Your Guide To MI (Motivational Interviewing)

What is Motivational Interviewing (MI)?

Motivational interviewing is a counseling style originally developed to help people struggling with addiction. The basic premise of motivational interviewing is that most people already have the motivation to change, but they may need help to tap into it. The goal of motivational interviewing is to help people explore their own reasons for change, and then develop a plan to make it happen. 

Motivational interviewing is based on the idea that ambivalence is normal. People usually don’t change behavior unless they feel conflicted about it first. For example, someone may want to quit smoking, but they may also enjoy smoking and be worried about what life would be like without cigarettes. Motivational interviewing helps people work through this ambivalence by asking open-ended questions and reflecting back on what they say. 

What is the primary goal of motivational interviewing?

The primary goal of motivational interviewing is to create change within the person being interviewed. This means helping them to see the importance of taking action to improve their situation. The interviewer will work to understand the person's motivations and barriers to change. They will then help the person to develop a plan to overcome these obstacles. The ultimate goal is for the person to be able to make positive changes in their life, such as quitting smoking or getting more exercise. Motivational interviewing has been shown to be an effective tool in helping people to make positive changes in their lives.

What is change talk in motivational interviewing?

Change talk is defined as any utterance that expresses confidence in one's ability to change, that committed to taking steps toward change, or that refers to specific changes that will be made. It is a key component of motivational interviewing, which is a counseling approach designed to encourage behavior change. Change talk can take many different forms, but all expressions of change talk share one common goal: to motivate the individual to take action. Studies have shown that change talk is an effective tool for promoting behavior change, and it can be used in a variety of settings, including healthcare, education, and mental health. When used effectively, change talk can help individuals overcome barriers to change and build momentum for lasting behavior change.

Is Motivational Interviewing Evidence-Based?

Despite its proven effectiveness, some people question whether MI is an evidence-based approach.

An evidence-based approach is one that has been shown to be effective through research. In the case of MI, there have been numerous studies conducted that have shown its effectiveness. For example, one study found that MI was successful in helping people quit smoking cigarettes. In another study, MI was found to be helpful in reducing risky behaviors among adolescents. There is a great deal of evidence to support the use of MI as an evidence-based approach.

Is Motivational Interviewing an intervention?

Motivational interviewing has been found to be an effective intervention for a variety of health-related behaviors, including smoking cessation, physical activity, and diet. The key elements of motivational interviewing include expressing empathy, developing discrepancy, avoiding argumentation, rolling with resistance, and supporting self-efficacy. Motivational interviewing has been shown to be an effective intervention for resolving ambivalence and promoting behavior change.

How effective is MI?

There's still debate on how effective motivational interviewing is. However, there are a lot of studies showing that can be very promising. Studies have shown that motivational interviewing is an effective intervention for reducing drug use and improving treatment outcomes. In one study, patients in environments where motivational interviewing is applied were more likely to stay in treatment and abstain from drug use than those who did not receive the intervention. Motivational interviewing has also been found to be effective in treating other disorders, such as eating disorders, depression, and anxiety. The strength of motivational interviewing lies in its ability to help people resolve ambivalence and find the motivation they need to change their behavior.

What are the OARS of motivational interviewing?

The OARS of motivational interviewing is a set of four basic principles that guide the counselor in how to interact with the client. The acronym stands for Open-Ended Questions, Affirmations, Reflections, and Summaries. These four elements provide a framework for the counselor to build rapport with the client, explore their motivation for change, and provide support and guidance throughout the counseling process. When used correctly, the OARS of motivational interviewing can help clients make lasting changes in their lives.

What are the Stages of Change in Motivational Interviewing?

