1. Motivational Interviewing

2. What is it?
Motivational Interviewing is a client-centered method of communication which seeks to call forth the client’s own motivation for change

3. The “Spirit” of MI Collaboration (v. Confrontation)
MI is a partnership between the social worker and the client, based on the perspective and the past experiences of the client
Collaboration builds rapport between the social worker and client, as it does not emphasize the social worker as the “expert”
The social worker may see things differently but the process is focused on mutual understanding, not the social worker being right

4. The “Spirit” of MI (cont.)
Evocation (Drawing Out, Rather than Imposing Ideas)
Evocation draws out client’s own thoughts and ideas
It does not impose the social worker’s opinions when it comes to change
Change most likely occurs when the client discovers their own reasons and motivations for change

5. The “Spirit” of MI (cont.)
Autonomy (v. Authority)
MI understands that true power for change rests within the client
It gives empowerment as well as responsibility to the client
There is no one “right way” to change, so clients are encouraged to develop many ways to achieve desired change

6. Principles of Motivational Interviewing
Express Empathy
See the world through the client’s eyes, share their experiences
When clients feel understood they are more likely to share in depth

7. Principles of MI (cont.)
Support Self-Efficacy
MI believes that clients possess the capabilities to change successfully
Self-efficacy is the client’s belief that change is possible
This is necessary for difficult changes to occur
In MI, social workers focus on previous successes and highlight skills and strengths the client already possess

8. Principles of MI (cont.)
Roll with Resistance
Resistance occurs when the client feels conflict between their views of the “problem” or “solution” and the social worker’s view of these things
It also occurs when the client feels like their freedom is impinged upon
Avoid confronting the client, de-escalate and avoid a negative reaction; “roll with it” instead
Having the client define the problem and develop their own solutions allows little for the client to resist

9. Principles of MI (cont.)
Develop Discrepancy
MI works to help the client explore the discrepancies between their current circumstances and where they want to be
Clients are more likely to experience motivation to change when they realize their goals don’t match up with their current circumstances

10. MI Skills and Strategies- OARS
O: Open-ended questions are not easily answered with “yes/no”. The client is able to answer in many possible ways, moving the conversation forward.
A: Affirmations are statements that acknowledge the client’s strengths. They build rapport and when they are genuine they can prove to the client that change is possible despite previous unsuccessful attempts.
R: Reflections, or reflective listening, demonstrate that the social worker sees the situation from the client’s viewpoint. Reflection can be used to guide the client toward resolving ambivalence by pointing out the positives of change.
S: Summaries are when the social worker recaps everything that has happened in all or part of the sessions. This calls attention to important parts of the discussion. It can also change the direction of the conversation and prepare the client to “move on”.

11. MI Skills and Strategies- Change Talk
Preparatory Change Talk
Desire (I want to change)
Ability (I can change)
Reason (It’s important to change)
Need (I should change)
Implementing Change Talk
Commitment (I will make changes)
Activation (I am ready, prepared, and willing to change)
Taking Steps (I am taking specific actions to change)

12. Efficacy of MI
MI is more effective than no intervention when treating alcohol use, marijuana dependency, and tobacco use. MI is usually most effective when combined with other forms of treatment.
MI has also been shown efficacious in promoting lifestyle changes for older adults with both chronic and acute illness.
Another study performed on homeless veterans as they waited to enter into a residential treatment program showed that using MI on the initial intake of the veterans increased program entry.

13. Sources
“A Definition of Motivational Interviewing.” Principles%20&%20Approach%20V4% pdf. From
Cummings, S. M., Cooper, R. L., & Cassie, K. M. Motivational interviewing to affect behavioral change in older adults. Research on Social Work Practice, 19,
Lundahl, B., & Burke, B. L. The Effectiveness and Applicability of Motivational Interviewing: A Practice-Friendly Review of Four Meta-Analyses. Journal of Clinical Psychology, 65, Retrieved July 24, 2014.
Wain, R. M., Wilbourne, P. L., Harris, K. W., Pierson, H., Teleki, J., Burling, T. A., et al. Motivational interview improves treatment entry in homeless veterans. University of Nebraska-Lincoln. Retrieved July 25, 2014.