Motivation is important to elicit behavioral changes. There are many ways to initiate this. One of the best ways to do so is motivational interviewing. This method is a short-term process that involves direct interaction between interviewer and client.
Although the interaction is direct, the process and techniques require a subtle and calm approach. It is an approach built on trust and openness. The interviewer acts as an aid in the change process but does not give direct orders as to what the client should do.
Instead, the interviewer will help make clear the mixed ideas and feelings of the client. Its main goal is for the client to find the self-motivation to change for the better. This is done by removing ambivalent ideas that can prevent the progress of the client.
This approach stems from psychologist Carl Rogers’ humanistic theories. These theories are centered on the innate abilities of people to choose freely and self-actualize.
Here are the Motivational Interviewing Techniques as below:
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Be empathetic
Empathy is the ability of people to understand and connect to another.
An empathetic approach can create a safe and open environment. It can also create trust between the interviewee and interviewer. When all these things happen, the client is more likely to open up. An empathetic practitioner will be able to listen and understand the client’s reason for his/her behavior. This will then give an idea of how to approach and solve the situation. Empathy will decrease resistance and increase willingness and capacity to change.
However, there are things that need to be clarified concerning empathy. This does not mean the practitioner approves of the client’s actions. Rather, he/she accepts and recognizes them. Also, there is a fine line between identifying with the client and understanding them. This could lead to the continuation of bad behavior and no progress.
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Discrepancy magnification
Discrepancy is simply defined as having a slight difference where there should not be one. You will usually hear that a large discrepancy is a negative thing. But in motivational interviewing, this is a good thing. Magnifying the difference between the client’s current situation and what their future could be will make them see that changes should be made.
One specific approach is called the “Columbo Approach.” This comes from the 1970s show Columbo, where the lead character rationalizes discrepancies. This method is not meant to judge but to get information. It requires the interviewer to curiously ask a question. When opposing ideas between what the client said and their behavior come up, the therapist can dive into that. Again, it is important to be non-confrontational and nonjudgmental.
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Augment ambivalence
When a person is prompted to change, he/she has mixed feelings. That person may want to quit something because they know the consequences but also want to continue doing it because they’re thinking about the small gains they can get.
Like discrepancies, ambivalent ideas that are out in the open can trigger internal motivation. This technique aims to recognize and verbalize these contradicting thoughts, preventing the person from change. Both client and therapist can discuss and understand these thoughts, and then the client can work through them.
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Resist resistance
This means avoiding arguments. Motivational interviewing requires a calm and open atmosphere. It’s built on trust and understanding. Disrupting this can prevent any progress on the client’s side. They can withhold vital information or lie. Avoiding resistance is important in motivational interviewing.
One reason resistance is created is because of the opposing views of the therapist and the client. It’s the interviewer’s job to adjust. Resistance is a signal for the interviewer to change their approach. He/she should understand the client’s perspective and work from there. Forcing the practitioner’s opinions on the client will create friction and a hostile environment. This can lead to the trust being broken.
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Fight the “righting reflex”
The “righting reflex” refers to the tendency of health professionals to direct patients to the “right way.” This usually happens when the patient is too stubborn to listen to the professional’s advice.
Doing this will look like the professional is asserting their dominance and power over the situation because of their knowledge and name. This will result in friction, increased resistance, and broken trust. This technique is also unidirectional.
The client will refuse to continue because they might think that is the end of things. It prevents the interviewer from understanding the client’s struggles more.
Be open. This will help in recognizing the client’s behavior. Both parties can then work together to come up with solutions. This will open opportunities to think without using force and minimize resistance.
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Boost self-efficacy
Self-efficacy is the belief of an individual in their ability to reach their goal. People who are praised will proceed in doing what they were praised for.
Commending them will urge them to move forward. Even the smallest of compliments can make a big difference. Telling them how well they are doing or how far they have come will greatly impact their motivation. On the other hand, people with low self-confidence tend to give up.
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Offer the right advice the right way
People who are forced and told what to do tend to turn the other cheek. They refuse to listen. They want to have choices and desire control. The right way to give advice in motivational interviewing is to pose suggestions. People want the freedom to decide. They should be casual, not judgmental.
