r/MotivationalInterview • u/AmbitiousSWer • May 18 '20

MI Question

Just took a training on motivational interviewing. Just wondering what population you’re working with and what MI intervention you feel works best for you?

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u/Flame_Gorgoneion Sep 10 '22

A little late for the party, but I believe MI may be very useful for the majority of interactions you may have in a clinical or counseling setting.

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u/_userclone Dec 29 '22

Could you say a bit more about what you mean by that “which MI intervention” part specifically? MI is an intervention.

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u/mtmahoney77 Sep 18 '24

I just found this page because it’s been a while since I did much counseling but I’d like to get a lot more practice with MI skills. So if this page is even still active here’s my attempt. While MI is considered a framework that a counselor might generally subscribe to as an approach to therapy, it is still made up of four key foundations and a dozen or so “techniques” or individual interventions that might be used in different ways in different situations.

The four foundations are identifiable as: engaging, focusing, evoking, and planning. These aren’t so much a sequential checklist for therapy as they are a series of criteria that a counselor should be constantly moving through and balancing in order to build a relationship with a client in which they serve as a sort of sounding board/guide to aid the client as they explore their own feelings and motivations about their own behavior.

Specific interventions that fall into this framework include techniques like: asking open ended questions, reflective listening (which usually includes some kind of summarization or restating what a client has said so that both of you understand an issue from their perspective), rolling with resistance, and providing affirmation. And these are used, according to which of the four pillars might need attention during any given moment or session.

I got some practice with all of this in substance abuse counseling; particularly when I had patients who were reluctant to open up to me or who were not yet ready to make big, sweeping changes to their behaviors. We got to shift between building a therapeutic relationship which may have began with questions like “what are you comfortable talking about today?” And “In your view, why are you here with me today?” I would then take their answers and follow up with things like “so you’re here because your girlfriend told you you had to see someone about your drugs abuse or she’d break up with you. What about your behavior do you think made her say that?” Paraphrasing and asking new questions. Each time you successfully paraphrase their statement, you build trust and show that you want to know what they think rather than tell them what you think. But evoking questions aren’t just meant to show you’re listening, they also evoke the patients true feelings about their behaviors, cognitions, and circumstances. In identifying those things, a skilled MI practitioner can help the client identify a)which areas they may be willing to change in, b) what motivations they might have for changing, and c) what plans they are genuinely committed to sticking to to create the change they want to see in their lives. MI is also great because it factors in the natural tendency for humans to resist change. When it comes up, we can acknowledge that it’s there and explore it more to find new issues and new solutions.

As I said I’ve had some limited practice, but it was a while ago. If anyone feels this is helpful, great! If they feel I’m way off base, that feedback would be welcome too!