Motivational Interviewing: What It Is and Who It is For

What Is Motivational Interviewing?

Motivational Interviewing (MI) is practical and often used for short-term goals. The goal of MI is to find the intrinsic motivation to change unhealthy behavior. This often means resolving ambivalent feelings and insecurities as well as growing healthy self-esteem and sustainable energy. 

Pursuing change is not always easy. Even those who want to change have a hard time implementing successful, long-lasting changes. Motivational Interviewing acknowledges this and seeks to help people commit to change despite its difficulties. 

When Is Motivational Interviewing Used?

Motivational Interviewing is primarily used when treating addiction and substance abuse. Many people with substance abuse disorders don’t think they have to change, don’t want to, or feel like they can’t or that changing just isn’t in the cards for them. A common facet of addiction is thinking you are managing everything well despite the opposite being true in your life. Addiction steals relationships, work, financial stability, and future dreams, but it can be hard to realize this when you’re in the thick of it. 

Motivational Interviewing can help you see your situation for what it is and provide a way out. It is best suited for those who are resistant to change. Those who are already motivated to change may not find MI as effective and should seek other treatment modalities. 

Motivational Interviewing is also effective for:

• Substance Abuse and addiction
• Weight Management
• Chronic Health Conditions and medicine adherence 
• Adolescent Issues such as academic performance, substance use, and emotional well-being
• Behavioral Addictions such as gambling, overeating, or video game and internet addiction. 

In recent years, therapists have begun implementing motivation interviewing during sessions for anxiety, depression, OCD, ADHD (including adult ADHD), trauma, and more. While it is rarely used as the primary method of therapy, using MI techniques can help people through the more difficult phases of recovery and coping skill implementation.

Motivational Interviewing Techniques

Motivational Interviewing is called such because it is structured much like an interview. The goal of the therapist is to guide the client in conversation towards why they want to change and what their goals are. They may point out observations and ask open-ended questions, but it is a much more client-led technique than other therapeutic modalities such as Cognitive Behavioral Therapy (CBT). 

The therapist will often reflect back what they hear so that their client can understand what they are saying and the implications of their actions. While doing so, the therapist will engage in the four principles of motivational interviewing. These are:

1. Express Empathy: Above all, the therapist should be understanding, respectful, and compassionate about the client's experiences and feelings. MI understands the difficulty of change, and it should never belittle the effort it takes to change. It focuses on creating a nonjudgmental and supportive environment that fosters collaboration.
2. Develop Discrepancy: A major barrier for people to commit to change is the question “Well, why should I change?” People in hardship often don’t understand that things can be better, and that they have the power to change it. Motivational Interviewing encourages the client to explore the discrepancy between their current situation and their personal goals or values. By highlighting this contrast, the client is motivated to consider change and the therapist's role is to support exploration rather than imposing solutions.
3. Support Self-Efficacy: Motivational Interviewing aims to bolster the client's confidence and belief in their ability to make positive changes. The therapist encourages the client to recognize and build on their strengths and past successes, reinforcing their capacity for change.
4. Roll with Resistance: Instead of confronting or opposing resistance, the MI approach involves acknowledging and respecting the client's perspective, thereby avoiding arguments and power struggles. This allows the therapist to maintain a collaborative and non-confrontational stance, which helps in facilitating meaningful conversations about change. For example, if a therapist points out that a client’s relationship with their mother would be healthier should they stop drinking, but the client disagrees, it is not the therapist’s job to get them to see differently. It is their job to help the client find their own reasons to change that are personal to them. 

The type of questions asked in motivational interviewing is also very important. These therapists will use four techniques when engaging in MI: 

• Open-ended questions: What are the values you try to live by? What are the most important things in your life? How are you living out those values right now? 
• Affirmations: This sounds really challenging; it makes sense that you feel overwhelmed. 
• Reflective listening: What I hear you say is . . . 
• Summarization: Therapist summarizes what they understand the meaning behind their client's words. 

Using these simple techniques, a therapist using Motivational Interviewing can instill in their client a desire to change that is personal and powerful. 

Should I Try Motivational Interviewing?

Motivational Interviewing is scientifically proven to be helpful, but it isn’t for everyone. The Motivational Interviewing site says that MI is most effective when: 

• Ambivalence is high and people are stuck in mixed feelings about change
• Confidence is low and people doubt their abilities to change
• Desire is low and people are uncertain about whether they want to make a change
• Importance is low and the benefits of change and disadvantages of the current situation are unclear”

If this sounds like you, then Motivational Interviewing can help. Lifebulb’s therapists offer MI and online, affordable sessions. Contact our support team for more information or browse our list of therapists to find one near you. Change is possible. 

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