Motivational interviewing is a counseling approach that helps people resolve ambivalent feelings and contradictions to bring about change. Practitioners must work to match their approach to the level of readiness for change of the individual they are serving. The level of readiness is what is often referred to as the stages of change. It is based on the Transtheoretical model for change developed by Prochaska and DiClemente in the late 1970s, and evolved through studies examining the experiences of smokers who quit on their own with those requiring further treatment to understand why some people were capable of quitting on their own. Although the Stages of Change is often referenced in teaching Motivational Interviewing (MI), it is not a part of the MI method. Nonetheless, the "stages of change" model is a key concept utilized within MI, as it helps practitioners identify where a client is in their readiness to change a behavior, allowing them to tailor their approach accordingly to best support the individual's progress through the different stages, from not considering change to actively maintaining it; essentially, MI uses the stages of change to guide the conversation and interventions to match the client's current level of motivation and commitment to change.

The stages of change are precontemplation, contemplation, preparation, action, and maintenance. Individuals do not stay permanently at any one stage of change. They progress forward or backward. Backward progression is referred to as “relapse”.

Precontemplation - The precontemplation stage is the first stage in the stages of change in motivational interviewing. In this stage, individuals are not considering changing their behavior and may be unaware of the problem or unwilling to acknowledge it. They may also feel ambivalent about change, feeling that the benefits do not outweigh the costs. However, during this stage, it is important to plant the seeds of change by helping individuals to see the value in making a change. This can be done through exploring their values and goals, and providing information about the benefits of change. With time and effort, individuals in the precontemplation stage can move into the contemplation stage, where they begin to seriously consider making a change.

Contemplation - In motivational interviewing, the contemplation stage is when an individual begins to recognize that they have a problem and starts to explore what changes they might need to make. This process can be difficult, as it often requires confronting some uncomfortable truths about oneself. However, it is an essential step in making lasting change. During contemplation, individuals will often start to seek out information about their problem and possible solutions. They may also experiment with small changes in their behavior. As they do so, they will begin to develop a more positive outlook on change and begin to see themselves as capable of making lasting improvements. With the help of a supportive coach or counselor, anyone can move through the contemplation stage and start working towards a healthier, happier life.

Preparation - The Preparation stage is the third of the five stages of change in motivational interviewing. This stage is characterized by increased motivation and a commitment to change. People in this stage are typically more open to suggestions and advice, and they may start to make small changes in their behavior. However, they may still need support and guidance to maintain their motivation and sustain their changes. The key task in this stage is to help the person develop a plan for making lasting changes. This may involve setting goals, identifying obstacles, and choosing specific strategies for making change. With the right support, people in this stage can move on to sustained behavior change.

Action - The action stage is the fourth stage of change in motivational interviewing. In this stage, the individual is ready to take concrete steps to achieve their goals. This may involve making lifestyle changes, such as eating a healthy diet or quitting smoking. It is important to remember that individuals will progress through the stages at their own pace. Some may move quickly from precontemplation to action, while others may need more time to reflect and make plans. The key is to respect the individual's process and provide support as they work to make positive changes in their life.

Maintenance - After a person has made the decision to change their behavior, they enter the maintenance stage. In this stage, the focus is on preventing relapse and consolidating the gains that have been made. To achieve this, people need to develop new coping skills and establish a support network. They also need to continue to monitor their progress and be prepared to deal with setbacks. Some people find it helpful to set goals and reward themselves for meeting milestones. Others find it helpful to keep a journal or daily log. The most important thing is to find what works for you and then stick with it. Only by remaining vigilant can you hope to maintain your gains and avoid slipping back into old patterns of behavior.

While not exactly part of the five stages of change in Motivational interviewing, there is another stage that people should be wary of - relapse. In motivational interviewing, the relapse stage is when an individual returns to their old behavior patterns after attempting to make a change. This can be a difficult and frustrating time, but it is important to remember that relapse is a normal part of the change process. There are a number of factors that can contribute to relapse, such as stress, fatigue, and peer pressure. However, there are also a number of strategies that can help to prevent relapse, such as maintaining a support network, staying focused on your goals, and making sure you have a plan in place for dealing with setbacks. By understanding the factors that can lead to relapse and taking steps to prevent it, you can increase your chances of successfully making lasting changes.

