A Guide to Motivational Interviewing
A Person-Centered Approach to Inspiring Change
Understanding Motivational Interviewing (MI)
Motivational Interviewing is a guiding style of communication that helps people resolve their ambivalence and find their own internal drive to make meaningful life changes. It is a respectful and curious way of being with people that facilitates their journey toward positive goals.
A Researched Method: MI is a well-established practice with a strong foundation in clinical research, demonstrating its effectiveness in a wide range of applications, from healthcare to social work and beyond.
The Guiding Spirit of MI
More than a set of techniques, MI is a fundamental way of relating to others. This "spirit" is built on four essential pillars:
Partnership
The practitioner is a companion on the journey, not a director. The work is done together in a collaborative spirit.
Acceptance
Honoring a person's absolute worth, providing accurate empathy, supporting their autonomy, and affirming their strengths.
Compassion
To genuinely act in the welfare of the other person. It is a commitment to prioritize their needs and well-being.
Evocation
The practitioner draws out the person's own ideas and wisdom. The resources for change reside within the individual.
The Four Processes of MI
The conversation in MI flows through four overlapping processes, each setting the stage for the next.
Engaging
The process of establishing a helpful connection and working relationship. This is the bedrock of MI.
Focusing
The process of clarifying a particular direction or goal for the conversation.
Evoking
Drawing out the person's own motivations for change by exploring their values and goals.
Planning
Cultivating commitment to change and co-creating a specific, actionable plan.
MI for Behaviour Support Practitioners
For Behaviour Support Practitioners (BSPs), MI offers a powerful alternative to directive approaches. It helps build intrinsic motivation in people with disabilities, which is often more sustainable than motivation based on external rewards or consequences.
Adapting MI means simplifying language, using visual aids, and focusing on concrete, values-based goals. The spirit of MI remains paramount: the practitioner is a guide, not an enforcer.
Example: Supporting a Person with an Intellectual Disability
Scenario:
Ben, a young man with a moderate intellectual disability, enjoys drawing but is hesitant to join a local art class. He says he wants to go but often refuses when it's time to sign up, leading to frustration for his support staff.
Applying MI:
- Engage with Open Questions: Instead of "Why won't you go?", the BSP asks, "Ben, tell me what you love most about making your art. What does it feel like when you're drawing?"
- Evoke Motivation (using visuals): The BSP uses a 'thumbs down' to 'thumbs up' scale. "How much would you like to meet other people who love drawing as much as you do?" If Ben gives a thumbs-up, the BSP can follow up with, "What makes that a thumbs-up idea for you?"
- Use Affirmations: "You've been thinking a lot about this. It's really brave to consider trying something new."
- Collaborative Planning: "Since sharing your art sounds exciting, what's one tiny step we could take? Maybe we could just look at pictures of the art room online this week. No pressure to go."
Example: Supporting a Person with Autism
Scenario:
Maya, a teenager with autism, has high sensory sensitivity and has started refusing to wear her school uniform, calling it "scratchy and loud." This is causing significant morning stress and she is missing school.
Applying MI:
- Engage with Sensory Respect: The BSP uses a communication board with fabric textures. "Maya, can you show me the texture that feels most like your school shirt? Now, which one feels the calmest?"
- Explore Ambivalence with Reflections: "So on one hand, the uniform feels really uncomfortable and makes it hard to focus. And on the other hand, when you're not at school, you miss out on science club, which you love."
- Focus on Values: "You are such a talented scientist. It's important for you to be at school to work on your experiments. Let's be a team and figure out how to make that happen."
- Simple, Concrete Planning: "I wonder, what if we tried wearing your super-soft pyjama top underneath the uniform shirt for just 15 minutes tomorrow, while we have breakfast? You would be in charge of the timer."
Schedules of Reinforcement
Reinforcement is a core principle in behaviour support, used to strengthen a desired behaviour. The *schedule* describes the rule for when a reinforcer will be delivered. Different schedules have different effects on behaviour.
Continuous Reinforcement
A reinforcer follows every single time a target behaviour occurs. This is best for teaching a brand-new skill but can lead to the skill disappearing if the reward is removed.
Fixed-Ratio Schedule
A reinforcer is given after a set number of responses. For example, earning 10 minutes of free time after completing 5 homework questions.
Variable-Ratio Schedule
A reinforcer is given after an average, unpredictable number of responses. This creates a strong, steady rate of responding, like winning on a scratch ticket.
Fixed-Interval Schedule
A reinforcer is given for the first response after a set amount of time has passed. For example, getting paid every fortnight.
Variable-Interval Schedule
A reinforcer is given for the first response after an average, unpredictable amount of time has passed. For example, receiving a "like" on a social media post.