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Motivational Interviewing (MI) is a specific approach in psychotherapy that began when William Miller published an article that covered principles for interviewing individuals who were abusing alcohol. Later, Miller worked with Stephen Rollnick to define the MI technique as well as the stages of change, and many of its principles have subsequently received quite a bit of exposure.
Because individuals with substance use disorders are often at different stages regarding their understanding of their behavior, Motivational Interviewing was originally developed as a method to enhance motivation and understand where a person with a substance use disorder stood regarding their understanding of their need to change their behavior. The MI technique has developed into an overall form of interviewing and even counseling that now is applied under many different circumstances. The core concept of MI is the outline of the process of change (the stages of change). This article will discuss the stages of change according to the MI model.
The developers of Motivational Interviewing accepted the fact that people who enter treatment for a substance use disorder are at different levels regarding their perception of their behavior and the need to change or not the change their behavior. After interviewing many individuals with different types of substance use disorders, the MI stages of change concept was developed and refined to help identify where individuals stood regarding their understanding of their issues as they enter treatment.
Not everyone begins treatment at the same level of understanding. The MI model proposes that the process of change occurs according to the following stages:
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It is important to understand that this model does not represent a linear process, such that an individual starts at Stage I and progresses to the final stage. The MI model assumes that different individuals start the process at different points along the stages; individuals can experience setbacks and drop back one or more stages and need to start over; and even individuals in the final stage of the model may still need to make changes and adjustments. Anyone who understands the treatment process understands that few individuals actually change difficult behaviors without setbacks. With respect to individuals with substance use disorders, many individuals often experience a relapse in the mist of being relatively accomplished in changing their behavior and often need to start over.
The model can be used by therapists who can attempt to ascertain where a particular individual stands regarding their understanding of their need to change their behavior, what stage of change they may be in, and then therapy can be individualized to suit the particular situation. Thus, an individual who is forced into therapy in the precontemplation stage would require a different approach than an individual who is already in the action stage.
The model has been demonstrated to have significant utility regarding this aspect of treatment.
Research studies investigating the effectiveness of the applications of Motivational Interviewing indicate that its use does have advantages over standard traditional interviews, and outcomes using MI are at least as effective as other forms of treatment for individuals who have substance use disorders. The principles of MI have also been applied to treatment for individuals with compulsive gambling issues, anxiety disorders, and depression. MI has also been applied in the areas of health education and has been used to identify and understand different styles of parenting.
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