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Division of Behavioral Health Services

Best Practice Advisory Committee: Motivational Interviewing

Motivational interviewing is a counseling approach, originally developed in the alcohol addiction field by William Miller in the early 1980's, which aims to help patients with behavior change. The style of questioning is non-confrontational and the method has a practical focus, using the techniques of problem solving and goal setting from cognitive-behavioral approaches.The patient is encouraged to identify aspects of their behavior related to their condition that they would like to change and to articulate the benefits and difficulties of making that change. The clinician's role is to facilitate this process, help the patient think of ways to overcome the difficulties, and set realistic targets for change in their behavior. Motivational Interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.

MI may appear simple, but training with ongoing mentoring and coaching is required to ensure proficiency.

Miller and Rollnick describe the trainable aspects of MI in a 1995 article as:

  • Seeking to understand the person's frame of reference, particularly via reflective listening.
  • Expressing acceptance and affirmation.
  • Eliciting and selectively reinforcing the client's own self motivational statements, expressions of problem recognition, concern, desire and intention to change, and ability to change.
  • Monitoring the client's degree of readiness to change, and ensuring that resistance is not generated by jumping ahead of the client
  • Affirming the client's freedom of choice and self-direction