4.58

5

Aug 08, 2013

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 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. ...more

4

Feb 12, 2015

As a new therapist, I often struggle over one thingmy client does not appear motivated enough. We have followed the CBT approach, but they are not doing thought records, they are not doing their exposures, they are not paying attention to our discussions from previous sessions. In short, they are not doing what we want them to do. But this stance is exactly the root of all the problems.
　　
　　My initial response was twofold: I either blamed myself or the client. It could be that I have pushed too As a new therapist, I often struggle over one thing—my client does not appear motivated enough. We have followed the CBT approach, but they are not doing thought records, they are not doing their exposures, they are not paying attention to our discussions from previous sessions. In short, they are not doing what we want them to do. But this stance is exactly the root of all the problems.
　　
　　My initial response was twofold: I either blamed myself or the client. It could be that I have pushed too far or too fast, or that the process was not collaborative enough. It could also be that the client is ambivalent about treatment, i.e., the cognitive/behavioural pattern serves certain functions. However, my subsequent actions seem to make things even worse—I tried to correct and pushed even more. This “righting reflex” only damaged rapport and evoked more resistance from the client.
　　
　　In Motivation Interviewing (MI), my approach would fall into the “directing” end of the continuum, which means to “prescribe” a certain course of actions to the client. The assumption is: I am the expert and I know your situation the best, you will get better as long as you follow my solution. The other extreme is “following”: I will follow you wherever you go, but you bear the responsibility to make changes. An ideal approach should be somewhere in the middle—“guiding” as suggested by MI. It follows four steps: engaging—focusing—evoking—planning, using OARS, i.e., open questioning, affirming, reflection, and summarizing.
　　
　 　The analogy is that a therapist acts like a fitness coach. The client wants to make changes but doesn’t fully know what and how. The therapist, on the contrary, knows how to set reasonable goals and has access to a variety of tools. Let’s say an obese client comes into our fitness studio, wanting to become healthier and lose weight. As you would imagine, this client can be quite ambivalent about abandoning his lifestyle—drinking beer, eating junk food, sitting on the coach and watching TV, and the list goes on. He is here not to hear the downside of obesity and the benefit of eating less and exercising more—I am sure he is aware of all these. He is not here to hear that he needs to walk two hours a day plus 30 minutes of cardio—I am also sure that he knows how to get healthier. The key is that he wants to change but is not fully prepared to change. Our role is to help him explore how much he wants to change (desire), how much he can change (ability), and how much he needs to change (need). We want to cultivate this intention to change and once the client is determined to move into a certain direction, planning and acting would follow naturally and effortlessly. This is why planning is only the last one of the four-step process in MI (engaging-focusing-provoking-planning).
　　
　　In a way, MI is not a new therapeutic approach. It is not much different from Carl Roger’s Client-Centred Approach or Humanitarian Therapy. The field of psychotherapy seems to follow a circular course—what was popular at one time found its way back decades later. MI is not a collection of techniques that you can use to “motivate” your clients. It is not something that you can obtain by taking a two-day workshop. To me, the spirit is far more important than the techniques. Many professionals are already practicing MI without even knowing its name. Many are not practicing MI even though they think they are well-trained in it.
　　
　 　Clients are paying money to see us. We are not meant to lecture them or give them directions or take the stance of an expert. Instead, they come here with some purposes (although they can be vague and ambiguous). If you want to know the root of their psychopathology, ask them. If you want to come up with strategies to help and wonder what is realistic, ask them. If you want to assess treatment efficacy, ask them. They are not fools, in fact, they know themselves better than you do. No change is sustainable unless it is premeditated and performed by the client themselves. No talk is more powerful than the one that originates from the client. The mission is not to “fix” the engine but to “start” the engine. However, to find the car key takes two people—one searches and the other holds the flashlight.
　　
　　This is a great book to read and inspirational for practitioners.
...more

5

Jan 09, 2014

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.

4

Feb 24, 2017

If you are giving services one on one this book will help you a lot.

Focuses on effective client-centered approach with good examples.

4

Jul 26, 2018

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 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! ...more

4

Apr 06, 2013

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.

0

Apr 25, 2014

i have done my master in social work and near to start any job .that's way i want to read some books which can help me in my practice.

5

Jul 16, 2014

Excellent. It's too bad that, as the authors say, you can't become a proficient motivational interviewer from reading a book. Still, though, the concepts and methods laid out in this book are clear and user-friendly, and to whatever degree I can, I've been using them with clients with some success. A wonderful approach for clients who are ambivalent about changing in therapy (who isn't, really?).

4

Mar 22, 2008

My purpose in reading this book was to get a better sense for motivational interviewing (MI) techniques and how to apply them to a health population. The first half of the book, by Miller and Rollnick, was helpful with this. The main problem is that the principles behind MI are theoretically simple, but pragmatically difficult to translate into effective interventions in the therapy room. The examples of transcribed client-therapist interactions were probably the most useful portion of the My purpose in reading this book was to get a better sense for motivational interviewing (MI) techniques and how to apply them to a health population. The first half of the book, by Miller and Rollnick, was helpful with this. The main problem is that the principles behind MI are theoretically simple, but pragmatically difficult to translate into effective interventions in the therapy room. The examples of transcribed client-therapist interactions were probably the most useful portion of the entire book. In the setting I am currently working in there are a number of therapists I consider experts in MI. I was a bit disappointed that the book by the creators didn't surpass what I had already learned from my local experts. The second half of the book is edited and addresses specific populations and concerns. I only read selected chapters that felt applicable to me. The quality of these chapters varied somewhat, as did their helpfulness to me. Overall, I felt that they did an average job of presenting the issues and the small bodies of research in these subareas. As the research addressing MI expands, it will be easier to speak to these special topics more effectively. ...more

3

Mar 04, 2016

When I first opened this book, I was so excited to read it. In theory, I think it's a great book for most medical professionals to read. How often do we all feel as though we are being herded in and out of the doctor's office without anyone actually listening or looking up from their laptop?

