Motivational Interviewing/ Motivational Enhancement

What is Motivational Interviewing (MI)?

  • MI is a brief, client-centered method used by therapists to strengthen a client’s motivation for and commitment to change.
  • It is especially useful for people who are reluctant to change their behaviors or are going back and forth about changing.
  • It was originally designed by Bill Miller (1983) for use with people with alcohol use disorders, but since then, it has been widely applied in a range of health care and mental health settings.

What are the goals of MI?

  • There are two primary goals of MI:
    • To reduce ambivalence about change (ambivalence is when someone wants to change but at the same time doesn't want to change).
    • To increase internal motivation to change.

What is the spirit of MI?

  • The MI spirit is core to the treatment. It means using a collaborative, evocative, and respectful approach that aims to increase a client’s sense of autonomy.
  • This style encourages a client to strengthen the part of them that wants to change and move toward concrete steps to change that come from the client rather than the therapist.

What are the guiding principles of MI and the methods used by clinicians?

  • There are four guiding principles of MI for therapists to follow:
    • Expressing empathy (showing they understand where the client is coming from).
    • Developing discrepancy (looking for ways to increase motivation to change).
    • Rolling with resistance (understanding that people have reasons to not change).
    • Supporting self-efficacy (encouraging clients to build on their strengths).
  • In MI a therapist will ask open-ended questions to explore and reflect what the client’s experiences are.
  • MI incorporates strategies designed to enhance clients’ motivation for change, address ambivalence about change, and emphasize client responsibility and ability to make choice.

Where can I learn more about MI?

What is Motivational Enhancement Therapy (MET)?

  • MET combines the therapeutic style of MI with a brief, structured intervention for evoking change behavior.
  • MET was originally developed as a manual-guided intervention (Miller et al, 1992) for people with alcohol use disorder as part of the Project MATCH initiative. (Information on Project MATCH and the research support for MET is available via clicking on the below link:
    https://pubs.niaaa.nih.gov/publications/ProjectMatch/matchIntro.htm)
  • MET consists of a pretreatment assessment, followed by two to four targeted treatment sessions with a therapist.
  • In the first session, feedback (e.g., information about current use) from the assessment is presented to client. A focus of this session is on building a client’s motivation to begin or continue to change. 
  • Early sessions of MET focus on evaluating information from the initial assessment and setting goals for the future.
  • Concerned significant others often are included in these sessions.
  • Subsequent sessions continue to focus on increasing motivation to make changes.

Where can I learn more about MET?