Motivational Interviewing

Motivational Interviewing

Motivational Interviewing, or MI, is one of many methodologies that I use with clients at Kildaire Counseling, often integrated into every session as we examine what clients want to achieve.

This client-centered approach was developed by William R. Miller and Stephen Rollnick in the 1980s in response to confrontational approaches used in substance abuse treatment before that time. In MI, the client (not the clinician) voices their own reasons and commitment for seeking change. It is not prescriptive, but led by the client at their own pace.

The “Core Skills” of MI are known as “OARS.” OARS is an acronym for the following:

O: Open-Ended Questions

-In a session, clients will rarely hear me ask yes/no questions. Rather, I will ask a variety of questions that will give us more insight into an observation the client has just shared. The goal of open-ended questions is to dig deeper into what may seem like simple statements to draw out valuable information that can guide the client into a next step. Open-ended questions are like a shovel or pick-axe that I use to uncover hidden treasures within client thoughts.

A: Affirmations

-It is important for me as a clinician to distinguish between flattery, fawning, or toxic positivity, and genuine affirmation. Often when I provide an affirmation for the first time to a client, I will explain that I don’t offer affirmations excessively or off the cuff, but I do so in a way that responds to a strength the client has just presented. It is important to me that clients feel the feedback from me is genuine and related to their abilities or progress. My goal is to help clients feel comfortable with receiving positive feedback that validates their efforts and good qualities.

R: Reflective Listening

-When I listen carefully to what a client shares, I often notate what seems most significant, or paraphrase their statement and reflect it back to them. Clients may hear me ask, “Did I understand this correctly?” It is important that I hear and relate important information to our mutual understanding of clients’ goals and desires, without inserting my own opinion when it comes to their personal statements. I often remind clients that it is okay (and I like it) when they may need to interrupt me and correct any information that I may not have accurate, because it is important that they feel heard and understood.

S: Summaries

-In my sessions, I follow a format that ensures that we can summarize the most valuable parts of the session at least once before our time is up. I like to ensure that we can cover strengths, concerns, and plan of action for each of the client’s goals so that everyone is clear on how to move forward in the week ahead. Some clients like to take written notes of these as we go through them. Others like to rehearse aloud statements that summarize the action plan or steps they will take in the coming days. No matter how the client prefers to take the summary away from the session, it is important to me that we can cover it together to be sure that it meets the client’s needs.

You can read more about MI at the Motivational Interviewing Network of Trainers to gain knowledge about its purpose and rationale. If you are not yet sure about starting therapy, a clinician trained in MI is a great partner to begin the journey.