Motivational Interviewing History

Motivational interviewing is a counseling approach that was developed in the 1980s by clinical psychologists William R. Miller and Stephen Rollnick. It is based on the premise that people are more likely to change their behavior when they are in a state of motivation. Motivational interviewing has been shown to be effective in treating a variety of issues, including substance abuse, eating disorders, and mental health problems. The approach has also been used in other settings, such as education and healthcare.

How To Do Motivational Interviewing

Unlike traditional forms of counseling, which often involve lecturing or giving advice, motivational interviewing relies on open-ended questions and active listening to encourage clients to reflect on their own goals and values. This self-reflection can then lead to the development of a change plan that is based on the client's own motivation and commitment.

While there are no hard and fast rules for conducting motivational interviewing, there are some basic principles that counselors should keep in mind. These include building rapport, maintaining a nonjudgmental attitude, and encouraging clients to express their own thoughts and feelings about change. By following these principles, counselors can create an atmosphere that is conducive to helping clients make positive changes in their lives.

What are some Motivational Interviewing Techniques?

Some of the key techniques employed in motivational interviewing include: 

• Open-ended questions - Open-ended questions are designed to encourage client self-exploration and discovery. They help the counselor to understand the client's experience and perspective, and they also help the client to clarify their own thoughts and feelings. 
• Reflective listening - Reflective listening is a technique in which the counselor repeats back to the client what they have said, in order to ensure understanding and promote further exploration. 
• Summaries - Summaries help to reaffirm what has been discussed during the session, and they also help to provide closure. 
• Goals - Setting goals is a key part of motivational interviewing. Goals help to provide direction and focus, and they also help to motivate clients by giving them something to work towards. 
• Action plans - Action plans are specific, realistic plans that outline how clients will achieve their goals. They should be achievable, measurable, and time-limited. 
• Follow-up - Follow-up is essential in order to support clients as they implement their action plans and work towards their goals. Follow-up can take the form of phone calls, emails, or scheduled appointments.

What are some examples of motivational interviewing questions?

The following are some examples of motivational interviewing questions that can help spark change in someone:

-What are your thoughts on your current situation? 

-What would you like to see happen? 

-How confident are you in your ability to make changes? 

-What has been your experience with making changes in the past? 

-What kind of support do you need from others? 

-What worries you the most about making changes? 

-What are the potential benefits of making changes? 

-What are the potential costs of not making changes? 

-What resources do you have available to help you make changes? 

These are just a few examples, but hopefully, they give you an idea of the types of questions that can be helpful in motivational interviewing. The key is to ask open-ended questions that allow the person to Reflect on their current situation and future goals and consider what it would take to make positive changes.

How do I learn more about motivational interviewing?

There are various ways to learn more about motivational interviewing. Professionals can receive training through online or in-person courses or by reading one of the many books on the subject. Therapists who use motivational interviewing often find it helpful to consult with colleagues who are also familiar with the approach. In addition, many helpful online resources, such as articles, blog posts, and podcasts, provide an introduction to motivational interviewing principles and techniques.

The Evidence-Based Professionals Society offers several resources to assist professionals. A webinar is available through this link, and you can also sample their ebook on MI.

Motivational Interviewing Training

There are a couple of training programs online related to Motivational Interviewing. Depending on how invested you are in the pursuit of learning, you can opt for some free or paid courses. Both options have a ton of resources available for you. The free option, however, may lack the hand-holding some people may need. If you need a guided training program, then choosing paid training will be the best option.

How do I get certified in Motivational Interviewing?

To our knowledge no certification is required to practice motivational interviewing. Nonetheless, proponents of motivational interviewing believe that in order to get the best out of any MI-related training, one needs ongoing support from their supervisors and trainers. When these are absent, resources spent training front-line staff is wasted.

