Motivational Interviewing

A Powerful Framework for Change

'Edward' (name changed to protect anonymity) sat on the edge of the couch in his new transitional housing unit. The room was quiet, save for the hum of traffic outside and the occasional creak of the radiator.  His life had been narrated for years by others: shelters, case workers, systems. And now, another person sat across from him asking questions.  He braced for judgment.

But this time, the questions felt different.  Rather than “What’s wrong?” the Life Coach asked, “What’s important to you right now?” Rather than advice, the Life Coach offers space. Rather than talking over him, the Life Coach leans in and listens.

That day, the couch was no longer just furniture, it became a bridge. A bridge between past and possibility. Through Motivational Interviewing, Edward wasn’t being “fixed.”  He was being heard.  And from that listening came a spark, not of persuasion, but of empowerment.  

At Welcome Home, Life Coaches use Motivational Interviewing in working with participants to help them identify their SMART (specific, measurable, achievable, relevant and time bound) goals and develop steps and strategies that will lead them to stability including employment/income and housing.

The five principles of Motivational Interviewing used by our Life Coaches include:

1. Expressing Empathy: It is possible to accept and understand a client’s perspective but not to agree with it. Acceptance facilitates change and ambivalence is normal. Skilled reflective listening is fundamental to the process.

2. Developing Discrepancy: Create and amplify, in the individual’s mind, a discrepancy between present behavior and broader goals, where one is and where one wants to be.  This includes raising awareness of the costs of change or not changing.

3. Avoiding Argumentation:  Arguments are counterproductive. Defending breeds defensiveness. Resistance is a signal to change strategies. Labeling is unnecessary.

4. Rolling With Resistance: Statements that an individual offers can be reframed slightly to create a new momentum toward change.  Individuals have important insight and ideas for the solution to their own problems.  Rolling with resistance includes involving the individual actively in the process of problem solving.

5. Supporting Self-Efficacy: The individual is responsible for choosing & carrying out personal change. Belief in the possibility of change is an important motivator. There is hope in the range of alternative approaches available.

Motivational Interviewing Fourth Edition 2023, “Is an evidence-based method for promoting change and growth. It is a particular way of talking with people about change and growth to strengthen their own motivation and commitment.”

Motivational interviewing was originally developed by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick Ph.D. The concept of motivational interviewing evolved from experience in the treatment of problem drinkers and was first described by Miller (1983) in an article published in Behavioral Psychotherapy. 

Miller and Rollnick (1991) subsequently provided a more detailed explanation of these concepts and approaches in their description of clinical procedures.  Motivational Interviewing is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior.

Over time the use of Motivational Interviewing has expanded into a variety of applications including substance abuse counseling, mental health services, health and wellness coaching, problem gambling, social work, corrections, employment services, physical therapy, preventive dentistry, coaching, education, leadership and management. The most recent book notes that Motivational Interviewing is most often used in combination with other evidence-based methods.

Motivational Interviewing uses the Stages of Change model that includes 6 steps:

1. Precontemplation: The individual has no recognition of need for change. The goal at this stage is to raise doubt and increase the individual’s perception of risks and problems with current behavior.

2. Contemplation: The individual is thinking about changing. The goal is to tip the balance – evoke reasons to change, risks of not changing; strengthen the client’s self-efficacy for change of current behavior.

3. Preparation: Helps the individual to determine the best course of action to take in seeking change.

4. Action: Helps the individual to take steps toward change.

5. Maintenance: Helps the individual to identify and use strategies to prevent relapse.

6. Relapse: Helps the individual to renew the processes of contemplation, determination, and action, without becoming stuck or demoralized because of relapse.

   
   

To learn more about Motivational Interviewing visit: https://motivationalinterviewing.org/