Motivational Interviewing: Emerging Theory, Research, and Practice

Abstract

Motivational Interviewing is a counseling approach in which therapists use a client-centered stance paired with eliciting techniques to help clients explore and resolve their ambivalences about changing behaviors that are not optimally healthy. It is characterized by a collaborative, autonomy-supporting, and evocative style in which therapists seek to understand clients’ perspectives, while directing clients towards considering changing one or more behaviors. Although it has strong roots in client-centered counseling, Motivational Interviewing can be considered atheoretical or theoretically eclectic. Currently, there is no comprehensive theory of Motivational Interviewing, although there are several threads relating Motivational Interviewing to personal growth and self-determination, to activation of emotions as a bridge to increased openness to change, and as a therapeutic approach that combines a friendly-submissive interpersonal style with more directive tasks. The relational and technical elements combine to evoke increased consideration or and openness to change, and therapists pay particular attention to client communications about change in order to focus efforts toward moving into new patterns rather than processing or dwelling in old patterns. Motivational Interviewing has strong evidence for its positive impact on addictive behavior. It often achieves good outcomes with fewer sessions and less time than other substance abuse treatment methods. There is a growing evidence base in support of adaptations of Motivational Interviewing across a wide array of practice domains, settings, problem behaviors, and conditions. Generally, Motivational Interviewing is superior to no treatment and is equivalent to other active treatments despite its relative brevity, thus there may be cost effectiveness advantages to Motivational Interviewing. Recent focus on measuring treatment fidelity and exploring possible mechanisms of actions should help to shed further light on the workings of Motivational Interviewing. Finally, as Motivational Interviewing expands across settings and cultures, it is being redefined in light of new experiences and developments.