What is motivational interviewing?

Motivational interviewing (MI) is a brief person-centered method for strengthening an individual’s motivation for and commitment to change. MI was originally designed for working with people with substance use disorders, but has since been more widely applied in health care. It is particularly indicated for individuals who are reluctant, ambivalent or defensive about change. The overall spirit or style of MI is collaborative and empathic, and is usually delivered over 1-4 sessions to elicit behavior change. Rather than working from a deficit model in which the therapist provides what the individual is missing (e.g., skills, insight, knowledge), MI seeks to evoke the individual’s own motivations, strengths and resources and then leverages those for change. The therapist elicits and explores the individual’s own reasons for change within an atmosphere of acceptance to minimize resistance and defensiveness (e.g., you want to lose weight because you do not like going to the Diabetes Clinic; you want to stop smoking because it is getting too expensive and you need the money for your new rent). MI therapists use a variety of strategies to evoke and strengthen “change talk” from the individual. Studies have demonstrated that therapists adhering to MI-consistent skills are able to significantly increase an individual’s change talk, which in turn predicts behavior change outcomes. Therapists learning MI typically begin by developing a strong foundation of client-centered counseling skills (reflective listening, open questions, affirmation, summaries), then learn to identify, evoke, and strengthen change talk from the individual using these skills strategically.