Motivational Interviewing

Motivational Interviewing (MI) is a behavioral health intervention that was developed by William R. Miller and Stephen Rollnick in the early 1990's.  According to Miller and Rollnick, MI is "a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence."  By client-centered, they mean that MI respects the values and concerns of the client.  The client provides the goals and objectives of treatment.  It is not, however, entirely client directed, as in Rogerian psychotherapy.  The practitioner of MI takes the client's objectives and goals, and directs the session by increasing cognitive discrepancy, rolling with resistance, supporting self-efficacy, and communicating in such a way as to enhance the client's natural motivation to change their behavior.  The therapist elicits the client's intrinsic motivation for change.

The MI therapist does this by facilitating the client's identification of the disadvantages of the status quo (their current problematic behavior), and eliciting statements about the advantages of changing behaviors.  The MI therapist also facilitates the client's self-efficacy  and expressions of intention to change.

Rollnick and Miller have chosen a peculiar name for this form of therapy.  The word "motivation" needs no explanation, but why did they choose the word "interviewing"?  They state that the word "interviewing" has "more of an egalitarian, sometimes even subordinate sense to the word."  The root of the word suggests "looking at something together."  This reflects their Rogerian bent.  Miller and Rollnick view MI as "an evolution of the client-centered approach that Rogers developed."  (Many therapist who have adopted this method prefer to call it Motivational Enhancement Therapy.)

Carl R. Rogers (1902-1987) developed Person-Centered Therapy in the 1940's.  Person-Centered Therapy is based on the premise that a client's mental health will improve organically in the setting of a therapuetic relationship that is empathic, non-judgmental, and characterized by unconditional positive regard.  Trust and caring are fundamental to Rogers' therapy who was raised in a strict Christian home.  His theory of personhood is diametrically opposed to behaviorism, believing that each person has  a creative power, a crucial force, that is not deterministically a product of heredity and upbringing,  i.e., a conditioned, mechanistic response to the environment.

Miller and Rollnick build on Roger's humanistic model, only making one major correction:  As stated above, MI is directive.  The therapist respects the client's perspective and experiences, resisting the imposition of his/her own goals upon the client.  The client remains autonomous.  However, with MI, the therapist is directive, consciously eliciting statements from the client that are congruent with the client's stated goals and objectives.  The therapist draws out motivation from the client's own values.  The MI therapist evokes discrepancy in the client, a gap between their current behavior and their stated goals.

Motivation Interviewing has been proven  to be very successful in the treatment of addictive disorders.  It is more effective as individual treatment, and is especially effective in treating people of color.  

DeVine Interventions Group adopts some of the theories of Miller and Rollnick, but not all.  The ideas of complete autonomy, the inherent goodness of the individual or the supremacy of self-esteem (self-worth, self-efficacy, etc.) are rejected.  Having said that, Miller and Rollinck's method has proven to be useful when adaptations are made:  First, the goals and objectives of the client must be congruent with the Scriptures.  Secondly, self-efficacy is replaced with the efficacy of the Holy Spirit.  Faith is foundational to this practice.  Overcoming besetting sins (such as addictions) is by grace alone, and a promise from God to all believers  (Matthew 18:19; 19:25-26; Luke 11:13; John 10:10; 14:14).  This is more effective than self-efficacy.  MI is one method among many, that works well with certain clients with particular conditions.  Each client is an individual and will require methods tailored uniquely to them.  DeVine Interventions utilizes Christian Psychology,  MI and other cognitive-based therapies as one method of an integrative approach to treatment.

If you are experiencing severe and persistent depression, anxiety that you just can't overcome, or are having hallucinations, DeVine Interventions Group can help.  If you are suicidal, call 911.  Would God have you give up?  Is His arm too short to help?  He is willing and able to help, and DeVine Interventions Group is willing and able to help you cope with hallucinations, overcome anxiety and/or improve your mood.  These are our areas of expertise.  Call us for a free consultation that is safe and confidential. (Unless, as stated above, you are having suicidal or homicidal thoughts.  Do get immediate help by calling 911 or the Suicide Prevention Line at 1-800-273-8255 or text 741-741.

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