Motivational Interviewing

Motivational Interviewing (MI) is a collaborative, person-centered counseling style specifically designed to elicit and strengthen your own motivation and commitment to change. Developed by William R. Miller and Stephen Rollnick, its fundamental principle is that motivation for change is intrinsic and most likely to occur when evoked from you, rather than imposed externally.

The Spirit of MI

MI operates from a guiding philosophy characterized by the "Spirit of MI," summarized by the acronym PACE:

• Partnership: The relationship is collaborative, not expert-driven or hierarchical.
• Acceptance: Your autonomy is honored through expressed empathy, affirmed strengths, and accurate understanding.
• Compassion: Your welfare and best interests are actively prioritized throughout the process.
• Evocation: Your own ideas, motivations, and resources are drawn out rather than solutions being provided.

MI aims to explore and resolve ambivalence about change by helping you identify your own reasons, desire, ability, need, and commitment to making a specific behavior change. The primary goal is not to force change, but to create a supportive atmosphere where you can explore your ambivalence and ultimately articulate your own arguments for change—what MI calls "change talk."

The therapeutic approach in MI is characterized by its collaborative and evocative nature, implemented through specific communication skills and strategic processes.

Core Communication Skills (OARS)

• Open-ended questions: Inviting exploration and elaboration rather than yes/no answers (e.g., "What concerns you most about your drinking?").
• Affirmations: Recognizing and acknowledging your strengths, efforts, and positive steps.
• Reflective listening: Understanding and conveying empathy by reflecting back what you say, sometimes adding deeper meaning.
• Summaries: Linking and reinforcing discussion points, especially collecting and presenting your own change talk.

The Four Processes of MI

• Engaging: Establishing a collaborative working relationship and building rapport.
• Focusing: Developing a specific direction or target behavior for the conversation.
• Evoking: Eliciting your own arguments for change—your motivations, values, and reasons.
• Planning: Developing a concrete plan for change when you express sufficient motivation.

A central principle is "rolling with resistance"—when you express reasons not to change ("sustain talk"), the practitioner responds empathically without arguing, instead redirecting toward exploration of ambivalence. The practitioner deliberately avoids arguing, confronting, or directing, supporting your autonomy throughout.

Motivational Interviewing is recognized as a well-established, evidence-based practice with extensive empirical support across a wide range of target behaviors and populations.

Research Support

• Hundreds of randomized controlled trials and numerous meta-analyses demonstrate its effectiveness in promoting behavior change.
• Particularly strong evidence for reducing alcohol and drug use and increasing treatment engagement.
• Proven effectiveness for smoking cessation, medication adherence, diet and exercise changes, and diabetes management.
• Efficacy established in diverse settings: healthcare, mental health, corrections, and social services.
• Recommended in numerous clinical practice guidelines as an effective approach for addressing ambivalence and facilitating change.

How MI Works

MI is often particularly effective when combined with other treatments, serving as a "front-end" engagement enhancement strategy. Studies demonstrate that MI works by increasing client "change talk," which directly predicts subsequent behavior change.

Specific Outcomes

• Increased treatment participation.
• Reduced substance use.
• Improved adherence to health regimens.
• Enhanced self-efficacy.