When is it appropriate to use motivational interviewing with clients?

1 What is MI and how does it work?

MI is based on four key principles: expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. MI aims to elicit and strengthen the client's own motivation and reasons for change, rather than imposing external pressure or judgment. MI works by using open-ended questions, affirmations, reflections, and summaries to engage the client in a respectful and constructive dialogue. MI also helps the client to resolve their ambivalence, explore their values and goals, and plan and commit to action.

2 When is MI appropriate?

MI is appropriate when the client has a behavior that is causing them harm or distress, but they are not ready, willing, or able to change it. For example, MI can be used to help clients who struggle with substance abuse, smoking, eating disorders, chronic diseases, or mental health issues. MI can also be used to help clients who face challenges or barriers in achieving their personal or professional goals, such as career development, education, or relationships. MI is especially effective when the client has mixed feelings or doubts about changing their behavior, or when they face external or internal resistance to change.

3 When is MI not appropriate?

MI is not appropriate when the client has no interest or need to change their behavior, or when they are already motivated and confident to change. For example, MI is not suitable for clients who are satisfied with their current situation, who have no problems or risks associated with their behavior, or who have already made a decision and taken action to change. MI is also not appropriate when the client has a severe mental disorder, cognitive impairment, or crisis that requires immediate intervention or referral. In these cases, MI may not be effective or ethical, and other approaches may be more suitable.

4 How to assess if MI is appropriate?

Assessing if MI is appropriate for your clients and their specific issue is important before using it. You can use the criteria of whether the client's behavior is causing them harm or distress, if they are aware of the need to change, if they are ambivalent or conflicted about changing their behavior, if they are willing to engage in a collaborative dialogue, and if their issue requires brief or moderate intervention. If you answer yes to most of these questions, then MI may be suitable for your client and their issue. However, other factors should also be taken into consideration such as your own skills and training in MI, the context and setting of your work, the expectations and preferences of your client, as well as the availability and accessibility of other resources and support.

5 How to use MI effectively?

If you decide to use MI with your clients, you should follow some best practices to use it effectively. To start, build rapport and trust with your client by showing genuine interest and curiosity in their situation and perspective. Utilize the core skills of MI, such as open-ended questions, affirmations, reflections, and summaries, to elicit and reinforce the client's own motivation for change. Additionally, avoid confrontation, persuasion, advice-giving, or labeling as these can increase the client's resistance. Help them explore and resolve their ambivalence by highlighting the discrepancy between their current behavior and desired outcomes. Guide them to set realistic goals and develop an action plan based on their values, strengths, and resources. Furthermore, provide support to anticipate and cope with potential challenges or relapses. Monitor the client's readiness, willingness, and ability to change and adjust your approach accordingly.

6 What are the benefits of MI?

Using MI with your clients can provide a variety of benefits for both parties. It can help to increase the client's motivation and confidence, while reducing their resistance, defensiveness, or denial. Additionally, it can empower them to take responsibility for their own change and increase their satisfaction with the intervention or service. Furthermore, MI can improve the quality and outcome of the intervention or service, while reducing the cost and time required. On top of that, it can improve your relationship and communication with your client, as well as your skills and confidence as a professional. Ultimately, it can lead to increased empathy, respect, collaboration, satisfaction and enjoyment in your work.

7 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?