Motivational Interviewing Techniques for Behavior Change
The motivational interview technique has been defined as "a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence."
The following general principles of motivational interviewing were described by Miller and Rollnick:26
- Express Empathy. The interviewer must be nonjudgmental, supportive, nonargumentative, understanding, respectful, and a good listener. It is important to avoid blaming and shaming the patient.
- Develop Discrepancy. The interviewer should help the patient identify his/her desired goal and contrast it with current behavior ("heat of the moment" vs "cold light of day"). Even though the interviewer may have floated the idea for the goal behavior, it must be perceived by the patient as coming from within and not imposed.
- Roll with Resistance. People are often very resistant to change behavior, especially if that behavior is pleasurable. Resistance exhibited by the client should be used as a basis to bring about change, not postpone it. The interviewer need not come up with all the answers; it is important to explore the reasons for the patient's resistance to change and channel this reluctance in a more positive direction.
- Support Self-Efficacy. The interviewer must create an environment that bolsters the client's self-confidence. Initially the client may feel that he or she won't succeed and may not want to try for fear of failure. The interviewer must support even a small kernel of self-confidence and nurture that seed until it becomes self-fulfilling prophecy. For this to happen, it is very important for the provider to be a reflective listener who can identify areas of ambivalence or lack resolve in the patient and reflect them back to the patient to ponder.
Adapted from: Shah S, McGowan J, Young S. Prevention in Positives: A Case-Based Workshop for Providers. New York/New Jersey AIDS Education and Training Center. February 2005. [PDF 8.4MB]