Motivational Interviewing (MI) is a client-centered method for guiding individuals through ambivalence and toward change. It facilitates change by helping clients generate the self-efficacy and preparation needed for positive change. MI is a conversational approach that relies on reflective listening and evoking in order to guide clients toward their chosen goals. MI has been shown to be especially useful in the treatment of substance use, however it can also be applied to just about anyone who is stuck and could benefit from processing their ambivalence and empowering them to make positive change.
Motivational interviewing relies on the stages of change as an overarching model to guide the treatment process. According to the transtheoretical model of change, there are five stages in the change process, namely precontemplation (not ready), contemplation (getting ready), preparation (ready), action and maintenance. This model can be used to assess where a client is within the change process and it can be further used to frame treatment progress and determine if the client is sufficiently ready for the next stage.
Motivational interviewing also relies on the technique of developing discrepancy, which is used to assess the incongruity between an individual’s behavior and their broader goals and values. The use of this technique provides a framework to identify both adaptive and maladaptive behaviors and how those behaviors help or hinder the client’s growth toward valued ends. Further, this tool identifies client values and strengths, which can then be a vital part of treatment planning.
The MI tool of readiness ruler can be a very effective assessment tool both at the onset and throughout treatment. The readiness ruler asks the client how ready they are to change on a scale from one to ten. For example, “On a scale from one to ten how ready are you to stop drinking?” This provides a clear indication of where the client is in terms of readiness for change. Another adaptation of this technique is the “importance ruler”, which is used to gauge the client’s level of both commitment and confidence in regard to the task or change at hand. For instance, the counselor could ask, “How important (or confident) is it for you to abstain from using drugs during your academic finals?”. Both the readiness and importance ruler are important for treatment planning because they can indicate what techniques and interventions are appropriate given the client’s current levels of confidence, readiness, and importance. In other words, it can identify if the client has sufficient self-efficacy and change talk for the preparation stage or if the counselor needs to continue evoking and reflective listening.