Christopher C. Wagner

Beyond Cognition: Broadening the Emotional Base of Motivational Interviewing.

Motivational interviewing (MI) techniques have been described in cognitive and behavioral terms, as means to positively resolve tension created by unresolved ambivalence about change. This view of motivation is consistent with a negative reinforcement model, in which behaviors are performed to escape from negative states. In contrast, the concept of positive reinforcement involves seeking positive states through behaviors that lead toward more satisfying conditions. From this perspective, motivation involves a desire to experience positive emotions. This paper focuses on the potential role that emotions may play in MI, particularly positive emotions. The authors posit that MI elicits positive emotions of interest, hope, contentment and inspiration by inviting clients to envision a better future, to remember past successes, and to gain confidence in their abilities to improve their lives.

Beyond behavior: eliciting broader change with motivational interviewing.

Descriptions of Motivational interviewing (MI) usually focus on helping clients change a single problematic behavior. In contrast, the current case study shows that MI can serve as a more comprehensive psychotherapy, focused not only on multiple problem behaviors but also on broader change consistent with its roots in client-centered therapy. In this case, the therapist interwove a focus on several discrete behaviors with a focus on broader lifestyle change as well as increased clarity of client cognitions, values, and choices, resulting in several lasting changes.

Personality Disorder Styles and Reciprocal Interpersonal Impacts During Outpatient Intake Interviews

This study investigated the relationship between personality disorder styles and the reciprocal interpersonal impacts of patients and intake clinicians. Ninety-two outpatients were interviewed by 29 mental health professionals as part of an intake procedure at a psychiatric outpatient clinic. Following the interview, clinicians and patients rated their perceptions of, and their reactions to, one another. These reciprocal “impact” ratings were analyzed in relation to patient scores on the MMPI Personality Disorder Scales. Most personality disorder styles were associated with increased hostile reciprocal impacts. Histrionic and narcissistic styles, however, were related to increased warm and friendly reciprocal impacts. These results suggest that patients with personality disorder styles elicit constrained reactions from the clinician, misperceive clinician behavior, and / or pull clinicians into constrained interaction patterns. Diese Studie untersuchte die Beziehung zwischen Personlichkeitsstorungsstilen ...

Motivational Interviewing and Client-Centered Therapy

Motivational interviewing (MI) uses client-centered methods to elicit and pursue client change goals. Described as “80 % Rogers,” MI adds a directional component to classic client-centered therapy (CCT) while focusing more narrowly on momentum toward change versus the broader personal growth and deepening goals of CCT. This chapter reviews MI processes and strategies, and explores similarities and differences between MI and CCT.

Development and Initial Validation of the Assessment of Motivational Interviewing Groups – Observer Scales (AMIGOS)

ABSTRACT This article documents the development and initial validation of a global observer instrument, the Assessment of Motivational Interviewing Groups – Observer Scales (AMIGOS). The AMIGOS includes three scales composed of 18 items documenting group processes, client-centered style, and motivational interviewing (MI) change focus. Three experienced coders independently rated 18 sessions of various group approaches. The AMIGOS showed high inter-rater intraclass correlation coefficient (ICC) and Cronbach’s alpha, strong convergent and discriminant validity with the MI Treatment Integrity scales (MITI), the Therapist Empathy Scale (TES), and the Group Climate Questionnaire (GCQ). The AMIGOS shows promise as a reliable and valid measure of MI group leadership and group processes, and could be useful measuring other group therapies as well.

Motivational Interviewing: Emerging Theory, Research, and Practice

Motivational Interviewing is a counseling approach in which therapists use a client-centered stance paired with eliciting techniques to help clients explore and resolve their ambivalences about changing behaviors that are not optimally healthy. It is characterized by a collaborative, autonomy-supporting, and evocative style in which therapists seek to understand clients’ perspectives, while directing clients towards considering changing one or more behaviors. Although it has strong roots in client-centered counseling, Motivational Interviewing can be considered atheoretical or theoretically eclectic. Currently, there is no comprehensive theory of Motivational Interviewing, although there are several threads relating Motivational Interviewing to personal growth and self-determination, to activation of emotions as a bridge to increased openness to change, and as a therapeutic approach that combines a friendly-submissive interpersonal style with more directive tasks. The relational and technical elements combine to evoke increased consideration or and openness to change, and therapists pay particular attention to client communications about change in order to focus efforts toward moving into new patterns rather than processing or dwelling in old patterns. Motivational Interviewing has strong evidence for its positive impact on addictive behavior. It often achieves good outcomes with fewer sessions and less time than other substance abuse treatment methods. There is a growing evidence base in support of adaptations of Motivational Interviewing across a wide array of practice domains, settings, problem behaviors, and conditions. Generally, Motivational Interviewing is superior to no treatment and is equivalent to other active treatments despite its relative brevity, thus there may be cost effectiveness advantages to Motivational Interviewing. Recent focus on measuring treatment fidelity and exploring possible mechanisms of actions should help to shed further light on the workings of Motivational Interviewing. Finally, as Motivational Interviewing expands across settings and cultures, it is being redefined in light of new experiences and developments.