This is Part 1 of a book summary of Motivational Interviewing by Miller & Rollnick.
You can get the necessary detail without ploughing through every page of the actual book in this summary.
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Miller, W. & Rollnick, S. (2013).
Motivational Interviewing:
Helping people change
(3rd ed.). New York: Guildford Press
, Content Page
Part 1 What is Motivational Interviewing?
• C1: Conversations about Change
• C2: The spirit of MI
• C3: The method of MI
Part 2 Engaging: The Relational Foundation
• C4: Engagement and Disengagement
• C5: Listening: Understanding the Person’s Dilemma
• C6: Core Interviewing Skills: OARS
• C7: Exploring Values and Goals
Part 3 Focusing: The Strategic Direction
• C8: Why Focus?
• C9: Finding the Horizon
• C10: When Goals Differ
• C11: Exchanging Information
Part 4 Evoking: Preparation for Change
• C12: Ambivalence: Change Talk and Sustain Talk
• C13: Evoking the Person’s Own Motivation
• C14: Responding to Change Talk
• C15: Responding to Sustain Talk and Discord
• C16: Evoking Hope and Confidence
• C17: Counselling with Neutrality
• C18: Developing Discrepancy
Part 5 Planning: The Bridge to Change
• C19: From Evoking to Planning
• C20: Developing a Change Plan
• C21: Strengthening Commitment
• C22: Supporting Change
, Part 1: What is Motivational Interviewing?
C1: Conversations about Change
● MI is designed to find a constructive way through challenges that often arise when a
helper ventures into someone else’s motivation for change.
● The righting reflex: the desire to fix what seems wrong with people & to set them
promptly on a better course, relying in particular on a directing style (telling people
what to do), which is often ineffective.
● Ambivalence: most people who need to make a change are ambivalent about doing so,
seeing both reasons to change and not to change.
○ If you are ambivalent, then you are one step closer to changing.
○ There are people who see no reason to make a change; developing
ambivalence would be a step forward.
● When persons are ambivalent, we will hear 2 kinds of talk mixed together (change &
sustain talk).
○ Change talk: person’s own statements that favor change
○ Sustain talk: the person’s own arguments for not changing, sustaining the
status quo.
○ E.g. I know i need to lose weight for my health [change talk] but i just love to
eat [sustain talk]
● Consider what happens when an ambivalent individual meets a helper with the
righting reflex. Arguments both for and against change already reside within the
ambivalent person. The helper’s natural reflex is to take the “good side” of the
argument, and fantasizes that the other will be persuaded and agree.
● However, the predictable response in a person who feels 2 ways about something but
only hears one set of the picture being emphasized, “Yes, but…” or “But…”. Argue
for one side and the ambivalent person is likely to take up and defend the opposite.
This sometimes gets labelled as “denial” or “resistance” but there is nothing
pathological about it. It is the normal nature of ambivalence and debate.
● The debate process might seem therapeutic, were it not for another principle of human
nature: most people tend to believe themselves and trust their own opinions more than
those of others. Causing someone to verbalize one side of an issue tends to move the
person’s balance of opinion in that direction.
● Ideally, the client should be voicing the reasons for change.
● Counsel in a way that evokes defensiveness and counter-argument and people are less
likely to change. It also confirms the clinician’s belief that these people are difficult,
resistant and intractable. It is a self-fulfilling prophecy.
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