Motivational Interviewing in Social Work
Motivational Interviewing in social work has recently become a widely used counseling style within the field due to its practicality.
It is a more directive, client-centered approach and is best used for clients who are illustrating a great deal of ambivalence around some sort of change. The goal of Motivational Interviewing in social work is to help resolve client ambivalence, elicit change talk and behavior, and utilize internal client motivation to do so.
The approach of motivational interviewing in social work is a very collaborative process between the counselor and client. MI focuses on the counselor standing alongside the client to aid in the process of change as opposed to being the superior expert. Five importance values of MI are:
- Be empathetic
- Create a discrepancy between the client’s presenting behavior and their goals
- Avoid confrontation
- Instead of contradicting client resistance directly, adjust to it
- Support self-efficacy and optimism
What it Looks Like (OARS)
Open-Ended Questions: avoid questions that only warrant a yes/no answer. Frame your questions to invite your client to think deeply and answer more elaborately.
Affirmations: acknowledge your client’s strengths. Affirmations provide genuine, honest feedback in regards to the positive thoughts, behaviors, and qualities of your client. This promotes further positive change.
Reflections: providing your client with reflective statements shows that you are actively listening to and validating what they say. These statements also allow your client to hear their main points aloud, triggering thoughts of change and those “aha” moments.
Summaries: summarization is similar to reflections but it recaps a larger portion, or all, of the counseling session. This is a tool used to highlight what the client has expressed throughout the session, call attention to important elements, promote strategic change and to move on to the next topic or end the session until next time.
Techniques for Motivational Interviewing in Social Work
When you ask permission as opposed lecturing, this builds trust with your client and makes them feel more comfortable speaking openly.
Eliciting/Evoking Change Talk
Helping your client utilize change talk is more beneficial then you simply telling them what they can do. Change talk promotes ownership.
Exploring Importance and Confidence
This is a great tool for both the counselor and the client to discover how the client currently views themselves as well as the likelihood of change. It is a great tool to use to compare the start and end of your counseling relationship.
This provides comfort to a client, helping them understand they are not alone in their struggle to change.
This technique has a client look at both the good and bad about their current behavior. This activity sheds light on their ambivalence and the positives that can come with change.
This tool is used to shed light on discrepancies without the counselor coming off as judgmental or blaming. For example, “It sounds like on one hand when you started smoking cigarettes you felt there were many positives.
Now, however, with your health scare and the consistent increase in cost, you have been thinking about quitting. What will your life be like if you do stop?”
Statements Supporting Self-Efficacy
When it comes to changing behavior, a lack of self-confidence plays a significant role. Utilizing these types of positive statements increasingly puts the control in the client’s hands and empowers them to make changes.
Readiness to Change Ruler
This technique uses the scale of 1-10 technique and is an honest way to gauge where the client is at in the counseling process. Because ambivalence is such a significant part of MI and changing behaviors, your client’s response can fluctuate often.
Educating clients on specific information related to their negative behavior is vital. Provide direct, relevant facts is essential because they simply may not be aware of the costs of their presenting issues.
This technique is used to encourage the client to argue for the importance of changing.
For example, “We have been seeing each other once a week for 2 months now but you are still smoking, maybe now really isn’t the best time to quit”.
These types of statements put the client on the offensive and inspire them to advocate for themselves.
The client’s response will also help you gauge how much more work needs to be done, for instance, if the client does not argue for change.
- Enhancing motivation for change in substance abuse treatment. (2012). Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.
- Miller, W. R. and Rollnick, S. (1991) Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press, 1991.
- Sobell, L. C., & Sobell, M. B. (2008). Motivational Interviewing strategies and techniques: Rationales and examples. Retrieved from http://www.nova.edu/gsc/forms/mi_rationale_techniques.pdf.