The Joyfields' EPB Society offers a training program designed to help organizations and their staff build MI capacity in-house. Agencies can, not only train individuals in MI, but also coach and teach them how to retain and effectively apply the acquired skills. It is a 3-step approach focused on helping agencies build and sustain their capacity to use MI in practice.

1. Lay the foundation by training the entire team on MI skills, then
2. Train supervisors and managers to supervise and coach their teams using their learned skills, and finally,
3. Train in-house training staff to be able to train others in MI.

This approach positions staff members to succeed in practicing MI and imparting their learned skills to others. This proven system will improve an organization's returns on their MI training investments while increasing team and client success. Another positive consequence is that it ensures agencies can train new staff immediately in the event that they need to ramp up quickly. 

The EPB Society does offer Certification programs on evidence-based approaches designed for individuals new to the profession, as well as others that are more tenured. Practitioners may apply credits they earn from evidence-based training they receive - including MI toward earning a certification credential.

Building MI Capacity In-House:

Building in-house Motivational Interviewing (MI) skills capacity can be a game-changer for your agency. Here’s why:

1. Cost-Effective: Investing in in-house training reduces the need for expensive external trainers over time. This means significant savings in the long run.
2. Consistency: Having a team trained in the same method ensures a consistent approach across the agency. This consistency can lead to better client outcomes and a more cohesive team.
3. Tailored Training: In-house trainers can customize the training to fit the specific needs and challenges of your agency. This personalized approach can be more effective than generic external training.
4. Sustainability: Building internal capacity means your agency can continue to train new staff and refresh existing staff’s skills without relying on external resources. This ensures the longevity of the MI skills within your organization.
5. Empowerment: Training staff internally empowers them to take ownership of their professional development. This can lead to increased job satisfaction and retention.
6. Flexibility: In-house training allows for more flexibility in scheduling and adapting the training to fit the agency’s timeline and needs.
7. Enhanced Collaboration: When the entire team is trained together, it fosters a sense of collaboration and teamwork. This can improve communication and the overall work environment.
8. Immediate Application: Staff can immediately apply what they’ve learned in their daily work, reinforcing the training and making it more relevant and impactful.

By building in-house MI skills capacity, your agency can create a sustainable, cost-effective, and empowering training program that benefits both staff and clients. It’s an investment in your team’s future and the quality of service you provide. [Request a quote].

Paid Motivational Interviewing Training Programs

There are several paid Motivational Interviewing training programs available online.

For agencies looking to develop their in-house capacity, the Yearly MI training Series offered at EBP Society is open to the public. The training is also available as a private Motivational Interviewing training option adapted for those who choose to go that route.

Free Motivational Interviewing Training Programs

For those not ready to shell out money for their Motivational Interviewing courses, there are also ways to learn MI. For starters, you can become a member of the EPB Society and access several short MI courses.

There are tons of various articles and Motivational Interviewing ebooks available online.

Motivational Interviewing Industry Applications

While it was initially developed to treat substance abuse, motivational interviewing has since been applied to a variety of other areas, including weight loss, smoking cessation, and exercise.

While motivational interviewing is often used in a clinical setting, it also has applications in the business world. For example, managers can use motivational interviewing techniques to help employees set and achieve goals. Salespeople can use motivational interviewing to build rapport with clients and understand their needs. And human resources professionals can use motivational interviewing to help new employees transition into their jobs.

Because it is such a versatile tool, motivational interviewing is increasingly recognized as a valuable asset in various industries. As more and more businesses begin to adopt this approach, motivational interviewing will likely become even more popular in the years to come.

In the healthcare setting, motivational interviewing is effective in helping people to make positive lifestyle changes, such as quitting smoking or losing weight. Additionally, research suggests that motivational interviewing may help reduce hospital readmissions and improve medication adherence.

In social work, Motivational interviewing is effective in various settings, including substance use treatment, mental health counseling, and community outreach.