Motivational Interviewing: Relationship in Action

–  Richard Armstrong

Chief Clinical Officer

“We think we listen, but very rarely do we listen with real understanding, true empathy. Yet listening, of this very special kind, is one of the most potent forces for change that I know”.

Carl Rogers (1980, p.129). A way of being. New York, NY: Houghton Mifflin.

Motivational Interviewing is one of the evidence-based practices (EBP) utilized extensively throughout the various treatment milieus in the behavioral health services continuum offered by DTAC.  The theoretical foundations of Motivational Interviewing were built upon the person-centered theory of Carl Rogers (1902-1987). Carl Rogers was a true leader and pioneer, and the founder of the humanistic psychology movement. He looked at human nature through the lens of empathetic hope and promise for the actualization of human potential. His legacy of non-judgmental acceptance and compassion are the foundations upon which Motivational Interviewing was built.  He elevated the values of human dignity and worth into both the counseling session and everyday life.

At the core of Motivational Interviewing is the requirement of being a good listener. Many clinicians would insist that being a good listener is perhaps the most important skill to possess. Our current worldly circumstances would suggest that we all would benefit from being better listeners. Empathic listening and communication skills can go a long way in reducing conflict, divisiveness, and strife. The understanding and use of Motivational Interviewing in our personal and professional communications with others can lead to growth, healing, and transformation for both ourselves and others. Using Motivational Interviewing can change you as well as the other person. It can transform people in many ways, both inwardly and outwardly. Motivational Interviewing can help develop deeper connections with others. It can contribute to a deeper trust in the inner wisdom, personal strengths, and unique gifts and talents of others.

The efficacy of Motivational Interviewing is supported by more than 1,200 publications in prestigious journals and books. It is currently utilized in a wide variety of problem areas and professional settings such as addictions, physical therapy, corrections, dental health, weight loss, medication adherence, smoking cessation, treatment retention, exercise, etc. Motivational Interviewing is a collaborative, respectful, person-centered approach that strongly acknowledges that the responsibility for change belongs to the client. Importantly, it is also directive, strategic, and evocative, and utilizes the client’s ambivalence to help bring about change.  Ambivalence is the discomfort people experience when they are considering a behavioral change. It is usually the case that part of us may want to change, but part of us does not. Ambivalence is almost always present when people are considering a change.

At DTAC, the development and nurturance of trusting human relationships/therapeutic alliances are the foundational elements of change and a cornerstone guiding principle for our clinical model.  From a person-centered perspective, it is the empathic, non-judgmental, accepting, genuine, and unconditional positive regard that are fundamental qualities that create this therapeutic alliance. Being fully present with a client allows for powerful and transcendent experiences of oneness and well-being. As Carl Rogers (1980, p.129) asserted, “Our relationship transcends itself and becomes part of something larger. Profound growth and healing and energy are present.” However, although Motivational Interviewing has been developed upon person-centered counseling theory, it has a specific directive agenda about bringing about behavioral change.  Motivational Interviewing is respectful, empathic, and honors client autonomy and their ability to choose how and when change may occur.

The core skills and basic processes of Motivational Interviewing include recognizing and assessing client readiness to change.  Counselors direct discussions in a way that invites the client to make arguments for change; utilizing client ambivalence and purposefully reinforcing what is recognized to be client “change talk”, as opposed to “sustained talk” which is about not changing.  Lasting and enduring change can be achieved through these interactions.

• Excerpts reposted from: https://traumaonline.net/motivational-interviewing-the-times-they-are-a-changin
• International Trauma Training Institute – MOTIVATIONAL INTERVIEWING: THE TIMES THEY ARE A-CHANGIN’ December 13, 2020, by ITTI by Jim Reynolds, Ed.D., LMHC, MAC