Motivational Interviewing aims to resolve ambivalence in the individual who is receiving treatment, often either psychological treatment or treatment for a substance use disorder. The goal of Motivational Interviewing is to help the individual seek treatment and help for their own reasons, rather than using externally driven reasons, which are typically viewed as coercive and may not create lasting change.
This style of therapeutic intervention was developed to help people struggling with alcohol use disorder overcome the compulsion to ingest alcohol and focus on long-term health. However, the format has proven to work with many different populations in need of counseling, including people with medical conditions like cardiovascular problems or diabetes. The counselor works with each client individually, building a rapport with the person through the four primary stages of motivational interviewing.
Processes of Motivational Interviewing
- Engaging: The counselor works to understand the client’s perspective, with empathy and without outside judgment or agenda. This is an important step toward understanding why the client is ambivalent about treatment and their dilemmas as they currently view them.
- Focusing: Once the client is more engaged in the process of overcoming addiction, mental illness, or another condition, the counselor guides them toward a specific goal. The goal is determined by the client and could be defined per session or last over multiple sessions. However, the focus is a behavior or circumstance the client picks, wishes to better understand, and overcome.
- Evoking: Based on the client’s choice of focus, the counselor or therapist will help them evoke reasons for the chosen focus. The therapist will listen and recognize changes in the way the client speaks, which may lead into the client soliciting advice; however, the therapist’s role, in this situation, is not to give advice unless requested.
- Planning: This step involves taking the language the client used to evoke their desire to change a specific behavior or situation and turning it into action. Depending entirely on the client, the planning stage could involve journaling, making a list, or working with the therapist to be held responsible for actions. Motivational Interviewing can still work as a process without planning to take action.
Motivational Interviewing is, ultimately, a process that can be transformed to fit each individual client that a therapist works with. While the first three stages are considered defining characteristics of Motivational Interviewing, the final stage – planning – is not a required step until the client is ready. It is not a step that must be taken during each session, but instead, a voluntary step after the way the client thinks about the world has changed.
It is also important to use this process to help the client develop self-efficacy. When the person notices that they are resistant to change or stress in their lives, they should be able to change their behavior based on Motivational Interviewing techniques. This may involve the planning stage, or the behavioral change could represent a larger, longer-term process involving the individual’s hard work in therapy sessions. When a therapist shows empathy toward the client, instead of enacting behaviors perceived as explaining or telling the client what to do, then they are more likely to elicit change in the client.
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