Intro to Motivational Interviewing

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Motivational interviewing is an effective way of talking with people about change

Change is often not made because of a motivational issue. We feel ambivalent which leads to anxiety so we procrastinate making the change.

Motivational interviewing helps people move away from ambivalence and towards agency / action

MI should be collaborative in nature (not an expert vs student dynamic), respectful of the client’s autonomy, compassionate (keeping the clients best interest in mind), and understand that the best ideas come from the client.

The four skills are open questions, affirmations, reflections, and summaries

• Open questions: not yes or no (how do you feel vs are you in pain?)
• Affirmations: statements about things that are positive
• Reflections: understanding what the client is thinking / feeling and saying it back to them, convey empathy and understanding
• Summary: longer form reflection, can guide client towards certain changes by selectively including certain information

The four processes are engaging, focusing, evoking, and planning

• Engaging: establishing trust and mutual respect.
  • Do not assess right off the bat, it is not engaging. Do not make a quick diagnosis, you have to develop trust first. Do not signal power / authority. Do not label.
• Focusing: ongoing process of seeking and maintaining direction
• Evoking: eliciting a client’s own motivation for change
  • Pay a lot of attention to “change talk” (e.g. I want, I wish, etc.)
  • You can elicit change talk by asking the right questions
• Planning: developing a change plan that the client agrees to implement
  • The plan should be specific, measurable, achievable, relevant, and timed