Motivational Interviewing


Motivational Interviewing is a person-centred counselling style for addressing the common problem of ambivalence about change (Miller and Rollnick 2013).

Motivational Interviewing emerged in the context of addiction treatment in the early 1980s when Dr William Miller was working in a clinic for people with alcohol problems. He was puzzled by the writings and opinions of practitioners in the field, who were overwhelmingly disparaging about their client group, characterising them as "pathological liars", "in denial" and "out of touch with reality". This had not been Dr Miller's experience of working with these people and there was no real scientific evidence to support these views. Addiction treatment in the 1980s (particularly in the USA) was overwhelmingly authoritarian, demeaning and relied on a confrontational style of counselling. It was as though the practitioners believed that if they just told people how bad their behaviour was, how destructive their substance use was, this would lead to enlightenment for the clients which, in turn, would lead to change. It became apparent to Dr Miller that the opposite was true, that the client's attitude and response is very much a product of the relationship between the worker and client.

It became apparent that ambivalence about change in conversations, was being interpreted as resistance to change. In fact, "Resistance" and motivation occur in conversations about change. This is now substantiated in research and evident to see in personal practice. The worker's response can increase or decrease a client's motivation. If the worker's approach inadvertently evokes defensiveness, clients are less likely to make change. In MI, a simple principle emerges from the research, that the client, not the worker, must voice the reasons for change for it to be effective. Since the emergence of Motivational Interviewing it has successfully been used to target a number of behavioural changes, not just addictions, in a range of settings, including healthcare, GP surgeries, youth offending, probation, and many aspects of social work. It has accumulated evidence demonstrating its effective in over 800 randomised control trials