Motivational Interviewing (MI)
If you are interested in counseling using Motivational Interviewing, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.
What is Motivational Interviewing?Motivational Interviewing, usually shortened to MI, is a collaborative, person-centered approach to talking about change. It was developed by Dr. William Miller and Dr. Stephen Rollnick, beginning with Miller's work with people struggling with drinking in the early 1980s, and it has since been studied and used across a wide range of settings. The aim of MI is to help a person find and strengthen their own reasons for change, rather than having those reasons supplied or argued for by someone else.
That distinction is the whole point. MI is not a set of techniques for persuading people. It is a way of having a conversation that takes seriously the fact that motivation cannot be installed from the outside, and that the most durable reasons for change are the ones a person arrives at themselves. Ambivalence and the Urge to FixMost people who are stuck around a change are not simply unmotivated. They are ambivalent. Part of them wants to change and part of them does not, and both parts are usually saying something true. Someone might genuinely want to drink less and genuinely rely on drinking to unwind. Ambivalence like this is not a flaw or a sign of denial. It is a normal and expected part of how people approach change.
The trouble is that ambivalence tends to provoke a particular response in others, including in helpers, which MI calls the fixing reflex: the urge to step in, point out the problem, and lay out the case for change. It comes from a good place, but it usually backfires. When one person argues for change, the ambivalent person tends to find themselves arguing the other side, talking themselves further into staying the same. MI is built to avoid that trap. Rather than making the case for change, the clinician helps the person voice their own. The Spirit of MIMI is often described less as a technique and more as a way of being with someone, captured in what its founders call its spirit. That spirit rests on partnership, working alongside the person rather than as an expert directing them; acceptance, including genuine respect for the person's right to make their own choices; compassion, keeping their wellbeing at the center; and evocation, drawing out what is already within the person rather than installing something from outside. The skills of MI only work when they sit on top of this stance. Used as tactics without it, they tend to fall flat.
|
|
What MI Looks Like in Practice
MI tends to move through four overlapping tasks. It begins with engaging, building a working relationship in which a person feels heard, because little useful happens without that. From there comes focusing, finding and agreeing on what the conversation is actually about. The heart of MI is evoking, where the clinician helps the person put their own motivations for change into words, and notices and gently strengthens what is called change talk, the person's own statements in favor of a different path. Finally, when the person is ready, comes planning, turning that motivation into concrete steps. The pacing matters. MI does not push toward planning before someone is ready, because a plan built on borrowed motivation rarely holds.
Underneath these tasks, the everyday work of MI is careful listening: asking open questions, offering honest affirmation, reflecting back what the person says so they can hear it more clearly, and summarizing to draw the threads together. When a person voices reasons to stay the same, or pushes back, the clinician does not argue. Arguing only deepens the position. Instead they roll with it, stay curious, and keep the person's autonomy intact, which tends to lower the defensiveness that resistance is usually made of.
Underneath these tasks, the everyday work of MI is careful listening: asking open questions, offering honest affirmation, reflecting back what the person says so they can hear it more clearly, and summarizing to draw the threads together. When a person voices reasons to stay the same, or pushes back, the clinician does not argue. Arguing only deepens the position. Instead they roll with it, stay curious, and keep the person's autonomy intact, which tends to lower the defensiveness that resistance is usually made of.
What Does the Evidence Say?
MI has a substantial research base built over four decades. A large meta-analysis drawing on more than a hundred studies found that MI produces meaningful and durable improvements compared with no treatment or minimal support, that it holds up well across many types of problems, and that it tends to perform on par with other established treatments while often achieving its effects in relatively little time. Its evidence is strongest in the areas where it began and has been studied most, particularly substance use, along with a range of health-related behavior change.
What MI Can Help With
MI is well suited to any situation where ambivalence about change is the sticking point. It has the deepest evidence base in substance use, where it was first developed, and it is widely used for other kinds of behavior change as well, along with the common situation of feeling two ways about whether to pursue or stay with treatment at all.
It is worth being clear about what MI is and is not. MI is not usually a complete treatment for a condition like depression or an anxiety disorder on its own. What it does extremely well is help a person get unstuck enough to commit to the work that change requires, which is why it is so often the thing that makes other treatment possible.
It is worth being clear about what MI is and is not. MI is not usually a complete treatment for a condition like depression or an anxiety disorder on its own. What it does extremely well is help a person get unstuck enough to commit to the work that change requires, which is why it is so often the thing that makes other treatment possible.
