This bestselling work for professionals and students is the authoritative presentation of motivational interviewing (MI), the powerful approach to facilitating change. The book elucidates the four processes of MI--engaging, focusing, evoking, and planning--and vividly demonstrates what they look like in action. A wealth of vignettes and interview examples illustrate the "dos and don'ts" of successful implementation in diverse contexts. Highly accessible, the book is infused with respect and compassion for clients. The companion Web page provides additional helpful resources, including reflection questions, an extended bibliography, and annotated case material. This book is in the Applications of Motivational Interviewing series. New to This Edition: *Reflects major advances in understanding and teaching MI. *Fully restructured around the new four-process model. *Additional case examples and counseling situations. *Reviews the growing evidence base and covers ways to assess MI fidelity. Pedagogical Features Include: *Online reflection questions and annotated cases, ideal for classroom discussion. *Key points at the end of each chapter. *Engaging boxes with special topics and personal reflections. *Extended bibliography and quick-reference glossary.
William Richard Miller is an American clinical psychologist, an emeritus distinguished professor of psychology and psychiatry at the University of New Mexico in Albuquerque. Miller and Stephen Rollnick are the co-founders of motivational interviewing.
I read an earlier addition of this manual when I was in school working towards my MA. I thought it was brilliant back then. But I had no idea how effective this stuff would be in practice. I'm currently doing my (MFT) internships and just beginning to implement this stuff, and WOW, it really works.
The first time I experienced a client drop dramatic, sudden, emphatic change talk in a session my jaw just about hit the floor. I was with a client who was on the verge of becoming homeless, but could not seem to take action due to depression and overwhelm. We explored the ambivalence, non-judgmentally, for just a few minutes, and suddenly she startled as if she were jerking awake from a deep sleep and said " oh my god, I have to go find a place to live". We scribbled out a quick list and she bolted for the door to go get some urgent and important stuff done. The next day she came into my office with the proud news that she got the apartment.
Listening with empathy and reflecting in a forward direction can transform an otherwise superficial or circular conversation into an insight and action provoking depth charge. KABOOM!
As an addendum I'm including the following progress update to the above mentioned clients status. She did in fact find and move in to the apartment. But as it turns out its is a meth house, and she has subsequently become hopelessly relapsed in her meth addiction (I was treating her opiate addiction at the time of writing, her meth addiction was in remission). One step forward three steps back I guess.
This of course does not at all reflect poorly on MI, but it does remind us that long term adaptive behavioral change takes sustained long term effort and commitment.
This is the most logical and effective approach I've learned for evoking change in people. I've seen it work in practice. It's pretty amazing. It would be a very good thing if this were required reading and training for everyone working in counseling, social work, medicine, criminal justice and teen mentoring as well as many other applications.
Several friends recommended William R. Miller and Stephen Rollnick’s Motivational Interviewing as a reliable and longstanding practice that would be useful for an aspiring counselor to explore. The book is a terrific resource for professionals and laypeople interested in the language of change and dynamics of personal development.
Miller and Rollnick originally invented motivational interviewing (MI) in the 1980s as a talk therapy treatment for alcohol addiction. They have continued to evolve its theory and practice over the last several decades; MI is now used in a variety of contexts and has been fruitfully integrated with other therapeutic methods. The approach borrows the conceptual foundations of Rogerian client-centered therapy, but also departs from it by being considerably more goal-oriented. The explicit purpose of MI is to help clients change their lives in ways that will minimize harm and promote growth and flourishing:
"Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion." (29)
In MI, the counselor’s prime directive is to draw out a client’s intrinsic motivations for change, rather than confronting them with extrinsic motivations or taking an authoritative tone:
"Telling someone that 'You can’t,' and more generally trying to constrain someone’s choices typically evokes psychological reactance, the desire to reassert one’s freedom. On the other hand, directly acknowledging a person’s freedom of choice typically diminishes defensiveness and can facilitate change. This involves letting go of the idea and burden that you have to (or can) make people change. It is, in essence, relinquishing a power that you never had in the first place." (19)
Motivational Interviewing is a process-oriented text that provides many concrete examples of how Miller and Rollnick’s theories succeed or fail in practice, as well as discussions of MI’s efficacy as demonstrated by academic research. The authors also have a talent for metaphor, often invoking creative references to music, dance, travel, and the natural world. The book strikes an excellent balance between instructional information and values-driven reflections on the art of therapeutic consultation.
