An Introduction to Motivational Interviewing and Developing Discrepancy

What is Motivational Interviewing?

Motivational Interviewing (MI) is a collaborative and person-centered approach to counseling and behavior change. It is widely used in various fields, including healthcare, addiction treatment, and mental health. MI aims to help individuals explore and resolve ambivalence towards change, ultimately motivating them to make positive behavioral changes.

The Four Core Principles of Motivational Interviewing

Motivational Interviewing is guided by four core principles:

1. Express Empathy: The therapist shows empathy by actively listening, being non-judgmental, and demonstrating understanding of the client’s perspective. This creates a safe and supportive environment for the client to express their thoughts and feelings.

2. Develop Discrepancy: Developing discrepancy involves helping the client recognize the discrepancy between their current behavior and their goals, values, or desired outcomes. By highlighting this discrepancy, the therapist encourages the client to consider the need for change.

3. Roll with Resistance: Instead of confronting resistance or arguing with the client, MI encourages the therapist to “roll with” or accept resistance as a normal part of the change process. By avoiding confrontation, the therapist maintains a collaborative and non-adversarial relationship with the client.

4. Support Self-Efficacy: MI recognizes and enhances the client’s belief in their ability to make positive changes. The therapist encourages the client to explore and strengthen their own motivation and confidence in their ability to change.

Developing Discrepancy in Motivational Interviewing

Developing discrepancy is a key principle of Motivational Interviewing. It involves helping the client recognize the discrepancy between their current behavior and their goals, values, or desired outcomes. This discrepancy serves as a catalyst for change and motivates the client to explore and resolve their ambivalence towards change.

A step-by-step approach to developing discrepancy includes:

1. Elicit and Explore Goals: The therapist begins by exploring the client’s goals, values, and aspirations. By understanding what the client wants to achieve, the therapist can later highlight the discrepancy between their current behavior and these goals.

2. Assess Importance and Confidence: The therapist assesses the client’s perceived importance and confidence in making a change. This helps the therapist gauge the client’s readiness for change and identify potential areas of discrepancy.

3. Highlight Discrepancy: Using reflective listening and open-ended questions, the therapist gently guides the client to explore the differences between their current behavior and their desired outcomes. This can include discussing the potential negative consequences of their current behavior and the benefits of change.

4. Amplify and Emphasize Discrepancy: The therapist continues to emphasize the discrepancy, encouraging the client to reflect on the impact of their behavior on their goals, values, and overall well-being. This process helps the client recognize the need for change and increases their motivation to take action.

Questions Therapists Can Ask to Develop Discrepancy

To develop discrepancy in a client, therapists can ask a range of questions that encourage reflection and exploration. Some examples include:

1. “What are your goals or aspirations in relation to [behavior]?”
2. “How does [current behavior] align with your values and what you want to achieve?”
3. “What are the potential benefits of making a change?”
4. “What are the potential negative consequences of continuing with your current behavior?”
5. “How confident are you in your ability to make a change?”
6. “What would it look like if you were to successfully make this change?”

By asking these types of questions, therapists can help clients recognize the discrepancy between their current behavior and their desired outcomes, facilitating the motivation for change.

Conclusion

Motivational Interviewing is a powerful approach that helps individuals resolve ambivalence towards change and find motivation for positive behavioral changes. Developing discrepancy is a key principle of MI, and therapists can use a step-by-step approach and thought-provoking questions to help clients recognize the need for change. By fostering a collaborative and empathetic environment, therapists can support clients in their journey towards achieving their goals and making lasting changes.