Motivation is the will to change. But for many of us, the well often runs dry.
Everyone may have a fleeting notion to learn a new skill or break an old habit, but motivation is the dividing line between those who follow through and those who don’t. It’s always easier to let things slide, kick the can down the road, or just resign yourself to the idea that it isn’t worth the effort.
Whatever the excuse, we’re all occasionally haunted by the thought of how life might improve if we were somehow able to find that elusive will to change.
Evidence of Effectiveness
A 2005 meta-analysis of motivational interviewing is published in the British Journal of General Practice. Out of 72 randomized controlled trials evaluating motivational interviewing, researchers concluded that it “had a significant and clinically relevant effect in approximately three out of four studies.”A Spirit of Empathy
Motivation comes from within, but we often look to other people to get ourselves going. It may be someone who can provide an inspiring example we can follow or one who can give us a pep talk to spark our drive and confidence. Whatever the influence—other people can give us a push—but it’s up to us to make it happen.Motivational interviewing also functions as a “push,” but one towards a different direction. Instead of offering up inspiring words or an example to follow, a motivational interviewer starts from the premise that the insight you require for change lies within you. The goal of the interview is to find it.
The seed of this idea was inspired by Carl Rogers, a psychologist who pioneered “client-centered therapy” in the 1950s.
In the early 1980s, William Miller, a professor of psychology and psychiatry at The University of New Mexico, began to cultivate this approach even further. Miller was curious about what inspired people to change. So he studied how people with drinking problems managed to turn their lives around.
Back then, the predominant method for counselors helping patients struggling with substance abuse favored a more confrontational approach. Addicts were to be lectured at length on how their habits were hurting themselves and the people around them. This tactic applied all the classic tools of persuasion—logic, reason, and facts—with the aim of convincing someone to change.
In several experiments evaluating what kind of therapeutic approach reliably fosters change, Miller found that the application of empathy—listening and responding to someone with a compassionate ear—consistently won out. Instead of forcing someone to confront the cold hard truth, a counselor who led with empathy allowed clients to relax, let his or her guard down, and freely evaluate the feelings and expectations that were holding them back.
As Miller conducted more studies looking at what worked and what didn’t, he began to piece together what he called motivational interviewing. Miller’s method aimed to get the patient to voice what they wanted to change, why, and how they might make it happen.
How It Works
A motivational interview basically works like any other interview. It’s conducted in an exchange of questions and answers. But there is a particular spirit and focus that sets it apart.“I’ve realized that motivational interviewing is simply a form of guiding that is really familiar to all of us, through our work as parents, coaches, and teachers. It emphasizes additional skills, particularly the use of empathic listening that appears to make all the difference,” Rollnick said.
There are several factors to consider when conducting a motivational interview, but the general attitude to carry is one of support, affirmation, and nonjudgment. This technique expressly avoids advice and argument and focuses on questions that can elicit genuine and thoughtful answers.
The counselor conducting the interview must listen closely, and reflect back what they hear in order to help an individual gain clarity about the things they may wish to change. The interviewer aims to avoid leading questions but instead acts as a kind of sounding board for the interviewee.
Tackling Ambivalence
Since the goal of motivational interviewing is to get people to open up, sessions involve open-ended questions. Examples could include: “What are your goals?” “What would you like to change about yourself?” or “How do your habits affect your life?” The questions steer towards a discussion of what change might look like and how you might accomplish it. Miller and Rollnick call it “change talk.”However, along the way, change talk usually breaks down, and “sustain talk” takes over. Sustain talk is when someone makes all their favorite excuses for why they should keep their old habits and resist change.
Both types of talk are expected throughout the interviewing process. Based on the responses, the interviewer navigates the conversation within what Miller and Rollnick describe as the five steps on the change ladder.
At the lowest rung, you have no intention to change—or total resistance. Then comes ambivalence (where you’re not quite sure if you want to change or not). Next, you see the possibility for change. Then you climb to a commitment, and at the top, you reach action—where the desired change takes effect.
These steps give the counselor conducting the interview some bearing in terms of where a person is at in their process to change. Change talk is encouraged, but thoughts of resistance and sustain talk also get a voice. This allows doubts and excuses a chance to be heard and leads to strategizing about how these factors could be addressed.
The further up you go on the ladder of change, the more you’re committed to change. But Miller and Rollnick say people may step back into ambivalence again and again. That’s because ambivalence is part of the dance of self-improvement.
It’s that place where you can see some of the advantages that might come from changing, but where you also realize what you’ll have to sacrifice and suffer for on the way there.
Ambivalence may also occur when you lack the confidence in yourself to leap, and fear that your feeble attempts will only end up in failure.
Limitations and Considerations
Motivational interviewing is a safe, well-researched treatment that may provide a much-needed push for many. But it’s also important to consider some of its limitations.For those who can benefit from a motivational interview, consider that both parties reflect on the success of a session.
A good interview is more than asking a few questions. The ability to empathize and listen takes practice, and therapists who specialize in motivational interviewing have had lots of it. However, this technique has been carefully refined over decades, and there is an abundance of literature available that make it accessible to virtually anyone.
Miller and Rollnick encourage coaches, teachers, and parents to all employ motivational interviewing when needed. The basic requirements are a genuine desire to help, and the patience to guide someone to their own inner answers.
Keep in mind that your relationships with the people you might attempt to interview may make this job more challenging. What makes a motivational interview work is the capacity of the interviewer to guide the conversation without trying to fix things, judge, or bicker when resistance comes up.
To get a feel for the right attitude, consider a conversation using the OARS approach. The acronym comes from the four communication aims of motivational interviewing: open-ended questions, affirmations, reflective listening, and summarizations.
Asking questions with genuine interest is important, but the last three steps require close listening. This is necessary to understand where someone is coming from, and what they’re trying to say. The interviewer must routinely reflect back what he or she hears throughout the process so that goals become clear, and the solutions to attaining them become more concrete. The combined efforts of OARS are what draw people out and keep them focused on finding the answers they need.
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