Don’t be afraid to ask — What does “motivational interviewing” really mean?
While motivational interviewing, or MI, has been an evidenced-based practice for more than two decades, in our new virtual world of video conferencing and telephone visits, the term has been bubbling up with more and more frequency. So we asked Elizabeth Morrison, an expert motivational interviewing trainer who has taught this communication approach to a number of CCI program participants, to walk us through the basics. She shares her learnings from her own experiences as a practicing clinician, integrated care leader, professional trainer, and consultant.
How to Get Started
Motivational interviewing was originally developed in part by William R. Miller and Stephen Rollnick in the 1980s to support patients with substance use disorders. Since then, it’s moved beyond the addictive disorders field into public health, medical care, criminal justice, education, sports, and even parenting. It is often engaged when we are helping others make positive changes in their lives.
The research on MI is extraordinary, in its breadth and depth, and more than 90 clinical trials prove its effectiveness in helping people make behavior changes. This research spans different cultures, ethnicities, and ages, as well as different disciplines and fields.
MI engages specific strategies to create an empathic connection to one another, encouraging people to share their thoughts, feelings, and experiences around struggles they may be having with particular behaviors, and enhancing and amplifying their own motivations. While motivational interviewing is sometimes defined as a counseling approach, Morrison encourages us to think of it as a communication philosophy, that is “just as applicable to our relationships with our family, friends, and ourselves.”
Here are the core elements:
- Empathic presence and skillful listening.
- Communicating empathy and non-judgment.
- Honoring autonomy.
- Evoking another’s thoughts, feelings, goals, and solutions around behaviors causing difficulties.
In her handout on core motivational skills, Morrison summarizes specific strategies in each of these elements.
How to Get Better at Engaging in MI
Want more practice?
Check out Morrison’s videos on motivational interviewing. These short videos demonstrate examples of motivational interviewing strategies like communicating empathy, open ended questions, assessing confidence and conviction, eliciting solutions, and more.
There are also thousands of other YouTube videos of MI, and many excellent books, such as these two by William R. Miller:
How to Become an MI Workshop Facilitator!
Want to teach these skills to your coworkers?
Since MI takes a partnering approach, so too does MI “training.” For this reason, Morrison encourages using the word “workshop” as opposed to training, and “facilitator” as opposed to “trainer.”
One way to become an MI facilitator, is to just start facilitating workshops! There is no right way to run a motivational interviewing workshop, and when it comes to facilitating, you’re not supposed to look like anyone else but yourself — everyone brings their own spirit and skills to facilitation.
The most important thing to remember is that your workshop and facilitation models MI principles — such as partnering with participants, using open ended questions and reflective listening, and engaging participants in MI practice — for at least a third of the workshop. This is not role playing — it’s practicing using our real selves.
Workshops can be 30 minutes, or hours long; they can be delivered in-person, or virtually. Here are some resources for facilitating your own workshops:
- MI slide decks (PPTX) you can use, with presenters notes for tips and support:
- Tips for conducting MI workshops, both virtually and in-person
- Converting longer MI workshops into shorter in-person or virtual workshops
- Guidelines for MI practice during workshops
As Morrison says, “You don’t need a special certification to do this work. If you love it, just give it a shot!”
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