Seven Principles Of Motivational Interviewing
The following are seven core principles of Motivational Interviewing:
Motivation to change is elicited from the client, and not imposed from without. Emphasis on coercion, persuasion, constructive confrontation and the use of external contingencies go against the spirit of motivational interviewing.
It is the clients task, not the practitioner’s, to articulate and resolve his or her ambivalence. They describe ambivalence as a conflict between two courses of action. The practitioner’s task is to facilitate expression of both sides of the ambivalence impasse, and guide the client toward an acceptable resolution that leads to behavior change.
Direct persuasion is not an effective method for resolving ambivalence. While tempting to be helpful by offering persuasive arguments for change, practitioners usually create resistance to change in their clients.
The motivational interviewing style is generally a quiet and eliciting one. To a practitioner accustomed to confronting and giving advice, motivational interviewing can appear to be a hopelessly slow and passive process.
Readiness to change is not a client trait, but a fluctuating product of interpersonal interaction. Resistance and denial are seen not as client traits, but as feedback regarding therapist behavior. Client resistance is often a signal that the practitioner is assuming greater readiness to change than is the case.
Would You Rather Work In An Ideal Environment With Low Pay Or A Less Ideal Environment For More Pay
Understanding your ideal work situation can help an interviewer learn your motives behind your work or job. This can help them ask more specific questions based on your answer so that they can determine which situation might be most helpful to increasing your happiness at work. When answering this, consider being honest about the way you’d prefer to work, even if it’s different from your current work situation.
Example:”I’ve worked in several environments in the past. Though higher pay is enticing, I’ve noticed that less ideal environments change the way I feel about my work. It’s far more rewarding for me to be proud of the work I do, even if the pay is lower.”
Can You Tell Me About A Time You Stayed Motivated While Doing Repetitive Work
The STAR method can help you answer questions directly related to your work tasks. Though an interviewer asks a question like this to help them understand the way you feel at work, STAR can help you clearly describe your work methodology. STAR stands for:
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Situation: Providing the background information that helps make your answer understandable
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Task: The specific responsibility or topic your story is about
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Action: What you did to resolve the situation
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Result: The resolution your action provided
Example:”One time, I had an assignment to manage a project to help implement a new policy. I had to create the goals and schedule and then supervise the team throughout the project. I’d done this many times before and had no motivation to complete it this time. Later, I realized that focusing on working with my team instead of working on specific tasks made the project a lot more enjoyable for me. By focusing on working well with my colleagues, I made sure we completed the project on time and helped implement the policy efficiently.”
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Establishing A Therapeutic Relationship Using Oars
The acronym OARS can represent the basic skills of MI. Each type of interaction can help build rapport while establishing a therapeutic relationship .
MI skills include the following:
- Open-ended questions encourage the client to talk.
I understand you are concerned about your drinking habits. Can you tell me about them?
- Affirmations can include compliments or statements of understanding. They build rapport and offer support during the process of change.
I appreciate that it must have taken a lot of courage to discuss your drinking habits today.
- Reflections rephrase what the client has said to capture the implied meaning and feelings.
You enjoy having a drink, but you are worried about your reliance on alcohol and its long-term effects.
- Summarizing links different points within the discussion while checking in with the client.
If it is okay with you, can I just check that I have understood everything we have discussed so far?
OARS offers foundational tools for mutual understanding before moving on to focusing, evoking, and planning .
Motivational Interviewing Questions And Skills
5 Nov 2019 Beata Souders, MSc., PsyD candidate
Have you ever been âhealedâ by a long conversation with someone where you were given full attention and felt the other person really listened to you without judgment?
Has a particular relationship made you feel normal, lighter, or good about yourself again? Chances are this happened in an environment that was trusting, open, and frank.
If I can provide a certain type of relationship, the other person will discover within himself the capacity to use that relationship for growth, and change and personal development will occur.
Carl Rogers
This article describes the underlying principles and techniques of one such form of communication known as Motivational Interviewing. Most commonly used to increase motivation toward behavioral change, motivational interviewing is an evidence-based approach designed to encourage clients to talk themselves into making beneficial changes in their lives.
Before you continue, we thought you might like to . These detailed, science-based exercises will help you or your clients create actionable goals and master techniques to create lasting behavior change.
