Example of Motivational Interviewing

If a psychiatrist or counselor is working with a patient who displays a low enthusiasm for making positive behavioral changes, the counselor may utilize motivational interviewing techniques to make steady progress. Motivational interviewing can help a patient fight destructive behavior, such as smoking, or in fostering positive change, such as finding a job.

Creating a Desire for Change

• The first step is to move a person out of her comfort zone into inspiring a need for change. For example, if the counselor is using motivational interviewing techniques to inspire a person to quit abusing drugs, the counselor would begin by discussing the behavior and what is negative about it. These questions may include: What would your life be like 10 years from now if you continue to abuse drugs? What was your life like before you were using drugs? What have other people told you about your problem?

  The goal is to get the person to discuss the never-before-realized effects of his behavior. A counselor should ask for numerous examples. If a person addresses a negative aspect of his behavior, the counselor should ask for an example, then another and possibly another.

Moving Forward

• While moving a patient to an zone of discomfort may take numerous sessions, the counselor should practice active listening and observation to discover when a person is beginning to see the error of his or her ways. Motivational interviewing puts the burden of making the change on the patient itself. The ultimate goal is to help a patient resolve ambivalence through the use of listening, providing feedback and interpreting the results.

  Some examples of helping the patient make the ultimate step to move forward include: "You have been continuing to abuse drugs and engage in risky behaviors. Maybe you're just not ready to change."

  In addition to visual cues, such as a seemingly more upbeat appearance, a counselor may ask a patient to assess her behavior and feelings. An example of this would be "On a scale of 1 to 5, how would you assess your desire to change your behavior at this moment?" If a person begins to move her desire to change up the scale, a counselor should explore this change, asking, "What do you think people will notice that is different about you now that you are more concerned about your behavior?" then, "What do you need to do to move up from your current number?"

Emphasize Freedom of Choice

• The ultimate goal of motivational interviewing is not to create a relationship of authority figure and patient, but instead one the counselor takes a position of guidance and empathy. The counselor reaffirms to the patient that any choices he makes are purely his own, just as the choice to change one day will be made on his own. The counselor listens and guides, but never forces behaviors to happen that the patient does not wish to make.