Motivation Interviewing:
a short introduction

This section gives a short introduction to motivational interviewing. For more information, please see:

Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.

The spirit of motivational interviewing

The MI spirit revolves around the elements of: Compassion, Partnership, Evocation and Acceptance. The aim is to work compassionately with the client to evoke their own solutions to their problems or dilemmas. The MI practitioner recognises and accepts that only the client knows what will work best for them.

It is important to note that all parts of the MI spirit have experiential and behavioural components. If one experiences compassion for another and does not express this through behaviour, the client may feel as if their concerns are not being listened to or taken seriously.

Partnership

The first aspect of the spirit of MI is partnership, which is an active collaboration between the practitioner and the client, both being experts. The client is the expert in their own problems and potential, as no one knows them better than themselves. Indeed, research has shown that the use of the clients’ expertise is essential for behavioural change. It is important to avoid the ‘expert trap’ of providing directions to the client, giving sense that the practitioner has the answers to the person’s problem.

This aspect of MI focuses on building a trusting and honest relationship with the client where change is facilitated. In essence, partnership is about creating a positive interpersonal relationship between both parties as change is conducted “with” an individual not “to or on” them.

Acceptance

The second component of the MI spirit is acceptance, which has four aspects: absolute worth, accurate empathy, autonomy support and affirmation. These four aspects of acceptance have also been previously explored by Carl Rogers and are embedded in his work.

Absolute worth is about understanding the inherent worth and potential of the person. It is about unconditional positive regard, regardless of the person’s past decisions. Individuals must feel respected and not judged.

Accurate empathy is the ability to see the world through the clients’ eyes. It involves active listening in order to understand individuals’ internal perspectives, their reasons for doing what they did, their reasons for change and their ambivalence.

Autonomy support is respecting and honouring individuals’ autonomy of choice and their ability to self-direct. Indeed, this may mean respecting individuals’ choice that they may not want to change. Respecting and acknowledging freedom of choice is likely to lead to decreased defensiveness and increased trust in the practitioner.

Finally, affirmation is the ability to reinforce and acknowledge the clients’ strengths and efforts to change. As with all aspects of acceptance, this is not just an internal affirmation but a method of communicating and interacting with the client.

Compassion

The third component of the MI spirit is compassion. Compassion involves the active pursuit of others well being and prioritising their needs. Compassion encompasses understanding clients’ experiences, values, understanding and respecting others decision without engaging in judgment. The practitioner needs to understand and validate clients’ struggles and emotions with genuine care and concern.

Evocation

Evocation is the last aspect of the MI spirit. As previously mentioned, the assumption here is that the client knows themselves better than anyone else. They are the person most likely to develop long lasting convincing arguments for change. The practitioner’s job is to help them do this by drawing out or evoking the client’s own motivations and resources for change, and not by imposing their own ideas.

The next section explains the communication skills that foster the spirit of MI and are an essential component of FIT