11.3 Motivational interviewing and behavior change
4 min read•august 9, 2024
Motivational interviewing is a powerful tool for social workers to help clients change behaviors. It's all about working together, not lecturing. By using specific communication skills and understanding the stages of change, social workers can guide clients to find their own motivation.
This approach fits perfectly with social work's focus on empowering individuals. It respects client autonomy while providing support. By mastering these techniques, social workers can be more effective in helping clients overcome challenges and achieve their goals.
Motivational Interviewing Techniques
Core Principles and Approach
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Motivational interviewing functions as a collaborative, person-centered counseling method
Aims to elicit and strengthen an individual's motivation for change
Emphasizes exploring and resolving about behavior change
Employs a guiding rather than directing style of communication
Helps clients identify their own reasons and capacity for change
OARS Communication Skills
OARS represents four key skills used in motivational interviewing
encourage deeper exploration of thoughts and feelings
"What concerns you most about your current situation?"
"How would you like things to be different?"
validate client strengths, efforts, and positive behaviors
"I appreciate your honesty in sharing that difficult experience"
"You've shown great resilience in facing these challenges"
involves restating or paraphrasing client statements
Demonstrates understanding and encourages further elaboration
"It sounds like you're feeling frustrated with your progress"
synthesizes key points discussed during the session
Highlights important themes and reinforces
"Let me make sure I understand what we've covered so far..."
Eliciting and Responding to Change Talk
Change talk refers to client statements indicating desire, ability, reasons, or need to change
Practitioners listen for and selectively reinforce change talk
Types of change talk include:
(I want to, I wish)
(I can, I could)
(It would be better if)
(I have to, I need to)
Responding to change talk involves reflecting, affirming, and exploring further
Resistance manifests as arguments, interrupting, denying, or ignoring
Practitioners roll with resistance rather than confronting it directly
Strategies for addressing resistance include:
Reflecting the resistance without judgment
Shifting focus to a less contentious topic
Reframing the resistance in a new light
Stages and Factors in Behavior Change
Transtheoretical Model of Change
Stages of change model describes the process individuals go through when modifying behavior
stage involves no intention to change in the foreseeable future
stage includes awareness of a problem and consideration of change
stage involves intention to take in the near future
Action stage entails actively modifying behavior, experiences, or environment
stage focuses on preventing relapse and consolidating gains
Interventions tailored to each stage can facilitate progress through the change process
Psychological Factors Influencing Change
Ambivalence represents simultaneous and contradictory attitudes toward change
Occurs when individuals have both reasons to change and reasons to maintain current behavior
Exploring and resolving ambivalence forms a key part of motivational interviewing
refers to an individual's belief in their ability to succeed in specific situations
Influences choice of activities, effort expended, and persistence in face of obstacles
Can be enhanced through mastery experiences, vicarious experiences, and verbal persuasion
weighs the pros and cons of changing behavior
Involves assessing perceived benefits and costs of current behavior versus change
Shifting the balance toward change can increase motivation and commitment
Strategies for Promoting Change
Behavioral Activation Techniques
Behavioral activation increases engagement in rewarding activities
Aims to counter patterns of avoidance, withdrawal, or inactivity
Process involves:
Identifying valued activities and goals
Scheduling and tracking enjoyable or meaningful activities
Gradually increasing activity levels
Monitoring mood in relation to activity engagement
Can be particularly effective for addressing depression and anxiety
Helps break cycles of negative reinforcement and promotes positive experiences
Effective Goal Setting Approaches
Goal setting provides direction and motivation for behavior change
SMART criteria guide the creation of effective goals:
Specific: Clearly defined and unambiguous
Measurable: Includes concrete criteria for tracking progress
Achievable: Realistic and attainable given current resources
Relevant: Aligns with broader objectives and values
Time-bound: Has a defined timeline or deadline
Breaking larger goals into smaller, manageable steps enhances success
Regular review and adjustment of goals maintains motivation and relevance
Celebrating progress and achievements reinforces positive behavior change