Motivational interviewing was developed by William Miller and Stephen Rollnick for use in addictive behavior counseling and has been used effectively since the early 1990s. Miller and Rollnick describe MI as “a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with nondirective counseling, it is more focused and goal-directed. The examination and resolution of ambivalence is its central purpose, and the counselor is intentionally directive in pursuing this goal." (1)
In recent years, the field of MI has expanded rapidly as more applications are recognized. The excitement continues as elements of MI are now being distilled into “brief components,” which may lend themselves to be incorporated more easily and successfully into the busy clinic day. Many clinicians now use brief components of MI to enhance patient counseling and to increase the likelihood that their patients will adhere to treatment plans and behavioral modifications requiring changes in behavior. Hundreds of published reports, including many randomized trials, discuss and document MI’s success.
Motivational interviewing assumes that people usually are not ready to change. They may have thought about changing, but they feel two ways about it: the yes…, but. “Yes, I’ve thought about exercising more, but…” Motivational interviewing helps people convince themselves that they can and should make a change. The individual makes the argument for change. Motivational interviewing puts the control into the hand of the “client,” either the patient (if sufficiently mature) or the parent/child for younger children. With the practitioner’s careful and thoughtful direction, the individual can develop a plan and enhance his or her motivation; thus, the likelihood for actually following through with the plan increases. The treatment of obesity is a relatively new area for the use of MI, but it is a powerful tool with a lot of potential and should definitely be added to our arsenal. In the nonauthoritative spirit of MI, may I invite you to read on and decide for yourself?