In trying to answer the question- ‘ Are we doing Motivational interviewing or are we doing Motivational Interviewing?”, it is important and only logical to understand what do we actually mean by Motivational Interviewing.
For me, there are a few givens here- that is- what MI is not. And if I were to qualify this, I mean we don’t do MI TO any one but rather do MI WITH someone. The word WITH in my experience is fundamental and crucial to any form of psychotherapy. In our jargon, we call it ‘therapeutic alliance’. Let me put it another way, wouldn’t it be better if I am able to understand and see the world from your perspective and work collaboratively with you to help you achieve your desired change? What is the likelihood of success, if you don’t establish any trust in the therapist?
MI in it’s fundamental approach is seeking to look at you as the sole agent of change and me as the MI practitioner, has the role of recognising that ‘change talk’ & evoking or extracting those internal resources that you have within your own self to facilitate that change.
So in some of the conversations that we may have in sessions, which may be regarding any change- alcohol control or abstinence, smoking cessation, tackling other substance misuse or behavioural addictions to name a few, if you tell me that you WANT to change, then MI will take us through the journey of going from ‘wanting’ to change to ‘willingness’ to change and ‘taking steps’ to change and then maintaining that change.
Of course, when you are talking about Substance Misuse the role of pharmacological options- Naltrexone for Opiates and Alcohol or newer treatments for alcohol as some examples, need to be kept in mind actively as well.