Motivational Interviewing
This style of interviewing is thought to reduce resistance and foster engagement between counsellor and client. When one uses Motivational Interviewing (MI), confrontation is the goal but not the style on interaction. Research from William Miller indicates that confrontation in counselling, as an approach will increase resistance in the client. At ADSTV we have adopted a style of interaction with clients that embraces the principles of motivational interviewing.
Motivational Interviewing is:
- Client centred
- Non-directive
- Respectful of the client's strengths and knowledge about what is best for themselves
- Empathetic
- Not interested in labels such as "addict" or "alcoholic"
- Not interested in confrontation as a style of interviewing
- Mindful of client choice and preference
Motivational interviewing offers a variety of counselling strategies that the counsellor can use. It is important to use different counselling strategies with people in different stages, for example;
- | Precontemplators need information and education to raise awareness and develop discrepancy between where they are and where they want to be. |
- | When and if the client shows resistance to suggestions or to the process, the counsellor can use specific techniques to decrease the resistance and realign with the client. |
- | Contemplators need strategies that tip the balance in favour of change so that they can move into the preparation stage. |
- | When in the preparation stage, clients need assistance with eliciting a commitment to change and preparation to alter behaviour. |
- | People in the action stage do not need a lot of education to raise awareness, as they are already committed to making change. They need specific strategies that will help them make changes and sustain them. |
One of the MI approaches is called a "Brief Intervention". It is defined as assessment + advice. It typically takes place in one or two sessions and is very helpful for clients in the early stages. A brief intervention is described using the acronym "FRAMES".
F - Feedback
- Give information/feedback about issue at hand
- Results of assessment tools can give objective feedback
R - Responsibility
- Reinforce the client's responsibility to change his or her own behaviour
A - Advice
- Give clear advice about what the options are
- Give advice about what others do, population statistics, trends
M - Menu of Options
- Offer a variety of solutions and assist the client to choose
E - Empathy
- Show an empathetic response to client's situation
S - Self-Efficacy
- Reinforce the client's ability to handle situations and make choices that are reasonable and responsible
- Try to elicit statements that reflect self-efficacy