Miller and Rollnick break down the method of MI into four stages: engaging, focusing, evoking, and planning. Their simplest articulation is as follows:
"Engaging is about 'Shall we travel together?' Focusing asks 'Where to?' Evoking is about 'Whether?' and 'Why?' Planning is about 'How?' and 'When?'" (271)
The four stages occur in sequence as the client makes their way toward change, but Miller and Rollnick point out that any stage can be revisited as needed.
Engaging is the stage of MI that most closely resembles client-centered therapy. It is all about listening well, creating a safe and acceptant space for the client, and demonstrating empathic attention to the client’s perspective and needs. Miller and Rollnick’s descriptions and examples of “reflective listening” are especially helpful, making it easy to see why their method is so effective when utilized properly. “Processes for engaging do differ across cultures,” they write, “but listening lies at the heart of nearly all of them” (349).
Once a solid rapport has been established, the consultation enters the focusing stage. This is where counselor and client collaboratively explore goals for change and agree on an intended outcome or set of outcomes. Miller and Rollnick recommend that counselors adopt a “guiding” style––a compromise between “following” (allowing the client to dictate the direction of the conversation) and “directing” (taking the reins in order to produce the counselor’s desired outcome):
"Midway between directing and following sits a guiding style. Guiding promotes a collaborative search for direction, a meeting of expertise in which the focus of treatment is negotiated. The client’s agenda is important, and any limitations inherent in the context are taken into account. The clinician’s expertise is also a possible source of goals. The focusing process of MI commonly starts in this middle ground between directing and following, where the focus, momentum, and content are mutually forged." (99)
After focusing comes evoking, which is arguably the most crucial and challenging of the four stages. Evoking is the process by which a counselor seeks to elicit and strengthen the client’s personal reasons for change. This is done through delving into the client’s ambivalence––their reasons for and against making the change or changes identified during the focusing stage. Careful attention is paid to “change talk” and “sustain talk”:
"Sustain talk and change talk are conceptually opposite––the person’s arguments against and for change––and they predict different outcomes. A predominance of sustain talk or an equal mix of change and sustain talk is associated with maintenance of the status quo, whereas a predominance of change talk predicts subsequent behavior change." (165)
Affirming and encouraging change talk is the main mechanism by which MI practitioners help clients articulate and commit to their intrinsic motivations for change. “Evoking is a co-creative process through which the person’s potential for change is released,” Miller and Rollnick tell us. “The motivation for change is emerging even as you speak together.” (182) Here we see another strong connection to Carl Rogers’s theory of personal growth, which prizes client autonomy and asserts that meaningful and lasting change typically stems from behavioral adaptations that are self-chosen rather than imposed from the outside.
The planning stage is precisely what it sounds like. “Planning is the clutch that engages the engine of change talk,” where client and counselor work out the details of how to transform the client’s desires for change into reality (30). Miller and Rollnick provide many useful examples and resources for how this can be accomplished, all the while staying true to their ethos of supporting the client as they discover what works best for them.
Although MI certainly seems like a great system, there are a couple apparent limitations I’d like to highlight. The first is simply that much of MI won’t apply to clients who aren’t seeking change or don’t need to change their behavior in any profound way. The second is that, by locating the potential and responsibility for change primarily within the client, MI runs the risk of downplaying or ignoring structural factors that may render change difficult or even impossible. To their credit, Miller and Rollnick are aware of this issue and mention it several times in the book. It’s important to remember that, due to external circumstances completely beyond their control, some people seeking counseling may not have the power to transform their lives in the way MI suggests. This isn’t really a criticism, but rather an acknowledgment that MI is just one of many effective tools we can use to meet humanity’s variety of mental health needs.
This review was originally published on my blog, words&dirt.
Read for work. Written with clinicians in mind but has a lot of useful advice for people who want to become better listeners in all types of settings. Has some really tangible advice on how to divorce yourself from the impulse of offering people unsolicited advice, and instead working with others to find what they want and how they can get to that goal on their own. Also found it super useful for personal goal setting, and thinking about how I work towards my goals and react to failure. I'm not much of a reader of "self-help" style books but really did like this one!
ספר מעולה, קריא וברור, מאורגן היטב בנושא של גישה מוטיבציונית כגישה טיפולית. ממליצה מאוד לכל עמיתי הפסיכולוגים. מומלץ גם לרופאים, אחיות, עובדים סוציאלים וכל אנשי הטיפול באשר הם.
