How Effective Motivational Interviewing Works
- Sep 15, 2022
- 8 min read
Updated: Sep 25
If you're looking for a clear, in-depth explanation of Motivational Interviewing (MI), you've come to the right place. We'll walk you through this powerful, evidence-based counseling style, from its core philosophy to its effective techniques, providing the definitive guide you need.
What is Motivational Interviewing?
Motivational Interviewing (MI) is a collaborative, goal-oriented style of communication designed to strengthen a person’s own motivation for and commitment to a specific goal by exploring their reasons for change within an atmosphere of acceptance and compassion.
We've only scratched the surface of how motivational interviewing works, its history, and its four core techniques. Keep reading to fully understand this nonjudgmental, effective approach to behavioral change and its proven applications across various fields.
What Is Motivational Interviewing?
Motivation is the process that initiates, guides, and maintains goal-oriented behaviors. It is what helps you quit smoking, for instance, or pushes you to reach out for help. In short, motivation causes you to act in a way that gets you closer to your goals.
In everyday usage, the term "motivation" is frequently used to describe why a person does something. It is the driving force behind human actions. Motivation includes the biological, emotional, social, and cognitive forces that activate human behavior. In the field of behavioral health motivation may seem lacking or absent.
At times an individual will appear motivated and goal seeking and within days or sometimes hours the same individual may appear stagnant or resistent. When an individual is struggling to change it may appear that they lack motivation. Sometimes this behavior will be classified as an unwillingness to change.
This is where Motivational Interviewing can be utilized; it is a counseling style that challenges people to develop the internal motivations necessary to counteract or change certain behaviors they consider problematic in their lives. This form of counseling can act as a precursor to other psychological interventions, work in adjunct to psychotherapy, or be a stand-alone technique to change a particular behavior.
“MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.” (Miller & Rollnick, 2013, p. 29)
Changing negative behaviors allows people to develop healthier choices, which, in turn, affects long-term physical and mental health outcomes. Motivational interviewing is helpful for individuals who have addictions or physical health issues and those who lack motivation, display hostility, or are unready to commit to change. The main goal is to elicit self-motivation by helping people see how tapping into motivation and generating lasting change are possible and accessible.
What Is the History of Motivational Interviewing?
Motivational interviewing was first developed in the 1980s by clinical psychologists William R. Miller and Stephen Rollnick to support patients with substance use disorders. Over time, other professionals have implemented motivational interviewing in public health, medical care, criminal justice systems, education, and familial systems.
As a counseling method, motivational interviewing has grown tremendously over the last few decades and is now an established, evidence-based practice. Its success is rooted in its view that the practitioner does not impose change; instead, practitioners who use this method cultivate and support self-directed change in their clients.
How Does Motivational Interviewing Work?
Motivational interviewing encourages clients to verbalize the changes they believe to be necessary and to explain their reasons for wanting change. The interviewer can be a psychologist, mental health counselor, social worker, or health care professional.
The interviewer’s job is to spark a conversation with a client about creating and committing to lasting change. Initially, interviewers will ask open-ended questions, listen reflectively, summarize and affirm the client’s points, and encourage self-motivational statements. This is a short-term type of counseling that lasts one or two sessions.
The Spirit of Motivational Interviewing
The spirit of motivational interviewing includes the following values:
• 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 person’s priorities, values, and wisdom to explore reasons for change and support success.
Acceptance
The MI practitioner takes a nonjudgmental stance, seeks to understand the person’s perspectives and experiences, expresses empathy, highlights strengths, and respects a person’s 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.
Core Skills of Motivational Interviewing
Four core skills required by a therapist for successful motivational interviewing include:
Open questions draw out and explore the person’s experiences, perspectives, and ideas. Evocative questions guide the client to reflect on how change may be meaningful or possible. Information is often offered within a structure of open questions (Elicit-Provide-Elicit) that first explores what the person already knows, then seeks permission to offer what the practitioner knows and then explores the person’s response.
Affirmation of strengths, efforts, and past successes help to build the person’s hope and confidence in their ability to change.
Reflections are based on careful listening and trying to understand what the person is saying, by repeating, rephrasing or offering a deeper guess about what the person is trying to communicate. This is a foundational skill of MI and how we express empathy.
Summarizing ensures shared understanding and reinforces key points made by the client.
Attending to the language of change identifies what is being said against change (sustain talk) and in favor of change (change talk) and, where appropriate, encouraging a movement away from sustain talk toward change talk.
Exchange of information respects that both the clinician and client have expertise. Sharing information is considered a two way street and needs to be responsive to what the client is saying.
Four Main Techniques of the Motivational Interviewing Process
The four main steps for the motivational interviewing process are engaging, focusing, evoking, and planning.
Engaging: This is the foundation of MI. The goal is to establish a productive working relationship through careful listening to understand and accurately reflect the person’s experience and perspective while affirming strengths and supporting autonomy.
