Does Motivational Interviewing (MI) Work with Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes.

Motivational interviewing (MI) is an innovative, collaborative method of drawing forth and enhancing client's motivation for change (Miller & Rollnick, 2002). Originally developed as a process for strengthening addicted clients' motivation toward recovery, MI has since seen considerable success in the treatment of various mental health and behavioral concerns (Miller & Rose, 2009). A cursory glance at the growing literature can often lead readers to assume falsely that MI is a motivational panacea, a form of manipulating people, or merely a therapeutic technique (Miller & Rollnick, 2009). In fact, MI is a substantially more complex method that assists helping professionals in communicating in both a person-centered and directive way. Therefore, reducing MI to merely a set of techniques can be misleading. The techniques and strategies suggested by MI are clearly important to its implementation. However, as noted by its founders, the spirit of MI is the essential component of this method (Miller & Rollnick, 2002). The spirit of MI is characterized by an emphasis on the clients' right to make choices (autonomy), the eliciting of clients' inner resources (evocation), and the partnering with clients to reach their stated goals with respect for the clients' inner strengths and resources (collaboration). Miller and Rollnick (2002) insisted that counselors espouse these core concepts while exercising MI techniques. The four main techniques as described by the founders are (a) empathy, (b) developing discrepancy, (c) rolling with resistance, and (d) increasing clients' self-efficacy (Miller & Rollnick, 2002). Empathy is defined as an understanding of the client's worldview, perception, and values. Empathy is seen as one of the most important elements of MI and is attained through reflection and active listening. Through active listening, counselors notice moments when what is described by the client is discrepant with what the client wants from his or her life. By highlighting and helping a client develop discrepancies, the counselor amplifies change talk, which enhances the client's motivation for change. When the counselor begins to feel resistance from the client, rather than confronting or challenging the resistance, the counselor is asked to roll with the resistance by continuing to empathetically explore the client's worldview and capitalize on the client's forward momentum (Miller & Rollnick, 2009). As the client makes efforts toward change, the counselor comes alongside him or her and instills hope, which alleviates feelings of failure and results in the client increasing self-efficacy (Miller & Rollnick, 2002). Through the skillful application of these four techniques, coupled with the attitude and perception embodied in the spirit of MI, counselors are able to elicit an increase in talk about change and an increase in motivation toward change. The premise is that an increase in motivation results in favorable treatment outcomes. * MI and Client Outcomes MI has shown promise with a variety of presenting concerns (Miller & Rollnick, 2002). Not all trials have shown positive outcomes; however, overall, the results of multiple studies suggest that MI is effective in reducing maladaptive behavior and increasing health-promoting behavioral change (Miller & Rose, 2009). A meta-analysis conducted by Vasilaki, Hosier, and Cox (2006) concluded that MI was an efficacious strategy for problem drinking. This study among others was cited as the rationale for MI's inclusion into the Substance Abuse and Mental Health Services Administration (2013) national registry of evidence-based programs and practices. MI has also shown favorable outcomes when used in the treatment of Axis I disorders such as obsessive compulsive disorder, posttraumatic stress disorder, eating disorders, and mixed anxiety and depression (Maltby & Tolin, 2005; Murphy et al., 2004; Murphy, Rosen, Cameron, & Thompson, 2002; Westra, 2004). …