Motivational Interviewing revisited and revised!

For those who have undertaken Coach training studies with us, you would be very familiar with the Motivational Interviewing (MI) model we work under and it’s origins, with the first edition date back to the 1980’s. The authors of MI, Bill Miller and Stephen Rollnick, revise this periodically and have released their fourth edition in late 2023.

The first three editions contain freely shared key information on a way of working with people to help them break addictive habits and replace them with new life affirming practices! The most recent fourth edition of this key resource has recently been published (Aug 2023) and we can recognise that the aim of this revision is to make the concepts of MI easy to apply and deepen our understanding of this conversational approach.

The changes are simple and designed to be just that.

Although this brief article can in no way document all the changes, our aim is to highlight some of the new terms and help us, as coaches, become aware of just how valuable it is to use the principles to support our client’s change journey.

The following list provides great examples of the attempt to simplify the approach:

  1. Terms redefined:

Agenda Mapping -> Choosing a path
Developing discrepancy –> Planting seeds
Elicit-provide-elicit –> Ask-offer-ask
Formulation –> Clarifying
Right reflex –> Fixing reflex
Running head start –> Pendulum technique

In our teaching we do not cover all the terms listed above as MI is only one part of our curriculum and we hope that our coaches will integrate the key principles in their sessions without getting too caught up in analysing their every statement. This does not mean that MI practitioners should not use the full model, however, we believe that MI can be woven into our work as HWC where we use so many theoretical approaches. As authors, Miller and Rollnick point out, “trying out the spirit and method of Mi can yield observable change in. how people respond…. And to many… “MI is not a totally new or strange approach, to some it feels more like a friend they had known long ago and perhaps lost touch with for a while”. They emphasise that MI is now being used in combination with other evidence-based methods and not as an “add-on” technique and it is not meant to replace, but enhance the way we work.

So to remind us – practicing MI is to recognise that by pushing, cajoling, coercing, or persuading people to making change is rarely successful and can often backfire.

2. Some key points on the changes follow:

• The new layman’s definition is “A particular way of talking with people about change and growth to strengthen their own motivation and commitment”.

• The authors have moved away from notion of “preparing people for change” and instead using it as a way of accompanying people through their journey of change and growth. So it can be used at all stages of change, not simply in pre-contemplation.

• When describing the spirit of MI, the constructs of partnership, acceptance and compassion remain and “evocation” has been broadened to mean “empowerment” although it should be noted that the term still remains as one of the tasks of MI.

• The idea of engaging, focusing, evoking and planning are now referred to as “tasks” rather than “processes”.

• The term “fixing reflex” is more self-explanatory than “righting reflex” and we can all know and recognise it!

• Instead of referring to clients presenting with “resistance” this term is being phased out and instead the focus is on reducing or responding to “sustain talk”. The thinking behind this is something that we have pointed out in our training – client’s don’t resist unless they are being pushed where they don’t want to go! The term “discord” is now used to describe that atmosphere where the coach is attempting to move the client along and they client is not willing to do there.

To conclude with another reminder – there are two aspects of Mi which make it work when used together. The relational aspects refer to who you are as a coach – your intuition, and the person-centred way of being. And then of course the technical aspects which are all about evoking and strengthening change talk while softening sustain talk and discord. Together they create a powerful tool in supporting others.

This is a brief introduction to the changes to whet your appetite. We encourage you to get your own copy – it is available at a reasonable price as an ebook on Amazon – and read more about this fascinating methodology.