MOTIVATIONAL INTERVIEWING

Motivational Interviewing (MI) is a method started by William R. Miller in 1983 and further developed with Stephen Rollnick. It is a collaborative, person-centered approach that helps individuals find their own motivation to change by addressing their mixed feelings. This approach combines Carl Rogers' principles of building relationships with more active strategies like those used in CBT. MI has shown promising results in areas like alcohol dependence, smoking cessation, drug addiction, HIV-risk behaviors, treatment adherence, diet, exercise, and eating disorders.

How Does the Motivational Interviewing Work?

Motivational Interviewing is a technique that helps people make positive changes in their lives and can be explained via four key ideas:

• Expressing Empathy: understanding the world from the client's perspective
• Supporting Self-Efficacy: encouraging clients to believe in themselves and their ability to change, while also being responsible for making and following through with their decisions.
• Rolling with Resistance: instead of arguing with clients when they resist change, counsellors use resistant statements to understand the clients' views.
• Developing Discrepancy: helping clients see the gap between their current situation and where they want to be (when clients realize their current behaviors are not helping them reach their goals, they may be more likely to want to change)

Autonomy, Goal-Setting, and Collaboration in Treatment

One key feature of MI is that it does not require professional training in psychology or nursing, making it useful in various settings including healthcare and prisons. Nonetheless, MI has standards and quality control measures, like the Motivational Interviewing Treatment Integrity (MITI) scale, to ensure it is done correctly.

Additionally, MI is distinguished by three main concepts that set it apart from many other treatment methods:

It is important to note that MI does not give an emphasis on the underlying causes of addiction, such as past traumas or mental health issues. Instead, it is meant to complement other therapies, like cognitive behavioral therapy. MI can be a valuable component of an inpatient treatment program or a preparatory step before exploring other recovery options. While MI incorporates elements from various therapeutic approaches, including humanistic therapy, cognitive dissonance theory, relationship building in therapy, and positive psychology, it achieves its greatest effectiveness when used in combination with other treatment forms.

What has been shown in recent studies on Motivational Interviewing?

Research by Apodaca and Longabaugh (2009) showed that three things in MI sessions lead to better outcomes: when clients talk about changing (change talk), when they feel the difference between their current state and their goals (experience of discrepancy), and when therapists stick to MI methods (therapist MI-consistent behavior). Conversely, when therapists deviate from Motivational Interviewing techniques, the efficacy of the approach notably diminishes.

Furthermore, MI can be useful in helping gay men, bisexual men, and other men who have sex with men (gbMSM) engage in healthy behavior. The effectiveness of MI in treating addiction is examined in two prior studies that investigated how MI can assist gbMSM who use methamphetamine and participate in risky sexual behaviors (Knight et al., 2019):

• The first, by Parsons et al. in 2014, divided participants into two groups. One group had four sessions of motivational interviewing, and the other received an equal number of educational sessions. After a year, both groups reported using less methamphetamine. However, the group that received motivational interviewing also showed a decrease in unprotected anal sex.
• The second research, by Zule et al. in 2012, focused on a single session of motivational interviewing with men who were not currently receiving any treatment for methamphetamine use. They checked on the participants two months later and found that this single session was linked to a reduction in both methamphetamine use and unprotected sex. This led the researchers to suggest that even one session of MI could be beneficial, especially in situations where more sessions aren't possible.