Motivational Interviewing

What is motivational interviewing?

Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change.  It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion. (Motivational Interviewing: Helping People Change. William R Miller, PhD, Stephen Rollnick, PhD. Guilford Press, Sep 2012.)  Source:

Motivational Interviewing came out of the struggles of Dr. William Miller when he was a yet a student  immersed in an internship with alcoholics in a VA hospital in Milwaukee, WI.  He didn’t know yet that the medical literature described the alcoholic patient as impenetrable, uncooperative and in deep denial. What he did find was that in having respectful conversations with clients wherein he gained their trust and gave them respect and empathy, the result was improved patient outcome. The clients began to exhibit self-awareness which included counting their drinks, and perhaps reconsidering “having another” more and more often.

William Miller replicated his success from Milwaukee to Oregon and then New Mexico followed by the benefit of sabbaticals in Australia, where he met Stephen Rollnick, who  had already helped introduce the ideas of Motivational Interviewing taken from Miller’s lone academic publication at that time. Rollnick had seen the wave of interest in Motivational Interviewing taken direct to helpers and clients all across the health system  by plucky practitioners in the UK, but needed access to Dr. Miller to nail down the concept.

Stephen Rollnick soon collaborated with Dr. Miller on two books which helped standardize the language and explain the approach, and Motivational Interviewing thrives as a sort of Open Source system that invites education, empathy and listening as a way of communicating trust and good intentions.  MI (Motivational Interviewing) as a method is now widely used in any situation that is appropriate for meaningful dialogue, such as in Africa, where it has been used to build working relationships in villages for water projects.

The results of various cross disciplinary studies confirmed the value of Motivational Interviewing both with and without behavior therapy or medication. Meta-analysis followed across a wide range of health care, counseling and education applications.

This method of listening reflectively, while maintaining empathy and respect for the client, is now standard in case taking and is modeled in client education across disciplines and around the world.



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