Motivational Interviewing Techniques

Study Notes

A collaborative conversational approach to strengthen an individual’s motivation for change.
The counselor’s role is to support the client in exploring their reasons for change, not to change their behavior directly.
Addresses ambivalence about change, recognizing that mixed feelings are common and precede change.
Avoids confrontation, as it can lead to defensiveness and hinder change.
Emphasizes empathy and understanding, rather than judgment or pressure.

It is normal to feel ambivalent about change, as this is a natural part of the process.
Directly confronting an ambivalent person about one side of the issue can lead them to adopt the opposing side, creating resistance.

Attending skills are crucial for building rapport and trust.
Includes active listening, eye contact, appropriate body language, verbal and vocal cues.

Open-ended Questions: Encourage the client to elaborate and express their thoughts.
Affirmations: Recognize the client’s strengths, values and efforts. Build confidence and reduce defensiveness.
Reflections: Empathic statements that demonstrate understanding and acknowledge the client’s perspective. More reflections than questions are encouraged.
Summaries: Reinforce key points, highlight ambivalence and change talk, and invite the client to respond.

Simple: Repeating or rephrasing the client's statement.
Complex: Paraphrasing, reflecting feelings, or interpreting the latent content of the message.

Can evoke change talk and allow the client to lead the conversation.
Example: "What concerns you about your smoking?" "How would you like things in your life to be different?"

Recognize the client’s strengths, values, and efforts.
Build confidence and reduce defensiveness.
Examples: "You’re working hard to get your life back on track." "You care a great deal about your children."

Used at transitions in the conversation to reinforce key points.
Include the client’s concerns, problem recognition, ambivalence, and optimism.
Example: "So let's make sure we're on the same page. You enjoy drinking and find it helps you relax and enjoy yourself with friends. At the same time, you don't like the way you feel after a night of drinking and have missed getting up with your kids to get them to school on time."

Expresses resistance to change.
Examples: "I don’t think that cocaine is really my problem." "There's really no room for improvement."

Acknowledges both sides of the client’s ambivalence.
Example: "You like the way coke makes you feel and at the same time you hate being broke and are afraid that your wife is going to leave if you don’t stop."
Avoid using "but".