviewing (MI) helps influence the change process in clients experiencing substance misuse-related challenges. Motivational interviewing is a more directive type of talk therapy that involves using four processes or key points—partnership, acceptance, compassion, and evocation—and an overall guiding style that includes expressing empathy regularly to help the individual build core skills that may aid in their recovery. Motivational interviewing practitioners usually find greater success in helping people change by supporting them in coming to their own decisions and setting their own goals.
What is the main aim of motivational interviewing for mental health?
According to the American Psychological Association, motivational interviewing is “a client-centered yet directive approach for facilitating change by helping people resolve ambivalence and find intrinsic reasons for making needed behavior change.” Motivational interviewing is often used in combination with other interventions for individuals experiencing challenges related to substance misuse. That said, the specific aim of motivational interviewing usually depends on the client. Examples of client goals for motivational interviewing could include reducing substance use, cessation of substance use, improving relationships, improving medication adherence, or others.
What is motivational interviewing in nursing?
According to the American Nurse Journal, motivational interviewing in a nursing setting is “a collaborative conversation style that promotes positive health behavior change and strengthens an individual’s motivation and commitment to change.” It also reports that research suggests that as many as 60% of factors that affect a person's risk of early mortality can be attributed to individual behaviors, so motivational interviewing may help healthcare workers motivate individuals to change those behaviors to promote their overall health and longevity.
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