How MI Fits With Other Treatments
Because MI is fundamentally about motivation and engagement, it pairs naturally with other approaches rather than competing with them. It is frequently used as a foundation at the start of treatment, and as something to return to whenever ambivalence resurfaces, alongside methods like Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. A person might begin with MI to work through their hesitation about change, then move into the more structured work of another therapy once they are ready, with the MI stance continuing to inform how that work is done.
How PCT Differs from General CBT
PCT is a specific, manualized form of Cognitive Behavioral Therapy built for one job, rather than the broad family of cognitive and behavioral techniques that CBT refers to. It shares CBT's foundation, the focus on the links between thoughts, sensations, and behavior, but it is organized tightly around the panic cycle, and its signature component, interoceptive exposure, is what distinguishes it from a more general course of CBT for anxiety. PCT is a member of the CBT family, refined and tested for panic disorder specifically.
MI at OakHeart
Our clinicians use Motivational Interviewing both as an approach in its own right, particularly around substance use and other change-related goals, and as a foundation woven into other evidence-based treatments to help work through ambivalence and build engagement. For many people, it is less a separate kind of therapy and more a part of how good therapy is conducted.
During your assessment, your clinician will talk with you about what you are hoping to change and how MI might fit, whether on its own or alongside another approach. MI is delivered in individual therapy, and you will meet one-to-one with your clinician for each session.
During your assessment, your clinician will talk with you about what you are hoping to change and how MI might fit, whether on its own or alongside another approach. MI is delivered in individual therapy, and you will meet one-to-one with your clinician for each session.
Frequently Asked Questions
What if I am not sure I even want to change?
That is exactly the situation MI is designed for. Feeling two ways about a change is normal, and MI does not require you to have already made up your mind. The work often begins precisely there, with the mixed feelings, rather than skipping past them.
Is MI only for substance use?
No. MI was first developed in the context of drinking and has its strongest evidence there, but it is useful in any situation where ambivalence about change is in the way. It is used for a wide range of behavior-change goals and for working through hesitation about treatment itself.
Is MI a complete therapy on its own?
Sometimes, for a focused change-related goal. Often, though, MI works best as a foundation or a complement to other treatment, helping you get unstuck enough to engage in the work, with another approach carrying the more structured part of treatment. Your clinician will talk through what fits your situation.
How long does MI take?
It varies. MI can have an effect in a relatively short span of time, and it can also continue throughout a longer course of therapy as something to return to whenever ambivalence comes back up. Your clinician will tailor this to your goals.
Is MI available via telehealth?
Yes. MI translates well to telehealth, and OakHeart offers it throughout Illinois in addition to in-person sessions at our North Aurora and Sycamore locations.
Our team of licensed psychologists, counselors, and social workers in North Aurora and Sycamore, Illinois provides evidence-based care, including Motivational Interviewing, to clients throughout Kane County, DeKalb County, DuPage County, and the surrounding Chicago suburbs, with in-person and telehealth options throughout Illinois.
That is exactly the situation MI is designed for. Feeling two ways about a change is normal, and MI does not require you to have already made up your mind. The work often begins precisely there, with the mixed feelings, rather than skipping past them.
Is MI only for substance use?
No. MI was first developed in the context of drinking and has its strongest evidence there, but it is useful in any situation where ambivalence about change is in the way. It is used for a wide range of behavior-change goals and for working through hesitation about treatment itself.
Is MI a complete therapy on its own?
Sometimes, for a focused change-related goal. Often, though, MI works best as a foundation or a complement to other treatment, helping you get unstuck enough to engage in the work, with another approach carrying the more structured part of treatment. Your clinician will talk through what fits your situation.
How long does MI take?
It varies. MI can have an effect in a relatively short span of time, and it can also continue throughout a longer course of therapy as something to return to whenever ambivalence comes back up. Your clinician will tailor this to your goals.
Is MI available via telehealth?
Yes. MI translates well to telehealth, and OakHeart offers it throughout Illinois in addition to in-person sessions at our North Aurora and Sycamore locations.
Our team of licensed psychologists, counselors, and social workers in North Aurora and Sycamore, Illinois provides evidence-based care, including Motivational Interviewing, to clients throughout Kane County, DeKalb County, DuPage County, and the surrounding Chicago suburbs, with in-person and telehealth options throughout Illinois.
Shape Divider - Style mountains
References
Lundahl, B. W., Kunz, C., Brownell, C., Tollefson, D., & Burke, B. L. (2010). A meta-analysis of motivational interviewing: Twenty-five years of empirical studies. Research on Social Work Practice, 20(2), 137-160.
Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy, 11(2), 147-172.
Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press.
Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy, 11(2), 147-172.
Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press.
