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What are some common pitfalls or barriers to applying MI principles in your practice?

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Motivational interviewing (MI) is a skillful and collaborative way of helping people explore and resolve their ambivalence about change. It involves four core principles: expressing empathy, supporting autonomy, developing discrepancy, and rolling with resistance. However, applying these principles in your practice is not always easy or straightforward. You may encounter some common pitfalls or barriers that can hinder your effectiveness and rapport with your clients. Here are some of them and how to overcome them.

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1 Assuming readiness

One of the most common mistakes in MI is to assume that your client is ready to change or to move them too quickly through the stages of change. This can create resistance, frustration, and disengagement. Instead of imposing your agenda or expectations, you need to assess and respect your client's readiness and motivation. You can do this by using open-ended questions, reflective listening, and scaling techniques to elicit and explore their reasons, values, and goals for change.

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2 Giving advice

Another common pitfall in MI is to give advice or solutions without eliciting your client's permission, interest, or feedback. This can undermine your client's autonomy and self-efficacy, and make them feel judged or lectured. Instead of telling your client what to do or how to do it, you need to offer advice or information in a collaborative and respectful way. You can do this by asking permission, providing options, eliciting pros and cons, and checking for understanding and acceptance.

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Michelle Drapkin, PhD ABPP

Behavior Scientist ? Award-Winning Author ?Speaker ? Innovator ? Trainer ? Board-Certified Psychologist
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We think we’re soooooo smart sometimes. And we become annoying know-it-alls. Who rob our patients of their autonomy by telling them what to do - before we even ask what they know. So stop and ask permission. Evoke before your provide advice or info. And always ask what they think about that info.

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3 Ignoring emotions

A third common barrier in MI is to ignore or minimize your client's emotions or emotional barriers to change. This can make your client feel unheard, invalidated, or defensive. Instead of avoiding or dismissing your client's emotions, you need to acknowledge and explore them with empathy and compassion. You can do this by using reflections, affirmations, and summaries to convey your understanding and appreciation of your client's feelings, challenges, and strengths.

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4 Forgetting OARS

A fourth common pitfall in MI is to forget or neglect the basic skills of MI: open-ended questions, affirmations, reflections, and summaries (OARS). These skills are essential for building rapport, eliciting change talk, and strengthening commitment. Instead of using closed-ended questions, judgments, interpretations, or interruptions, you need to use OARS consistently and skillfully throughout your MI sessions. You can do this by practicing and reviewing your OARS regularly, and seeking feedback and supervision from an MI expert or peer.

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Leigh C.
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OARS are vital to being sensitive to cultural application. Professional discernment and experience are not sufficient for best practice with the use of MI without consideration of all diverse factors present with any client.

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Daniel M.
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In my experience, reinforcing the use of OARS has been crucial in building trust and rapport with clients. It's essential to remember that OARS not only helps in establishing an open and supportive communication but also encourages clients to explore their thoughts and feelings more freely. An example of using OARS effectively is when a client is hesitant to discuss a sensitive topic; demonstrate genuine interest and create a safe space for them to open up & clients feel heard and understood, which can lead to more meaningful conversations and better outcomes. I've found that regularly revisiting these skills and seeking feedback from colleagues and supervisors have been invaluable in my professional growth.

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5 Losing focus

A fifth common barrier in MI is to lose focus or direction in your MI sessions. This can happen when you get sidetracked by irrelevant topics, distracted by external factors, or overwhelmed by too much information. Instead of drifting or wandering in your MI sessions, you need to maintain focus and direction on your client's agenda and desired outcomes. You can do this by using agendas, summaries, and transitions to clarify and prioritize your client's goals, concerns, and action plans.

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Kerry Arnold

Assistant Professor at Community College of Philadelphia
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In addition to using the tools identified here to provide structure and help practitioners regain focus, I would highly recommend practicing and integrating mindfulness into sessions. I teach a semester-long course on Motivational Interviewing for behavioral health/human services students. We practice simple techniques such as grounding by feeling one's feet on the floor or tuning in when your mind drifts so that you can re-focus on "being in the here & now" and shift the focus back to your client, using active listening or a clarifying summary.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Elizabeth Zimmerman-Clayton, DSW, LCSW

Licensed clinical social worker and educator
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In consideration of any method, the theory behind it must be considered, as well as the context, historical contributions, and specific people behind its development. Not every method will be culturally appropriate for everyone you work with, and may operate under assumptions that have been formulated around positions of privilege, creating major blind spots. Understand the power dynamics in the relationship that may exist and think critically about how they impact the work you are doing together.

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What are some common pitfalls or barriers to applying MI principles in your practice?

1

2

3

4

5

6

1 Assuming readiness

2 Giving advice

3 Ignoring emotions

4 Forgetting OARS

5 Losing focus

6 Here’s what else to consider

Motivational Interviewing

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What are some common pitfalls or barriers to applying MI principles in your practice?

1

2

3

4

5

6

1 Assuming readiness

2 Giving advice

3 Ignoring emotions

4 Forgetting OARS

5 Losing focus

6 Here’s what else to consider

Motivational Interviewing

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感谢您的反馈

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