From an interpersonal communication standpoint, it is great. If you have no skills in this area or are not naturally empathetic towards others, this book can greatly help you. However, I found a lot of the When I first opened this book, I was so excited to read it. In theory, I think it's a great book for most medical professionals to read. How often do we all feel as though we are being herded in and out of the doctor's office without anyone actually listening or looking up from their laptop?

From an interpersonal communication standpoint, it is great. If you have no skills in this area or are not naturally empathetic towards others, this book can greatly help you. However, I found a lot of the chapters to be a bit redundant and a little bit too "text booky".

I felt as though the authors have a lot of knowledge, but being in the medical field they felt the need to constantly reference without trusting in themselves and the information they are here to offer. The book spent a lot of time talking about revisions they have made to this philosophy/book over the years--which as a first time reader, I felt was unnecessary and caused me more reading. Perhaps a section in the back devoted to this would have been great. I think the book could have been a third of the length and got the same message across.

Great theory. ...more

5

Feb 12, 2017

This was part of my Tobacco Treatment Specialist Training. There are many things I will apply to my work as an oncology navigator. So much of it is about listening, and opening the door for engagement. I will read this more thatn once.

4

Apr 01, 2008

This is only example #2 of an Empirically Supported Treatment that, despite my skepticism of ESTs (thanks to their history of strict session-by-session manualization in a cognitive-behavioral style) has really grabbed me as doable for both therapist and client.

The MI technique comes from the substance abuse field, and strikes me as an amazing revelation in that field. Over time, it's become apparent that it's also wildly useful for any intervention in which shame or punishment has been a This is only example #2 of an Empirically Supported Treatment that, despite my skepticism of ESTs (thanks to their history of strict session-by-session manualization in a cognitive-behavioral style) has really grabbed me as doable for both therapist and client.

The MI technique comes from the substance abuse field, and strikes me as an amazing revelation in that field. Over time, it's become apparent that it's also wildly useful for any intervention in which shame or punishment has been a primary tactic to induce change. With MI, resistance isn't something to be extinguished or beat down. It's the key. Everyone's ambivalent, and especially about change. If I, as the professional, advocate the 'gotta change' side of the ambivalence, the client will always take the other side. Try it sometime, anytime you disagree with someone. What if instead, I work hard to honor, value, and understand the 'don't change' side too? But then whenever the talk turns to the reasons for change, I manage to reinforce it...somehow without making it my idea?

Who knew Rogerian person-centered therapy could be turned into a measurable, marketable EST that government entities would pay for? And aside from being billable, it's also brilliant, and feels like what I've always wanted to do, and I intend to use it with lots of parents who are used to being shamed into changing how they handle their kids. ...more

4

Sep 22, 2019

Okay, but very focused on addiction care although the title suggests a broader application.

5

Sep 23, 2018

A very helpful, easy to read textbook. I rented it for a class but have every intention of buying a copy for use in my daily practice as a social worker

5

Dec 27, 2018

The classic text on Motivational Interviewing and background on Transtheoretical model of change.

5

Apr 15, 2019

Very helpful to anyone, mainly those in counseling. Gives you another way to talk to others and not be forceful on what people should do

4

Jul 09, 2018

This book is basically the MI bible. It is well written and extremely helpful. I will be keeping this one and refering back to it for a long time.

4

Aug 16, 2019

Without any previous counseling experience I found this book a little dense at first. As I grow in experience I find this book to be an amazing resource I call back to on a weekly basis!

4

Oct 02, 2017

Really liked this book. Great examples. Wish there were few exercices at the end though.

5

Nov 03, 2018

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.

5

Nov 03, 2018

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.

3

Jan 02, 2018

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!

4

Jul 22, 2019

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. 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.

4/5 ...more

5

Nov 27, 2018

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!

4

Dec 06, 2019

Motivational Interviewing is less about chit chat and is contingent upon listening and respecting personal life choices an individual has decided on, and thereby not resorting to taking on an authoritative role of: "I have more experience than you do in life, therefore you should listen to me when I tell you this".

The reasoning behind this structure of communication is that it demonstrates compassion and patience with the individual; since let's face it, everyone's patience can be stretched Motivational Interviewing is less about chit chat and is contingent upon listening and respecting personal life choices an individual has decided on, and thereby not resorting to taking on an authoritative role of: "I have more experience than you do in life, therefore you should listen to me when I tell you this".

The reasoning behind this structure of communication is that it demonstrates compassion and patience with the individual; since let's face it, everyone's patience can be stretched thin, and that's the idea and logic behind Motivational Interviewing... It forces the practitioner of it to learn to be a person with a steady temperament and not to explode in an outburst of "You need to step it up!". It also teaches the practitioner to not be condescending by expressing "good job" when a more meaningful and respectable statement can replace those words of expression.

Instead of saying "good job" express why you truly feel the person has done a good job. Keeping this in mind prevents from insulting a person if you ask someone to do something simple and after they do it, your reflex utterance could be "good job" when such an utterance could be felt as condescending to the individual, even though the individual could say nothing in reply to what was said to them. This is especially useful for the household (all ages of individuals: 1-115 years of age) and the workplace. ...more