Focusing: In this process an agenda is negotiated that draws on both the client and practitioner expertise to agree on a shared purpose, which gives the clinician permission to move into a directional conversation about change.
Evoking: In this process the clinician gently explores and helps the person to build their own “why” of change through eliciting the client’s ideas and motivations. Ambivalence is normalized, explored without judgment and, as a result, may be resolved. This process requires skillful attention to the person’s talk about change.
Planning: Planning explores the “how” of change where the MI practitioner supports the person to consolidate commitment to change and develop a plan based on the person’s own insights and expertise. This process is optional and may not be required, but if it is the timing and readiness of the client for planning is important.
Effectiveness of Motivational Interviewing
Motivational interviewing is very effective in many ways. For example, in a 2011 study of meta-analyses of randomized control trials of people dependent on or abusing substances, researchers concluded that motivational interviewing could reduce substance abuse compared to no treatment.
A 2018 study found that motivational interviewing improved treatment outcomes (i.e., how well the therapy improves a client’s symptoms) for individuals with anxiety disorders when used as an adjunct to cognitive behavioral therapy for anxiety disorders.
In a 2017 study, a group of Australian psychological researchers found that two motivational interviewing sessions that lasted for as little as 15 minutes effectively enhanced clients’ attendance in mental health treatment.
Motivational interviewing may also improve health care management for adolescents with chronic illness and enhance group treatment engagement for adolescents with anxiety and mood disorders.
As an additive value, motivational interviewing helped improve symptoms of depression in clients in primary care settings.
Additionally, substantial evidence indicates that combining motivational interviewing with other existing treatments enhances overall treatment engagement. When an individual admits into residential treatment they will receive maximum benefits of Motivational Interviewing coupled with these other treatments.
Frequently Asked Questions:
• Who first developed Motivational Interviewing and when?
Motivational Interviewing was first developed in the 1980s by clinical psychologists William R. Miller and Stephen Rollnick to support patients with substance use disorders.
• What are the four main steps of the Motivational Interviewing process?
The four main steps for the motivational interviewing process are engaging, focusing, evoking, and planning.
• What does the spirit of Motivational Interviewing include?
The spirit of motivational interviewing includes the values of partnership, evocation, acceptance, and compassion.
• What are the four core skills required for successful Motivational Interviewing?
The four core skills required are open questions, affirmation, reflection, and summarizing.
• What types of individuals can Motivational Interviewing be helpful for?
Motivational interviewing is helpful for individuals who have addictions or physical health issues and those who lack motivation, display hostility, or are unready to commit to change.
Navigating the journey of change, especially when dealing with mental health or addiction challenges, requires partnership and personalized support. At Chateau Health and Wellness Treatment Center, we believe in the power of Motivational Interviewing (MI) to cultivate and strengthen your own reasons for change. If you or a loved one is ready to move from ambivalence to action, know that we are here to meet you where you are, using an approach rooted in acceptance, compassion, and evocation. Our commitment is to help you take that crucial next step toward health and lasting wellness. Don't face this alone; call us today at (435) 222-5225 to begin a conversation about how we can support your personal journey of change.
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About The Author
Zachary Wise is a Recovery Specialist at Chateau Health and Wellness
Where he helps individuals navigate the challenges of mental health and addiction recovery. With firsthand experience overcoming trauma, depression, anxiety, and PTSD, Zach combines over 8 years of professional expertise with personal insight to support lasting healing.
Since 2017, Zach has played a pivotal role at Chateau, working in case management, staff training, and program development.
Danny Warner, CEO of Chateau Health and Wellness
Brings a wealth of experience in business operations, strategic alliances, and turnaround management, with prior leadership roles at Mediconnect Global, Klever Marketing, and WO Investing, Inc. A graduate of Brigham Young University in Economics and History, Danny has a proven track record of delivering results across diverse industries. His most transformative role, however, was as a trail walker and counselor for troubled teens at the Anasazi Foundation, where he directly impacted young lives, a personal commitment to transformation that now drives his leadership at Chateau.
Austin Pederson, Executive Director of Chateau Health and Wellness
Brings over eight years of experience revolutionizing mental health and substance abuse treatment through compassionate care and innovative business strategies. Inspired by his own recovery journey, Austin has developed impactful programs tailored to individuals facing trauma and stress while fostering comprehensive support systems that prioritize holistic wellness. His empathetic leadership extends to educating and assisting families, ensuring lasting recovery for clients and their loved ones.
Ben Pearson, LCSW - Clinical Director
With 19 years of experience, Ben Pearson specializes in adolescent and family therapy, de-escalation, and high-risk interventions. As a former Clinical Director of an intensive outpatient program, he played a key role in clinical interventions and group therapy. With 15+ years in wilderness treatment and over a decade as a clinician, Ben has helped countless individuals and families navigate mental health and recovery challenges.
