Underlying the spirit of Motivational Interviewing is a long-standing tradition of the humanistic counseling or person-centered approach of Carl Rogers. MI is theoretically linked to Carl Rogers’ theory of the “critical conditions for change” which states that a client changes when she/he is engaged in a therapeutic relationship in which the therapist is genuine, warm, expresses unconditional positive regard, and expresses accurate empathy.
MI is client-centered therapy with a twist. It is a respectful, client-centered, collaborative and directive counseling method to help people resolve ambivalence and move toward changing health risk behaviors. In MI the clinician is more directive than a purely Rogerian style of counseling and that is the twist.
How Motivational Interviewing is Directional
- Selective eliciting questions
- Selective reflection
- Selective elaboration
- Selective summarizing
- Selective affirming
Source: Miller & Rollnick, 2010
So while MI is more directive than a purely person-centered counseling method it is guided by the broader principles of a the person-centered approach to care:
- Health, mental health and substance abuse services exist to help the people we serve not for our personal or the organization’s benefit. The needs of consumers take precedence.
- Clinical services facilitate the consumer’s natural processes of change. The person is engaged in a process of self-change.
- People are the experts in their own lives and have their own local knowledge about what works and doesn’t work for them.
- We do not make change happen.
- We are not responsible for coming up with all the good ideas about change and we probably don’t have the best ideas for any particular consumer.
- People have their own motivations and resources and we are here to help them activate those motivations and resources. We can make people become motivated.
- Change requires a partnership and “collaboration of expertise.”
- It is important to understand the person’s own perspective on their problems and what they need in order to make changes.
- Change is not a power struggle. The conversation about change should feel more like dancing instead of wrestling. It is not about winning or persuading a person that your position is the correct position.
- Motivation for change is evoked, not given to a person.
- People make their own decisions about what they will or will not do. It is not a change goal until the consumer says it is.
Source: Miller & Rollnick, 2013, pp. 22–23
William Miller on the Background of Motivational Interviewing Video (8:41 minutes)
One of the creators of Motivational Interviewing (MI), William Miller, is interviewed about the history of the development of MI, some of its underlying principles, ambivalence, and the clinician’s stance in the therapeutic relationship. Here is an opportunity to hear directly from Dr. Miller about the underlying philosophy and practice of MI and how motivation arises out of the interpersonal context of the therapeutic relationship.