Motivational Interviewing Supports Behavioral Change
 Motivational interviewing is deeply grounded in humanistic psychology, especially the work of Carl Rogers, according to Petros Levounis, M.D. Speaking at an APA annual meeting session titled “Advances in Motivational Interviewing,” he noted that William Miller and Stephen Rollnick have proposed that change is a natural and ubiquitous process that is intrinsic to each person and may occur without any outside intervention. Motivational interviewing seeks to hasten this natural change process by creating an interpersonal situation, wherein the patient can engage in a collaborative dialogue that supports behavioral change from the patient’s perspective.
Fundamentally, motivational interviewing is not exactly a method or a “bag of tricks,” not something that can be done to someone, but something that is done with someone, a way to be with another person that increases the likelihood they will consider and become more committed to change, he continued. Clinicians adopt a style or “spirit” of interacting and communicating with patients such that they (1) honor the patient’s experiences and perspective (collaboration), (2) affirm the patient’s right and capacity for self-direction (autonomy), and (3) draw out the patient’s goals, values, and perceptions that support change (evocation). This empathic stance conveys respect and acceptance of the patient and presumes that the resources for enhancing motivation reside within the patient. By creating a therapeutic atmosphere grounded in this spirit, clinicians help patients feel more open to exploring their ambivalence about change and empowered by the self-direction afforded to them.
Levounis is director of the Addiction Institute of New York. He also is chief of the Division of Addiction Psychiatry and associate chair for clinical services in the Department of Psychiatry and Behavioral Health at St. Luke’s and Roosevelt Hospitals. He is coeditor of the handbook of motivation and change by American Psychiatric Publishing.
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