Five Principles of Motivational Interviewing
Motivational interviewing is a form of psychotherapy where a therapist becomes an integral part of a client’s change process by expressing acceptance of their clients. In the approach, therapists help clients solve the ambivalence that limits clients from achieving their personal goals. The foundation of motivational interviewing is humanistic and optimistic theories by Carl Rogers on the capabilities of people to make independent choices and change (Arkowitzet al., 2015). Motivational interviewing taps on an individual’s potential for positive change. While some people can manage to change on their own and freely navigate the change process, others need medical treatment and support.
Assumptions and Applications
Motivational interviewing makes a few assumptions. They include ambivalence being an obstacle to recovery; working with a client’s values and intrinsic motivations resolve ambivalence; the client-therapist relationship is collaborative in which both parties bring vital expertise; and counseling offers directive, supportive, and empathetic conditions which facilitate change. Motivational interviewing is finds its application in mental disorders and other health issues where behavior change leads to better outcomes, for example, in people with substance use disorders or those requiring lifestyle changes to manage chronic medical conditions such as type 1 diabetes (Caccavale et al., 2019).
Ambivalence
Ambivalence is at the center of motivational interviewing, and it plays a vital role in client motivation. Usually, ambivalence is a significant problem, which can manifest as a lack of motivation. The five principles of motivational interviewing address ambivalence as well as facilitating the change process. Ambivalence is characterized by mixed feelings presented by clients regarding a change, concurrently showing the desire to stop and continue with the behavior. Individuals are aware of the dangers and negative effects of their behaviors, such as drug abuse, but continue with the undesired behavior anyway. They may express their wishes to stop the behavior but at the same time, wish to continue with the behavior. It essential for the therapist to understand and accept that ambivalence is natural irrespective of the readiness state of the client (Arkowitzet al., 2015). Interpreting ambivalence as resistance or denial tends to bring friction between the client and therapist.
Five Principles of Motivational Interviewing
Expressing Empathy
Empathetic motivational interviewing creates an environment where a client feels safe to examine issues, provide reasons, and explore methods of change (Arkowitzet al., 2015). It helps a therapist to understand the unique perspective, feelings, and values of each client. When therapists build a trusting relationship through empathy, it enhances the success of motivational interviewing.
Developing Discrepancy
Helping a client perceive discrepancies between their current behavior and ideal or desired behavior enhances motivation for change. A therapist’s role is to help the client concentrate their attention on achieving the desired behavior through carefully selected and strategic reflecting that highlights discrepancies.
Avoiding Argument and Direct Confrontation
Occasionally, a therapist has the temptation to argue with a client, especially when the client is unwilling to change, is unsure about change, or is defiant, hostile, and provocative. Trying to prove a point to the client or convincing them a problem exists may evoke resistance. Arguments with a client may result in a power struggle and discourage motivation for change. Since the aim of motivational interviewing is to “walk” with clients through treatment, a therapist should start with a client wherever they are and alter their self-perceptions effective means that avoid arguments (Arkowitzet al., 2015).
Rolling with Resistance
Resistance is a critical concern for a therapist as it indicates a lack of client involvement in the therapeutic process or poor treatment outcomes. Although resistance can be seen as client defiance, it can also be viewed constructively to signal a different view by a client, which requires the therapist to understand the different perspective and start from there (Arkowitzet al., 2015). Resistance offers a chance to reconsider responding in a new way that capitalizes on the situation without resulting in a confrontation.
Supporting Self-Efficacy
A majority of clients lack a strong sense of self-efficacy and may not believe they are capable of initiating or sustaining change. A therapist needs to recognize the strengths of the client and capitalize on them to improve self-efficacy by electing and supporting hope, optimism, and the practicality of achieving change. Also, a therapist needs to believe in the client’s capacity to meet their goals (Arkowitzet al., 2015).
Why I Prefer Motivation Interviewing
Since my childhood, I have always had a desire to help others. My role as a PMHNP in motivational interviewing is to direct clients in making a positive change of behavior. Seeing change in my clients gives me satisfaction. Initially unmotivated or unprepared clients become motivated to change their behaviors and commit to change to make healthier choices is all a could hope for as a nurse. Motivational interviewing allows me to take a back seat and give the client control by encouraging them to talk about their need and reasons for wanting to change. It an approach that enables me to take a supportive role, and the client makes their own choices and arrive at their own conclusions situation. Clients have autonomy in this approach. Instead of taking directions from a therapist, clients utilize their internal desire to change. Furthermore, the process of motivational interviewing takes into consideration the difficulty in making life changes.
Personal Bias and Limitations
Negative bias is prevalent in psychology, where negative emotions and treating mental health problems and disorders take center stage (Csillik, 2015). Motivational interviewing goes against this trend and focuses on positive traits to facilitate change. As a health professional, I may occasionally be tempted to critically examine a client’s opinions, which may result in me disapproving rather than accepting them.
Limitations of motivational interviewing include stage-specific motivational conflicts, having no methodology for resistive clients, a strong influence of outside forces, nor addressing the urgency for change (DiClemente et al., 2017). Stage-specific motivational conflicts explored by the motivational interviewing approach can potentially hinder further progress. A therapist needs to see the opportunity offered by each dilemma to help a client explore and resolve conflicting opinions to overcome this limitation (Arkowitzet al., 2015). The approach relies on collaboration between the client and the therapist. However, it does not provide alternatives for clients who are unwilling to work with a therapist and alter negative behavior. Clients in denial tend not to benefit from motivational interviewing (DiClemente et al., 2017). While the client may be willing to change, great external influence may make the client switch back to the negative behavior. Some clients may not understand the urgency for change despite and may feel that they can change later.
Motivational interviewing is a form of psychotherapy in which a therapist takes and supporting role in helping a client find intrinsic motivation and desire to change. It is an approach that requires a therapist to have knowledge and skills that enable clients to initiate and sustain change by expressing empathy, developing discrepancy, avoiding arguments, rolling with change, and supporting self-efficacy. Motivational interviewing focuses on a client’s positive traits to support a change of behavior. Despite having various limitations, it an effective approach in people with substance abuse or those requiring a change in lifestyle behaviors for better health outcomes.