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Motivational Interviewing

Motivational interviewing is a type of counseling technique that focuses on the client as being the agent of change in his life. The therapist offers acceptance and helps the client reach his goals.

It was built on Carl Rogers’ theories about a person’s capability to exercise free choice and his ability to change through self-actualization. The short-term therapy is practical and helps the client to identify and address the feelings holding him back from making positive changes.

When is Motivational Interviewing Used?

This style is especially effective when working with clients with substance abuse issues. Often a client in this life situation expresses that they want to change their life but then is ambivalent about taking the steps involved in achieving that goal.

It can also be used to treat clients who are living with a chronic illness. Someone who has to cope with a condition like diabetes, asthma, or heart disease may have to make lifestyle changes due to their health condition.

What to Expect from Motivational Interviewing

Using a supportive tone, the therapist encourages clients to talk about the reasons they need to change. The therapist listens as the client talks and then reflects the client’s thoughts so he can hear them expressed back. The client can then correct any misunderstanding the therapist may have or provide more information.

Motivational interviewing may only take place in one or two sessions. As soon as a client can commit to change, then another form of therapy can be used to provide support through that process.

Four Basic Assumptions of Motivational Interviewing

This counseling style is based on four basic assumptions:

• It’s normal to feel ambivalent about making a major life change. This ambivalence creates an important motivational obstacle to moving forward.
• Ambivalence can be conquered by working with a client’s basic motivations and values.
• The therapist and the client work as a team where each person brings their expertise to the table.
• A direct and supportive style is needed to create conditions where the client can create change. If the therapist becomes aggressive or confrontational, the client may react by becoming defensive and refuse to make a behavioral change.

Ambivalence in Clients with Substance Abuse Issues

Clients seeking help for substance abuse usually know that their drug or alcohol use is putting their health and safety at risk. However, they continue with the behavior anyway. Even if the client expresses that they want to stop using his drug of choice, they may also have reasons why they can’t or don’t want to.

In this type of interview style, the therapist must take care not to interpret the client’s ambivalence about moving forward as being in denial or resistant to change. Empathy and acceptance are at the forefront of the relationship between the therapist and the client. This doesn’t mean that the therapist must always agree with the client. Instead, the therapist acts as a sounding board to a client who makes his own choices.