قرأته قراءة سريعة و تجاوزت اجزاء عدة اعتقد انى فهمت الفكرة العامة مؤكد سأعاود قرأته بالتفصيل
ما جذبني في فكر روجرز و فلسفة العلاج المتمركز حول العميل هو المنظور الايجابي و البراديم الذي يرى به العميل باعتباره انسان يرغب ف التغيير و بداخله نورا يسعي المعالج لتللامس معه و اخراجه وصقله لإزالة توترات التناقض الوجدانى الذي يثقله و يجثم على صدره و يعيقه
ولا يرى العميل كشخص سلبي فاقد للتحكم ينبغي توجيهه و الضغط عليه .. وهى النظرة الشائعة !
و عجبني تشبييه للأمر فى مقارنته بين أسلوب المواجهة و أسلوب التمركز حول العميل و احتوائه بشئ من القبول و الدفأ يعينه على التعامل مع التناقضات الوجدانية بمصارعة بين شخصين أو رقصة لطيفة تدار من المعالج بخفة !
اعتقد المنظور دا ان تم تعميمه كفلسفة للتعلم و التعليم عموما سيصبح العالم مكان أفضل بمراحل !
Daca iti place Carl Rogers aceasta carte este un must-read. Metoda MI este o metoda care pleaca de la principiile lui si le duce mai departe definind mai clar cum ar trebui sa aiba loc o conversatie in care un client sa fie ajutat sa isi schimbe anumite comportamente. Cum sa construiesti motivatia pentru schimbare in celalalt intr-un mod potrivit fiecaruia. Tehnicile MI au multe cercetari si evidente in spate si pot fi complementare multor tipuri de terapii sau interactiuni in care sunt implicati oamenii.
Obviously I like this in part because I gravitate towards MI but I also think this book is incredibly well written for a clinical resource/textbook given the amount of concrete examples given throughout! The commentary throughout on how MI has evolved with time and exploration of how it stems from Rogerian and other theories is also helpful in getting a deeper understanding of the theory and practice. Also, the chapters are short and it is incredibly readable, so easily read even when exhausted!
THE textbook on Motivational Interviewing. I read this as it pertains to my career (clinical psychologist in training), but this was not assigned reading. This book solidified my perspective that motivational interviewing is crucial for therapists who are often engaging with clients who are not yet ready for or committed to making changes. This book was quite dense and I found it hard to translate directly into my practice, but the authors speak to that and provide recommendations for training. I look forward to pursuing training opportunities in the future.
Motivational Interviewing is a useful style of interacting with people in counseling situations where the person may not want to be there & may not see the need for change. This book gives a very easy-to-understand & practical guide to using this style to help people build their own motivation for change. It provides a good mix of theory & practice for clinicians & I think it's useful for anyone who works with people who may not want help.
I was always intending to read about Motivational Interviewing, and until my internship where I encountered a common theme of people wanting to change, but unable to proceed (for whatever reason; particularly ambivalence) and also with not many sessions to work with clients, my supervisor handed me a copy of this book. While not the smoothest read (and not the driest), this is a great resource! Miller and Rollnick take a comprehensive look at this therapeutic approach, breaking it down into its elements (engaging, focusing, evoking, and planning), and how to apply it to clinical practice. There are plenty of techniques, diagrams, and case studies to facilitate learning (the best way of course being actual client work). That said, there's a lot of content to sift through, reference, and learn. But the most important aspect (among all the therapeutic approaches I've attempted) is the essence of therapy and counseling: the relationship. And with that, the person-centered approach of MI is a great way for any therapist (especially beginning ones) to learn since it can be adapted to many situations, issues, and combined with other approaches. Overall, this will definitely be a go-to resource in the future and probably a starting point to build from.
So this was the book I was looking to read for my new position. I'm glad I read Finding Your Way to Change first, because that was written for regular folks and served to put the basic concept of Motivational Interviewing into my head. This book is written for professionals--folks who actually know what they're doing. But the book was clear enough for this under-educated dude to follow along.
Motivational Interviewing is a way of doing counseling--a mindset as much as a technique. Drs. Miller and Rollnick describe it as a dance, where counselor and client work together to help the client achieve their goal. Simply put, it involves engaging the client in working out their own issue. The counselor would then help the client focus on specific goals, encouraging them to decide and then plan to make the changes they need to achieve those goals. The book came across as a very comprehensive explanation of MI and a guidebook for using it. Of course, my opinions as a newbie don't carry much weight, but considering that this was the third edition of the book, I feel confident in recommending it to folks who are interested in this sort of thing. I, myself, am strongly considering getting a copy to put on my shelf. (And then hope I don't get fired a week later.)
