What is Motivational Interviewing and why is it important?
Motivational Interviewing (MI) is “a collaborative person-centred form of guiding to elicit and strengthen motivation for change” (Miller & Rollnick, 2009; p137). Most young people who come into contact with behavioural health care services such as AOD or mental health services are ambivalent about making any changes to their behaviours such as ceasing or reducing substance use. They may see some benefits of changing but they also see disadvantages, or changing may appear too difficult, and seem to be beyond their ability.
The purpose of Motivational Interviewing is to help the client elicit, explore and resolve his or her own ambivalence towards change.
It does not try to persuade the client to change (Miller, 1996). Consistent with its philosophical basis within humanism and Rogerian client-centred therapy, Motivational Interviewing interventions are tailored to the needs and issues of the individual (Tevyaw & Monti, 2004). Miller and Rollnick (2009) emphasise that MI begins with the assumption and honouring of personal autonomy – the belief “that people make their own behavioural choices, and that such power of choice cannot be appropriated by another” (p131).
Motivational Interviewing has been used effectively with adolescents experiencing various types of AOD problems, as well as persons who might benefit from changing various other behaviours.
When should it be used?
Motivational Interviewing is a tool for addressing a particular problem or behaviour: when a person might benefit from making a behaviour or lifestyle change, but is ambivalent about doing so, or reluctant to embark on a change program (Miller & Rollnick, 2009). It can be used in a wide variety of settings. Although MI was originally designed as a brief intervention, in services that support young people with complex needs, MI needs to be used regularly, as young people move through a process of addressing a variety of challenging issues over the course of time.
MI is particularly useful at those times when external pressures are driving a young person to consider making changes in their life but intrinsic motivation is low.
It is also useful whenever a young person experiences a period of ambivalence, or loses confidence in their ability to change.
There are some times when MI is not appropriate. Young peoples’ ability to change can be compromised or very limited under some environmental conditions or when their functioning is impaired. A strengthened commitment to change that cannot be enacted can be a source of distress and engender a sense of hopelessness. Also, MI may not be the most suitable approach when there is an immediate threat to a client’s health and safety. In such cases practitioners may need to help bring the crisis to resolution by being more directive and taking increased control for a brief period, which is not consistent with MIs more reflective conversational style.