What is MI?
Motivational Interviewing (MI) is an approach to helping relationships that uses “change talk” to strengthen mentees’ intrinsic motivation to make positive change. Although it was developed for work in addiction counseling, MI has since been applied to improving health behaviors, mental health, behavioral and educational outcomes, and more.
MI draws on the language of change to motivate people (see below)
William Miller, the developer of motivational interviewing, made 3 observations about the people that formed the basis of MI
- Most people are ambivalent about changing their behaviors.
- The more someone who is ambivalent argues for change, the better the odds of change occurring
- Typically, if mentors argue for the other person changing, then the mentee will often argue against change
As mentors, it is important that we use our understanding of language to help mentees talk themselves into change based on their own values, and not our own.
Knowledge and confrontation is not enough to motivate change.
- Change happens when it is connected to something that your mentee values
- Identify your mentee’s ambivalence about change
- Why might they want to change, why might they resist change
- Explore this ambivalence to get your mentee to think about what they truly value
Connecting mentee’s positive change to what they truly value is the backbone of motivational interviewing and leads to much more productive conversations about change.
MI is not…
- easy to learn and use consistently
- a way of balancing decisions
- a manipulation technique to get people to do what you want
- a solution to all problems with your mentees
What are the stages
Motivational Interviewing consists of four important processes, or stages. It is important to note that these stages are not sequential, and you’ll be revisiting the earlier stages multiple times. Below is a brief overview of what you can expect in each stage. A more in-depth breakdown of the stages is discussed later in the training.
- Establish rapport with your mentee.
- Understand their concerns and show empathy.
- Promote and identify your mentee’s intrinsic desire to change.
- Clarify the direction of change.
- Clarify your mentee’s readiness for change.
- Explore motivation, ideas, and goals.
- Identify barriers to change.
- Help to strengthen the mentee’s own motivation for change.
- Develop your mentee’s commitment to change.
- Create a solid plan of action with your mentee.
Ambivalence is the “I want to change, but I don’t really feel like doing it now” talk that we have in our heads when we consider changing our behavior.
The part of us that argues for change engages in “change talk” whereas the side of us that doesn’t want to change initiates “sustain talk.”
“Change talk” refers to the language your mentee uses that indicates a desire, ability, reason, need, or commitment to change. Change talk can be categorized into different types, including:
- Desire: Statements indicating your mentees wish to change (e.g., “I want to improve my grades”).
- Ability: Expressions of their capability to change (e.g., “I can quit smoking if I try”).
- Reasons: Reasons or motivations for change (e.g., “I need to change to be around for my kids”).
- Need: Statements that express the necessity of change (e.g., “I must stop skipping assigments”).
- Commitment: Indications of a person’s commitment to change (e.g., “I will start exercising regularly”).
The opposite of change talk is “sustain talk,” which reflects reasons to maintain the status quo or arguments against change. Mentors can help shift the conversation from sustain talk to change talk.
As a mentor, we can often feel like we need to “fix” what we see as wrong in others. This can lead us to use techniques that push individuals along the path that we believe would be best for them.
The “righting reflex” refers to the natural tendency of mentors to want to correct or fix what they perceive as problematic for their mentee, particularly when it comes to unhealthy behaviors or attitudes. It may even lead the mentor to directly confront and advise their mentees on what they should do to change.
While well-intentioned, the righting reflex can be counterproductive in the context of MI. This is because MI is based on the principle of guiding rather than directing. The approach emphasizes collaboration and autonomy, rather than authority and persuasion. When mentors act on the righting reflex, they may inadvertently provoke resistance in mentees, as it can make mentees feel misunderstood, judged, or not in control of their own change process.
Why is this a problem?
It is likely that you mentee has made all of these arguments to themselves before, and if you are busy giving all the arguments for change then it is likely that they will respond with arguments against change.
Read this example of the righting reflex coming from a mentor:
Mentor: “I’ve noticed that you’ve been having a tough time making friends at school. Can you tell me more about what’s been going on?”
Mentee: “I try to talk to kids, but they always seem to ignore me or walk away.”
Mentor: “Well, one thing you can do is to join their table during lunch and ask them questions. That should help you make friends.”
Mentee: “I feel really lonely and sad. I want to have friends like everyone else.”
Mentor: “Don’t worry; I’ll introduce you to some of the kids in your class tomorrow. You’ll see how easy it is.”
In this example, the mentor is pushing their mentee to make friends in a specific way, instead of exploring what’s going on. Put yourself in the mentee’s shoes – how does this conversation feel to you?
There are different types of helpful communication styles:
A communication style where you would lead or direct the flow of the conversation
An example of this style would be a a doctor telling their patient to take take their medication and then explain how it would benefit them if the took it as prescribed.
A guiding communication style is a collaboration between both parties. A mentor using this style would focus on encouraging and inspiring their mentee.
An example of this style would be a doctor having a nonjudgmental conversation with a patient who is ambivalent about integrating a new medication into their daily routine.
This communication style is focused on listening and observing your mentee. Here, you let them take the wheel while you understand and respond to what they say.
An example of this would be a doctor understanding the fact that his patient is anxious about adding a new medication to his daily routine.
Motivational Interviewing uses the guiding communication style as it represents the middle ground of the communication spectrum. This allows us as mentors to incorporate aspects of both styles and get all of the benefits.
The MI spirit refers to someone who embodies a combination of the following characteristics:
- and many more…
Collaboration: MI is a partnership, not a relationship where one person knows what is best for the other.
Compassion: MI should only be used to help the person that you are supposed to be helping, and not abused for your own benefit.
Acceptance: Accepting that people have absolute worth and not looking down on them for their decisions.
Evocation: Drawing out already existing motivation rather than pushing it into them.