Does Motivational Interviewing Work?

Motivational interviewing is a clinical psychology therapy technique that works with clients to explore, understand and resolve ambivalence. It utilizes a directive approach where the client elicits change from within rather than imposing external stimuli. Motivational interviewing can be successful for most behavior issues as long as the therapist and patient are working as a team in accordance with the methods of motivational interviewing.

Behavioral Coping Skills

• Because motivational interviewing requires patients to find the answers within and thus find motivation for change, it does not use behavioral coping skills to teach changes before the client is ready. If the client is truly motivated to change, there is less likelihood that she will revert back to the original undesired behaviors. People are naturally resistant to change and thus forcing behavioral changes can be a temporary solution like an alcoholic who is taught coping mechanisms without having found the desire to change.

Open Dialogue

• For motivational interviewing to succeed, there needs to be an open dialogue between the therapist and patient. This is not a traditional therapy scenario where the therapist is the authority figure. Motivational interviewing resembles a partnership that respects the freewill of the patient, giving him complete autonomy to make his own choices. When people feel that they have come upon an idea on their own without it being forced upon them, they are less resistant to making changes. In motivational interviewing, resistance and denial are actually very valuable resources for the therapist to help the client explore what motivational notions would divert the resistance to a motivation of change.

Interpersonal Dialogue

• In motivational interviewing, it is important that the person understand that the therapist is seeking to understand what the patient's frame of reference is on any relevant issue. This is done with reflective listening. Some patients who are not open to this therapy or are at a point of resistance will accuse a therapist of manipulation or using "psycho-babble" on them. This is not the case; in fact, the base of motivational interviewing is recognizing and accepting the desire for a patient to change and providing affirmations with each step that the patient is making her own choices based on her own conclusions and directives.

Non-Confrontational

• In motivational interviewing therapies, therapists are not confrontational to patients. There is no accusing a person of wrongdoings or arguing the facts as to why he needs change. It does not work when the therapist scares or intimidates the patient into change. This can close down the interpersonal dialogue and prevent the patient from opening up. The therapist primarily listens and allows the patient to regulate the tempo of the session, either speaking a lot, a little or none.

Effectiveness

• For motivational interviewing to succeed, patients must have a balance and respect for the therapist and understand that the answers are within themselves. If patients are looking for someone to tell them what to do, this is not the therapy option for them. For those who embrace it, empowerment is obtained, understanding that this approach can be used in other areas of their lives.