There's an old adage about how you can't change someone. While it may be true that people only change if and when they want to, mental health therapists have one technique that might be the key to helping patients change behavior.
Motivational interviewing (MI) is a psychotherapy technique often used in substance abuse treatment that aims to enhance a person's motivation to change a particular behavior. This approach is designed to increase motivation for change by asking questions that get to the root of why the desired behavior change is important.
Motivational interviewing techniques are typically used in a general practice setting where the doctor will help in facilitating behavior change by also identifying barriers. It is also important that clinicians express empathy in order to build a strong therapeutic relationship with their patients as they elicit "change talk" and eventually, reach a point where the patient is ready to change the target behavior.
When used appropriately, motivational interviewing can not only be a powerful tool with such issues as substance use disorders, but in professional and personal settings as well. This article will explore how motivational interviewing strategies work, the core principles of motivational interviewing, and how to use it to benefit your relationships.
What Is Motivational Interviewing?
The foundation of motivational interviewing recognizes that we all can make positive changes and act toward them. However, certain experiences, situations, fears and doubts can often get in the way of a person taking the first step toward making that change.
As part of the umbrella of behavioural and cognitive psychotherapy, one of the main goals of motivational interviewing is to increase a client's self-efficacy. This is their belief that they are capable of successfully accomplishing a task, in this case, changing a specific behavior. The idea being that you cannot change a behavior if you don't first believe that you can, and are not mentally ready to change it.
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Motivational interviewing is often used as part of Motivational Enhancement Therapy (MET); a structured therapeutic approach that aims to increase a patient's motivation for change. Once the patient is ready to make the change, clinicians often use Cognitive Behavioral Therapy (CBT) to help them execute the change. This approach focuses on thoughts and behaviors, and teaches patients how to actively make the desired behavioral change.
Motivational interviewing often begins with asking a person to describe what change looks like to that individual. It is important to ask questions that explore the person's motivation for this change and what a difference looks like to them. However, a key part of the motivational interviewing process is also recognizing why the person may be hesitant to make the change; in other words, identifying the barriers to change.
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Often, the decision to change or not has to do with the comfort of the status quo. For example, one of your coworkers may be interested in pursuing a promotion. However, they may also be comfortable with their current workload and enjoy the work/life balance that their present position offers them.
When using motivational interviewing to help empower your coworker toward the change they want to make, it's important to approach the topic with ambivalence. Acknowledging your coworker's desire for change as well as their desire to remain in the same place are important parts of the process.
Ultimately, motivational interviewing works not by pushing someone toward a certain outcome but rather to encourage the person's autonomy in the decision and conclude that they can and want to make the change.
What Are The OARS Of Motivational Interviewing?
There are five techniques and skills used in interactions that make up motivational interviewing. These are open questions, affirmations, reflective listening, and summary reflections (OARS).
Open questions are questions that can't simply be answered with a yes or no. Instead of asking a person if they want to change, asking why that change is important to them, how that change would improve their current situation, or what challenges a person may face when trying to make that change.
Affirmations are used to recognize the qualities possessed by the person that show they can make the change they're seeking. For example, recognizing that though a person has faced obstacles in the past, they are determined to make changes to earn a promotion at their company.
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Reflective listening shows you understand what a person has shared with you by reiterating the message back to them. During a motivational interview, a person may share that they are concerned a promotion would impact their work/life balance. In this case, try saying something like, "It sounds like having free time to spend with your family and friends is important to you." This will not only make them feel heard and understood but will invite deeper conversation about the obstacles that are preventing them from making the change they wish to implement.
Summaryreflections are similar to reflective listening in that they recap what a person has shared during a motivational interview. Rather than continuing that conversation, they wrap up key shared points. For example, telling the person having a manageable workload is a must-have for their next career move, then making it a goal to determine how the person can make this happen and still advance their career.
What Are The 5 Principles Of Motivational Interviewing? And How To Use Them
When trying to help someone make a change, there 5 principles underpinning motivational interviewing that should be implemented:
1. Express Empathy
A core component of motivational interviewing is to show understanding and compassion for the person's situation and recognize how or why the change may be difficult. Your goal is to listen more than you talk and to show that you respect and accept the person and their struggles.
For example, if you and your partner have set a goal to spend more time together but they've had to work more than usual, address the concern from a place of understanding. "I know you're up for that promotion. It must be hard to make it home to have dinner with me right now," can be a great conversation starter. It also makes your partner feel comfortable sharing the difficulty they might be having at work and allow you to support them.
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2. Develop Discrepancy
You know it's important to your partner that the two of you spend time with one another. However, if you notice it hasn't happened, address behaviors that don't align with the change they want to make. The key here is not that you guilt or shame them about not doing what they said they would, instead, you simply want to highlight the discrepancy and invite them to express themselves.
This is where open-ended questions come in handy. Ask them questions that will help your partner identify for themselves the discrepancy between their current behavior and their desired behavior. For example, you can say, "It must be hard juggling work and trying to spend more time together. How would you like things to be different?" or "How can I help you with X?"
3. Avoid Arguments
Even if you're angry or frustrated by the lack of change, keep the conversation grounded in facts. Ask questions about what activities your partner enjoys doing with you, how they prefer to spend their free time, and the challenges they're facing that keep them from spending more time with you. You want to avoid leading the person to defend their current behavior, and oftentimes, it is argumentative or persuasive language that will have this result.
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4. Roll with Resistance
While many think it's helpful to talk about why someone shouldn't do something, this approach often provokes resistance and is counter-productive. Instead, try to get the person to say for themselves why they should be making the change. You can ask what they think might happen if nothing changes. Taking a look at how a lack of changed behavior impacts themselves and others can create a positive shift during motivational interviewing.
5. Support Self-Efficacy
Offering support during a motivational interview is perfectly okay, but the focus should be on the other person and their ability to make the change independently. Identify small, achievable changes that can be made while working toward a larger goal. Help build their confidence in achieving this goal by highlighting past successes. For example, if your partner isn't able to make it home for dinner, ask if they're willing to share some dessert with you when they do get home – or wake up earlier so you both can have coffee together in the morning before the workday starts.
Summary
You can't force someone to change. But when used correctly, motivational interviewing can help improve your relationships by encouraging an individual to recognize their ability to change and help them envision a future for themselves where that change is possible.
Two of Mr. Moriarty's students pose with their yearbook from 1982.WHAM via CNN / Video
man holding a yearbookWHAM via CNN / Video
Black and white photos from school yearbookWHAM via CNN / Video
Patrick Moriarty (center, blue shirt) and a group of his former students watched the solar eclipse together on Monday in New York.Caitlin Moriarty Hynick
