How can you combine Motivational Interviewing with other therapies?

MI is a style not an intervention by itself. So you can deliver CBT in an MI consistent fashion and leverage MI throughout. Whenever someone is ambivalent you can use MI to help them resolve it - maybe they are even ambivalent about doing CBT!

Just as we don’t have different ‘schools’ of orthopaedics or radiology, so too in 40 years we won’t have different ‘schools’ of therapy. We will just have an evidence and process based approach to talking with someone to help them suffer less and experience better health and wellbeing. What we currently call MI will form a big chunk of the approach, combined with psychological and behaviour change techniques described as in Susan Michie et al’s BCT ontology - including techniques from behavioural activation, CBT, positive psychology interventions (PPI’s), Mindfulness based interventions (MBI’s) and CFT. Some practitioners will stick to single ‘schools’ and limit their ability to help people, like a carpenter using just a hammer and a saw.

Mindfulness Based Sobriety is a group therapy intervention that combines Acceptance and Commitment Therapy, Motivational Interviewing and Relapse Prevention to address substance use issues. This intervention was created by Nick Turner, Phil Welches and Sandra Conti.

As a coach, I find Motivational Interviewing (MI) helps people lean into change and the collaborative conversation helps them talk themselves into changes based on their own values, interests, and goals. There is a lot of research that confirms its effectiveness. It helps clients activate their own motivation, commitment, and resources for change. By integrating SFBT, it becomes a collaboration focused on a strengths-based and optimistic orientation. The book Now, Discover Your Strengths is a great resource for individuals and teams. When we focus on a client's strengths, they have more confidence, energy, and resilience. Cultivating their strengths will help them perform better at work and achieve their goals.

MI is not the stages of change. They are different - albeit related - concepts. You can use MI to help with engagement in the process of change and then move toward focusing (or aligning on "what" to change) - all before you start evoking change talk and way before you start planning. The tasks of MI are thoughtful and strategic and they are like overlapping stairsteps. You re-visit these tasks often and go back and forth as needed.

I use MI when doing EMDR therapy with clients. With clients with a trauma background, some people find themselves addicted to things such as gambling, food, alcohol or drugs. MI helps the client to move through the process of change and to start moving away from unhealthy coping mechanisms.

Wherever you are working with a client in changing behaviours or incorporating new behaviours, MI strategies are useful. For example, you set up a mindful breathing practice you can use MI strategy of scaling to check in on their readiness and confidence in engaging in this activity.