Motivational Interviewing
For less motivated patients with alcohol
problems, a motivation-enhancing
technique known as motivational interviewing
(MI) may be more beneficial
than either self-help books or cognitivebehavioral
interventions (Heather et al.
1993). Based on motivational psychology
and the stages-of-change model, MI
focuses on enhancing and facilitating
the patient’s internal motivation to
change (Miller and Rollnick 1991).
This approach assumes that the patient
is responsible for changing his or her
addictive behavior and recognizes
ambivalence as a natural part of the
process. In contrast to confrontational
approaches, MI is designed to assist
patients in working through their
ambivalence and in moving toward
positive behavioral change.
The MI therapist uses various techniques
to help increase the patient’s
motivation to change his or her behavior.
One technique is reflective listening, a
form of paraphrasing that enables
patients to more fully tell their stories
and to feel that they are being heard by
the empathetic MI therapist. A second
technique involves exploring the pros
and cons of change, which may help
patients realistically evaluate their
behavior and current situation and,
ideally, determine whether the pros of
change outweigh the cons. A third MI
technique, which supports the patient’s
self-efficacy, or confidence that he or
she can change, can help bridge the gap
between a patient’s desire to change and
Motivational InterviewingFor less motivated patients with alcoholproblems, a motivation-enhancingtechnique known as motivational interviewing(MI) may be more beneficialthan either self-help books or cognitivebehavioralinterventions (Heather et al.1993). Based on motivational psychologyand the stages-of-change model, MIfocuses on enhancing and facilitatingthe patient’s internal motivation tochange (Miller and Rollnick 1991).This approach assumes that the patientis responsible for changing his or heraddictive behavior and recognizesambivalence as a natural part of theprocess. In contrast to confrontationalapproaches, MI is designed to assistpatients in working through theirambivalence and in moving towardpositive behavioral change.The MI therapist uses various techniquesto help increase the patient’smotivation to change his or her behavior.One technique is reflective listening, aform of paraphrasing that enablespatients to more fully tell their storiesand to feel that they are being heard bythe empathetic MI therapist. A secondtechnique involves exploring the prosand cons of change, which may helppatients realistically evaluate theirbehavior and current situation and,ideally, determine whether the pros ofchange outweigh the cons. A third MItechnique, which supports the patient’sself-efficacy, or confidence that he orshe can change, can help bridge the gapbetween a patient’s desire to change and
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