A great therapeutic tool and practice. A philosophical debate could be had over what change talk or direction is being overtly or covertly endorsed by the provider, even though "MI spirit" claims that the therapist is joining with the client's own internal motivations. But still--these are great strategies, and the book does a fine job of laying out phases of treatment with case examples. There's a lot of content here, and it did feel like sometimes the authors were putting in concepts into sections where they didn't quite fit just to get them across. It makes for a meandering and sometimes repetitious read. I can think of two care settings I've worked across where these strategies were a mainstay, and it's easy to see how the clinicians who adopt them fair better (in rapport, outcomes, and their own sustainability) than the ones who get stuck in more directive, "righting reflex" ways of responding to folks.
If you work in any field where you need to help people change this is *the* book to get. This was the required textbook for my graduate class in nutrition counseling. I particularly appreciated the example client-counselor conversations. Perhaps it could be edited down to a shorter read for non-students but I'm glad I have the hardback so I can reference it as I begin my career in nutrition and dietetics.
My primary takeaway from this book: I've got the theoretical foundation of MI under my belt but now I need to have about 1000 more conversations with people about change before I really "get" MI. It's a journey this book made me excited to begin.
Un libro interesante para todo aquel que quiera aproximarse a un estilo de entrevista que promueve el cambio de comportamiento y el empoderamiento del paciente. Especialmente interesantes las estrategias de entrevista descritas, así como las situaciones difíciles. Dichas estrategias son aplicables no solamente a personas con problemas de uso de sustancias sino también en otro tipo de problemáticas.
This book was excellent and very helpful for me as I pursue a degree in counseling. The MI process is straightforward and presented in a clear manner with examples. Though the last 100 pages are more just informational about how MI can be used and integrating MI into various practices, overall this is a great approach to working with people. I particularly liked the elements of applied linguistics regarding change and sustain talk, which highlights how powerful language is in a person's life.
One of my textbooks this semester. I thought it was a decent read, however I felt as if the concepts were very straight forward. This book was presented as a groundbreaking theory of sorts but I got the feel that MI is simply an explanation of current concepts counselors face. It was valuable for learning a few new skills though!
اخييييييراااا .. حاسة اني بقرأه من عشر سنين بس الحمد لله خلص 🥴💪 الكتاب من المركز القومي للغات والترجمة وعليه خصم 70% يعني سعره زهيد جدا جدا مقارنة بالمحتوى وجودته. حبيته ومفيد جدا للمتخصصين في المقام الاولى ولاي حد حابب يطور مهاراته في الاقناع والتواصل، ممتع في قرأته (خصوصا الفصول الاولى) عيبه الوحيد ان في حاجات كانت ممكن تبقى اكثر اختصارا وكانت طوووووووووويلة بدون داع
Parts I through IV were very helpful for my understanding of MI. I hope to implement this technique into my clinical practice and I feel I have a much deeper understanding now than when I learned about MI in my MSW program. Grateful the book incorporates real world examples of cases, as well as reflections, summaries, and questions that fit into the MI style.
The go-to guide for Motivational Interviewing. This coaching technique to motivate people to make behavior changes has proven to be very successful with people overcoming addictions and other changes in their life by building buy-in and self efficacy. I read all of the sections recommended for the NBHWC exam.
This is a very good resource and a wonderful companion for the education I received regarding motivational interviewing. It is a textbook I decided to invest in and have continued to go back to and review in order to be a better therapist. It offers a reminder of the core principles required for motivational interviewing and the pitfalls that a professionals can fall into when offering therapy.
I read selected chapters, not cover to cover, but MI is a powerful therapeutic technique, and this book by Miller and Rollnick effectively outlines the process and practice of the skill. Necessary for any interpersonal work.
I learned a lot from this book. I have already started using these methods in my own counseling sessions and have seen great results. This book is easy to follow, has great examples, and very well written. Highly recommend.
In my line of work as a coach in the health and wellbeing world I found this book very useful. It definitely flagged some of my directorship traits that I need to work on as a coach to a more guidance approach.
A 4 out 5 stars for me and one for the shelf to for future reference.
The last two sections could do well in a separate book. Nonetheless this manual is comprehensive, and teaches MI in a way structured much like a college course. A bit repetitive at times, but does so in a way that strengthens the core concepts and provides variety in applications.