It’s recommended that the interviewer ask first before giving advice. This will give the client a chance to decide whether they are open to listening. Also, giving unprompted and unsolicited advice is a negative approach. Then the advice has been given, ask for feedback. The two parties can work on tweaking it for the better.
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Therapeutic Paradox
This method requires contradictory statements from the viewer. The ideas are meant to be unexpected. These will lead the client to argue the importance of changing. When the client has confirmed their desire for change, the reason for no progress will be let out and understood.
This technique is more on the riskier side. This is because the interviewee might take it negatively. They might view this as sarcastic or insincere. This approach can also be considered a “last resort” for when the client has undergone the program or has been going to sessions for a long time, but little to no progress is seen. The professional should always be prepared to handle whatever reaction the client expresses.
Qualities of a Good Motivational Interviewer
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Empathetic and understanding
As motivational interviewing is built on trust, being empathetic and understanding is important. Viewing the situation as the client does will help in understanding how their negative behavior began and their reasons for remaining that way.
Being empathetic and understanding can also improve trust and create a safe atmosphere. Being in a safe space can bring the client to open up more freely. Once the professional grasps the interviewee’s ideas, they can proceed to come up with ways they can get the person out of the situation, with respect to the person’s views.
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Supportive
This coincides with the sixth technique. It’s important for the professional to lead the client to a healthier path, but it’s also important to praise them for their progress. As mentioned, boosting their self-efficacy will urge them to continue on the road to positive change on their own.
Making them believe they are doing great can make them self-sufficient. With that, they will proceed to better themselves because of the motivation they got from the confidence they were given. If their self-esteem and confidence are low, they are more likely to give up on change.
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Calm
Being forceful can result in the client becoming resistant, hostile, or scared. Whichever reaction will elicit no progress. They will refuse to listen and open up. That’s why it’s essential to be calm. This will make the therapist seem trustworthy, making the client confident to talk. Then, they can begin the process of looking for answers and solutions.
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Strong
This may be contradictory, but it is necessary. It’s important to stay calm but also remain firm. Don’t let the client sway your views. Agreeing with the client too much will lead to them believe what they are doing is okay. Don’t give in to asserting power and dominance. Being strong in this sense means there is control.
Being strong also means continuing to believe the client can change. No matter how difficult they may be, never give up on helping them. Do not be forceful but do not be too lenient. Keep in mind the purpose of counseling them.
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Strategic
As with anything, a strategy is important. Interviewing the client with no plan will lead to nowhere. Have an initial plan and be ready for any sort of change elicited by the client’s answers.
Understanding also comes hand-in-hand with being strategic. As said, you should be ready for changes. There also needs to be an understanding of what kind of tweaks are needed and how it should be done.
Being strategic is also vital in interacting with the client. The mind needs to work to find acceptable responses without being confrontational, judgmental, and unsure.
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A good communicator
Interaction is at the center of motivational interviewing. The key to good communication is understanding on all parties. The message needs to get across in line with the situation. This is connected to being strategic.
The professional needs to know what to say and how to say it. They should not come across as intimidating or weak. They need to maintain a professional but inviting aura.
Verbal and non-verbal cues are also important. This will help in understanding the patient more, especially if they tend to be a closed book. The interviewer needs to know how to read between the lines.
- Open-minded and unbiased
Having an open mind will greatly benefit the interviewer in recognizing the situation. Being open will lead to more ideas and positive interaction. A closed and biased mind will eliminate any chance of progress on the client’s behalf.
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Available
A therapist or counselor’s job is never easy, nor is it ever done. Although there are office hours, being ready for a patient’s call will greatly help them. No one can control when they will have an episode or need immediate help. It’s better to be always prepared.
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Creative
This is not the common word you hear when it comes to a medical job. But being creative helps in solving impromptu problems. It can help in adjusting to whatever response or reaction comes. Then, you will be able to counter that reaction with a proper response that will not be detrimental to the process.
Takeaway
There are many different ways to elicit positive behavioral change in a person. However, it’s been proven that motivational interviewing is one of the most effective methods. The effectivity stems from the innate ability of humans to self-actualize. It’s also one of the simplest because it’s centered on trust and leading the person to motivation to better themselves.
Motivational interviewing is best suited for a number of people. The most common are people who are addicted to substances. This method can help them help themselves out of their addiction. Motivational interviewing also benefits people who have diseases. It can teach them to change their routines for the betterment of their health.