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Read This Article To Learn More About:
- the rationale and core components of motivational interviewing
- how MI differs from traditional consultation styles, and the ways in which it should and should not be used
- the benefits for patients and the wider health service of integrating MI into everyday practice.
Read this article online at: GinP.co.uk/456768.article
Strengthening Commitment To Change
The planning process is just the beginning of change. Clients must commit to the plan and show that commitment by taking action. There is some evidence that client commitment change talk is associated with positive AUD outcomes . One study found that counselor efforts to elicit client commitment to change alcohol use is associated with reduced alcohol consumption and increased abstinence for clients in outpatient treatment .
Usually, people express an intention to make a change before they make a firm commitment to taking action. You can evoke the client’s intention to take action by asking open questions: What are you willing to do this week? or What specific steps of the change plan are you ready to take? . Remember that the client may have an end goal and intermediate action steps to achieving that goal .
Once the client has expressed an intention to change, elicit commitment change talk. Try asking an open question that invites the client to explore his or her commitment more clearly: What would help you strengthen your commitment to ________________ ? .
Other strategies to strengthen commitment to action steps and change goals include :
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Box : Core Components Of Mi810
Four general principles of MI8,9
R resist the urge to change the individuals course of action through didactic means
U understand that it is the individuals reasons for change, not those of the practitioner, that will elicit a change in behaviour
L listening is important the solutions lie within the individual, not the practitioner
E empower the individual to understand that they have the ability to change their behaviour.
Five techniques that can be integrated into your current approach10
MI=motivational interviewing
Core Elements Of Motivational Interviewing
- MI is practiced with an underlying spirit or way of being with people:
- Partnership. MI is a collaborative process. The MI practitioner is an expert in helping people change people are the experts of their own lives.
- Evocation. People have within themselves resources and skills needed for change. MI draws out the persons priorities, values, and wisdom to explore reasons for change and support success.
- Acceptance. The MI practitioner takes a nonjudgmental stance, seeks to understand the persons perspectives and experiences, expresses empathy, highlights strengths, and respects a persons right to make informed choices about changing or not changing.
- Compassion. The MI practitioner actively promotes and prioritizes clients welfare and wellbeing in a selfless manner.
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Avoiding The Righting Reflex
Understandably, as therapists and practitioners, the natural response to resistance talk such as the above tactics evokes in us a felt need to work harder to persuade the client, to let them know that they are wrong . This righting reflex is to be resisted at all costs, as it is the prime response on our part which feeds an escalating spiral of resistance, to the total detriment of any possible change. Instead of playing into a power struggle, we can adopt a motivational interviewing stance, which would say that our job is to clarify and understand, inviting consideration and openness to new perspectives. By encouraging people to come up with their own solutions to situations as they define them, we invite them to new ways of thinking without badgering, lecturing, or imposing our views on them. Emphasising and allowing personal choice and control over their problems can help minimise resistance, as can statements about how normal resistance is.
Principles Of Motivational Interviewing
Psychologists William R. Miller and Stephen Rollnick helped develop the motivational interviewing approach to counseling. In their book Motivational Interviewing: Preparing People to Change Addictive Behavior, they outlined five principles that therapists should adhere to.
The five principles that therapists should adhere to include:
Empathy refers to displays of understanding and sensitivity that help a person relate to the feelings of another. During motivational interviews, therapists create an open environment where clients feel safe to express emotions and attitudes.
Therapists also help clients recognize discrepancies between their current lifestyle and their future goals. By recognizing discrepancies, clients realize the consequences of their actions.
An honest and safe dialogue is created through understanding and empathy. To prevent hostility, therapists should avoid arguing with clients. Clients and therapists naturally take opposite sides of arguments. Instead of forming sides, therapists and clients need to work together.
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The Motivational Interviewing Approach
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Motivational interviewing is a counseling technique which assists the interviewee in identifying the internal motivation to change the clients behavior by resolving ambivalence and insecurities. The term holds similar meaning when it comes to interviewing an individual with substance abuse background. The main aim of Motivational interviewing is to facilitate the intrinsic motivation of the person with a substance use problem to change the behavior. It is a patient-centered approach which aims to help people change their problem behaviors. Similarly, it also facilitates movement towards achieving this goal by consolidating commitment to change.
