1 Origins and philosophy: William Miller and Stephen Rollnick
Developed in the 1980s in the treatment of alcoholism, motivational interviewing (MET) is a therapeutic communication method premised on the view that ambivalence, 'I want to change, but I also want to carry on', is a normal, universal stage of any change process rather than evidence of bad faith or pathological denial.
2 The motivational spirit and key OARS skills
The practitioner rejects aggressive confrontation and guilt-inducing moralising. They draw on OARS skills: open questions, sincere affirmations of the person's strengths, compassionate reflective listening, and summaries. This reassuring stance allows patients to express their own arguments for change.
3 Clinical applications
MET is particularly effective in treating substance addictions, including alcohol, tobacco, illicit drugs and medication, and behavioural addictions, including gambling and internet addiction. It is also widely used in managing chronic illnesses such as diabetes and hypertension to improve treatment adherence and the adoption of healthy habits.
4 The place of this approach within care
This approach often has a place from the first meetings: it helps overcome initial obstacles and build a strong alliance. Patients feel that their autonomy is respected, becoming the true authors of their own transformation.
5 Unconditional respect for the person's pace of change
Practitioners of motivational interviewing remember that human change is rarely linear and naturally involves movement backwards as well as forwards. By maintaining an empathic, non-judgemental listening stance during moments of doubt, they preserve the therapeutic alliance and provide lasting support for the client's confidence.