How can you use motivational interviewing in the maintenance stage of change?

1 The maintenance stage of change

The maintenance stage of change is the last stage in the transtheoretical model of behavior change, which describes how people go through different stages of readiness and action to modify their behavior. The maintenance stage is reached when people have successfully implemented their change plan for at least six months, and are now focused on sustaining their new behavior and avoiding relapse. This stage can last indefinitely, as people may face new challenges and temptations that could undermine their progress.

3 The principles of motivational interviewing

Motivational interviewing is based on four principles that guide the interaction between the practitioner and the client. These principles are: expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. Expressing empathy means showing genuine understanding and acceptance of the client's perspective and feelings, without judging or criticizing. Developing discrepancy means highlighting the gap between the client's current behavior and their values, goals, or needs, and eliciting their own reasons for change. Rolling with resistance means avoiding arguments or confrontations, and instead reflecting and reframing the client's statements that express doubt or reluctance. Supporting self-efficacy means encouraging and empowering the client to believe in their ability and willingness to change, and to take responsibility for their actions.

4 The skills of motivational interviewing

Motivational interviewing relies on a set of skills that help the practitioner to communicate effectively and respectfully with the client, and to facilitate their change process. These skills are: open-ended questions, affirmations, reflections, and summaries. Open-ended questions are questions that invite the client to elaborate and explore their thoughts and feelings, rather than giving yes or no answers. Affirmations are statements that acknowledge and appreciate the client's strengths, efforts, and achievements, and that express confidence and support. Reflections are statements that restate or paraphrase what the client has said, to show understanding and empathy, and to check for accuracy. Summaries are statements that recapitulate and link the main points that the client has made, to emphasize their key messages and to prepare for the next step.

5 The strategies of motivational interviewing

Motivational interviewing also involves some specific strategies that help the practitioner to address the client's needs and goals in the maintenance stage of change. These strategies are: feedback, decisional balance, values clarification, goal setting, and action planning. Feedback is the process of providing the client with information or evidence about their behavior and its consequences, to raise their awareness and to reinforce their change. Decisional balance is the process of exploring the pros and cons of changing or not changing, to help the client to weigh their options and to resolve their ambivalence. Values clarification is the process of helping the client to identify and prioritize their core values, to help them to align their behavior with their values and to increase their motivation. Goal setting is the process of helping the client to define and specify their desired outcomes, to help them to focus and to measure their progress. Action planning is the process of helping the client to develop and implement a realistic and feasible plan to achieve their goals, to help them to organize and to take action.

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?