Motivational Interviewing: An Effective Tool for Change

Introduction: The Interview as a Fundamental Tool in Social Work

In the field of social work, the interview is a fundamental technique, interpreted from various theoretical-epistemological perspectives that account for different worldviews. It is known that the interview is not an exclusive technique of this profession, as it is also used by various disciplines, such as psychology, sociology, social psychology, medicine, psychiatry, and education sciences, among others.

It must be understood that the social worker does not work with informants, but with individuals who are co-participants in their process of change, rights holders who provide more than just information, allowing access to their "subjective worlds". In this scenario, the interview has emerged as a crucial tool for facilitating change and personal development. Federico Bustos highlights the interview as a fundamental technique in social work, not only as a method of collecting information but as a means to construct a liberating discourse that amplifies the voice of the Other and fully recognizes their historical project.

The interview, being an impeccable communicational strategy, allows the social worker to understand and know the assets available in individuals' social trajectories, their strategies, and the relationships they establish with their community and institutions. It is a technique that, when well used, can help avoid the imposition of power interests and promote the democratization of human relations, recognizing individuals not only as sources of information but as rights holders and co-participants in their process of change.

What is Motivational Interviewing?

Motivational interviewing (MI) is a communication technique developed by William R. Miller and Stephen Rollnick in the 1980s. Its main objective is to strengthen the individual's intrinsic motivation for positive change, through a collaborative and non-confrontational style. This method is based on principles of empathy, support, and guidance, helping individuals resolve ambivalences about change. ??

Philosophy of Motivational Interviewing

According to Rollnick and Miller, the philosophy of MI can be described through several key principles:

• Motivation for change is elicited from the client themselves, not imposed from outside: MI relies on identifying and mobilizing the client's intrinsic values and goals to stimulate behavior change. ??
• Relationship between people, not expert/recipient roles: The therapist respects the client's autonomy and freedom of choice, acknowledging the consequences of their own behaviors. ??
• Support in natural change processes and client resources: Instead of teaching the client how to change, the therapist builds motivation and extracts ideas from the client on how change could happen. ???
• Focus on motivation as a key factor for lasting change: MI focuses on developing a positive therapeutic bond with the client through empathic communication and active listening. ??

The Spirit of Motivational Interviewing

Miller and Rollnick use the term "spirit" to describe the four professional values that underpin MI and are applicable in all clinical contexts. These values are:

• Collaboration: A collaboration of experience between the provider's professional knowledge and the client's self-awareness of what they are capable of and willing to do. ??
• Acceptance: Granted by the provider without judgment. ?
• Compassion: Added to ensure that the practice of MI is carried out in the client's interest and not the professional's own interest. ??
• Evocation: The skilled motivational interviewer elicits, extracts, and strengthens the client's wisdom and resources for change instead of presenting solutions. ??

Used together in a therapeutic relationship, these elements involve the individual's intrinsic wisdom and can help strengthen their determination to make positive changes.

Fundamental Principles of Motivational Interviewing

• Expressing Empathy: Listening to and understanding from the client's perspective, creating an environment of trust and respect. ??
• Developing Discrepancy: Helping the client identify the discrepancy between their personal goals and current behavior. ??
• Avoiding Direct Confrontation: Promoting change through dialogue and understanding, rather than confrontation. ??
• Accompanying Resistance: Navigating client resistance with flexibility and adaptability. ??
• Fostering Self-Efficacy: Supporting the client's belief in their ability to make change. ??

Basic Skills of Motivational Interviewing (OARS)

The basic skills of MI can be remembered with the mnemonic OARS:

• Open Questions: Encouraging dialogue and self-exploration. ???
• Affirmations: Reinforcing the client's confidence and validating their experiences. ??
• Reflective Listening: Demonstrating understanding and empathy by reflecting the client's thoughts and feelings. ??
• Summarizing: Recapitulating the discussion to ensure clarity and understanding. ??

Conclusion

Motivational interviewing is a powerful technique that, when applied correctly, can help transform lives through positive change. Whether you work in the field of health, social work, or criminal justice, integrating MI principles can lead to significant and lasting impact. By adopting an empathetic and collaborative approach, you not only facilitate positive change in others but also position yourself as a leader and an empathetic, authentic, and trustworthy professional. ??

References:

Federico Bustos. The interview as a fundamental technique in Social Work. National University of Cuyo. Link. Rollnick, S. and Miller, W. (1995). What is Motivational Interviewing? Behavioral and Cognitive Psychotherapy, 23, 325-334. Link.

Miller, W. R., & Rollnick, S. Motivational Interviewing: Helping People Change." ??