Motivational Interviewing as a Core Communication Style

Abstract

Motivational interviewing (MI) is an evidence-based, person-centered communication style and set of technical skills and processes, all directed at facilitating behavioral change. The term was first coined in the early 1980s as an approach to help “problem drinkers” (Miller, Behav Psychotherapy. 11:147–172, 1983). In each decade since, the use of MI has expanded across an ever-widening array of applications and settings within and outside of healthcare (e.g., the carceral system, chronic disease management in primary care, nutrition and exercise, dental health, education, sports coaching, organizational leadership, and, most recently, vaccine hesitancy.) MI is now taught and practiced in over 50 languages all over the world. It has a robust evidence base, with more than ten thousand peer-reviewed publications and, at last count, over 1600 controlled clinical trials, more than two-thirds of which show a significant benefit relative to a control or alternative approach (Miller, Controlled clinical trials involving motivational interviewing updated 11/16/2020). Yet its use in psychiatry remains surprisingly limited, outside of co-occurring substance use issues, as evidenced by the dearth of clinical trials and publications in the psychiatric literature and its relatively limited coverage in most psychiatric training curricula.

In this chapter we will review the key concepts underlying MI, discuss aspects of MI that are particularly relevant to community psychiatry, and hopefully evoke the readers’ own motivation for further training and utilization of the technique and spirit of motivational interviewing.