Motivational InterviewingMotivational Interviewing
“a therapeutic style intended to help clinicians work with patients to address the patient’s fluctuation between opposing behaviors and thoughts.”
Source: Miller and Rollnick, Motivational Interviewing 11.
 
 
%an &e Identified%an &e Identified
%ognitive Recognition of the proble$ 'e.g., (I guess this is $ore serious than I thought.()
*ffective +pression of concern about the perceived proble$ 'e.g., (I-$ really worried about what is happening to $e.()
* irect or I$plicit Intention to change behavior 'e.g., (I-ve got to do so$ething about this.()
 
ResistanceResistance Source:Source: Miller and Rollnick, 11.Miller and Rollnick, 11.
Arguing  The patient contests the
accuracy, expertise, or integrity of the clinician. 
 
Major Types of Patient ResistanceMajor Types of Patient Resistance   'cont.)'cont.)
Interrupting   The patient breaks in and interrupts the clinician in a
defensive manner. 
Denying   The patient expresses
 
Ignoring   The patient shows evidence of ignoring or not following
the clinician. 
Simple refectionSimple refection
 
Shifting FocusShifting Focus 
 
ReframingReframing 
 
$omentum can be used to good advantage.
%erceptions can be shifted.
&ew perspectives are invited but not imposed.
 
Siding with the NegativeSiding with the Negative 
 
Motivational Interviewing Skills:Motivational Interviewing Skills:
Sel-EcacySel-Ecacy
 The belief that one can perform a behavior or accomplish a particular task
-elief in the possibility of change is an important motivator.
 The client is responsible for choosing and carrying out personal change.
 
Avoiding ArgumentsAvoiding Arguments
!rguments are counterproductive.
efending breeds defensiveness.
/abeling is unnecessary.
Open-Ended QuestionsOpen-Ended Questions 
 
Listen ReflectivelyListen Reflectively 
 
Expressing EmpathyExpressing Empathy 
*cceptance facilitates change.
 
Develop DiscrepancyDevelop Discrepancy
perceive differences between their current
situation and their hopes for the future.
eveloping awareness of conse0uences helps
clients ea$ine their behavior.
* discrepancy between present behavior and
i$portant goals $otivates change.
change.
AffirmAffirm 
 
#i$ple Reflection
#hifting !ocus