Furthermore, use of these substances co-occurs with various mental illnesses such as depression, anxiety and psychotic disorders. Substance use is a preventable cause of adverse events such as injury, disability, mental illness, social, legal and financial outcomes and death. Although with a high prevalence of substance use and the adverse effect, only twenty percent of the youth seek professional help. The reason behind it might be the stigma associated with the treatment and moreover, people with substance use disorder do not see it as a problem. MI helps such clients to get insight into the problem.
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Support And Develop Discrepancy
Supporting and developing discrepancy helps the interviewee see the difference between possible outcomes. It also shows them how their behavior affects those outcomes.
Cognitive dissonance occurs when a person holds two or more conflicting beliefs or behaviors. An example might be continuing to smoke cigarettes even though you know smoking is bad for you.
Developing discrepancy helps the interviewee build awareness of the gap between their goal and their current behavior.
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Tell Me About A Time You Thought You’d Miss A Deadline How Did You Resolve It
Motivational interviewers might ask about high-stress moments on the job. This can help them understand how you feel about such moments and how you handle them. The STAR method can help here as well because it can help you structure a story about a specific event to tell the interviewer.
Example:”I once had an article due at the end of the week, even though I had a full schedule of other tasks. I recognized that some of those tasks had higher priority than others. I created a schedule that helped me accomplish the higher priority tasks first before moving on to the others. After I created the schedule, I realized I had time in between tasks to work on the article a little at a time. This allowed me to complete all of my tasks before the end of the week.”
How To Use Motivational Interviewing
On top of the abovementioned MI principles, therapists use other techniques to evoke change. Here are some of the best ones.
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Therapeutic Paradox
The therapeutic paradox is a seemingly contradictory statement from the therapist. This technique is beneficial for clients who have made little progress.
For example, a recovering drug addict will say that staying away from substances is difficult. The counselor might say, Youve tried to quit, but youre still using. Maybe now is not the time for you to quit.
With the client resistant to what the therapist said, they could say that they really want to stop using. Then, the therapist can dig deeper and figure out why quitting is difficult for the client.
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Columbo Approach
This approach revolves around the TV series Columbo, where the titular protagonist rationalizes discrepancies using his skills.
Your therapist may ask a curious question about your behavior. Its not meant to sound judgmental but rather a question that wants more information.
While youre answering, your therapist will listen for contradictory information. Then, theyll present it in a non-judgmental way to make you think about your mindset. Their questioning will end with a call to action to reflect on your behavior.
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Offer Advice
Offering advice may be tricky as people generally dont like being told what to do, resulting in resistance.
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What To Avoid Saying
There are some answers that will not reflect well on you as a candidate. Here’s what to avoid in your response:
- Being off-base from the job at hand. If you’re motivated by factors that aren’t involved in the job description, it’s going to be a red flag for the interviewer. For example, if you say you’re a person motivated and working with people, but the job is an accounting position with little interaction with others, you won’t be considered a good fit for the job.
- Namechecking money. Avoid responses that name money as a motivating factor. While a paycheck and financial benefits are an important reason for working, that’s not the kind of answer interviewers are looking for. Being motivated by praise and acknowledgment is also best avoided in your response.
- Do your best to provide an honest or specific answer. Vague responses aren’t helpful for interviewers. Remember, every question is an opportunity to show off your strengths.
Competencies Of Motivational Interviewing
Competencies of motivational interviewing are a framework that details the delivery of motivational interviewing. Motivational interviewing competencies consist of six domains that act as guidelines for successful motivational interviewing.
Engaging
Engaging with a person is the foundation of motivational interviewing. Maintain a person-centered style to understand a person’s dilemma and values. Engaging also refers to the overall spirit of motivational intervieing. The overall spirit of motivatioanl interviewing highlights open mindedness in collaborating with a person, while recognizing his/her autonomy. This includes:
- > Being empathetic towards a person’s perspective, feelings, and world view.
- > Accepting a person by desmontrating an unconditional positive regard.
- > Supporting a person by contributing sympathetic, compassionate, or understanding comments.
- > Collaborating with a person avoids an authoritarian approach, and treats the person as an equal partner to create a positive environmnet for change.
- > Evocation draws out solutions from a person, and evoke a person’s reasons and possible methods for change.
- > Recognizing a person’s autonomy in choosing his/her path.
- > Recognizing any possible discord in the relationship, and use strategies to reduce discord and re-engage the person.
Open-ended Questions
Affirmations
Reflections
Summaries
Roadblocks
Focusing
Evoking
Planning
Generic Competencies
Meta-Competencies
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