Toward a Theory of Motivational Interviewing

• Published in: The American psychologist Vol. 64; no. 6; pp. 527 - 537
• Main Authors: Miller, William R, Rose, Gary S
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-09-2009
• Subjects: Alcoholism - therapy; Behavior Change; Behavior Modification; Biological and medical sciences; Causal Models; Client Centered Therapy; Clinical psychology; Clinical training; Clinical trials; Convergence; Counseling - education; Counseling Techniques; Counselor Client Relationship; Drinking; Empathy; Human; Humans; Interviews; Medical sciences; Methodology; Miscellaneous; Models, Psychological; Motivation; Motivational Interviewing; Nondirective Counseling; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapies. Psychological and clinical counseling; Psychotherapy; Questioning; Reinforcement; Specification; Substance-Related Disorders - therapy; Theories; Therapist patient relationships; Therapist-Client relationships; Treatment Outcomes; Treatments; motivational interviewing; psychotherapy; client-centered; behavior change; theory; Motivational interviewing; Human; Treatment; Theory; Behavior change; Psychotherapy
• ISSN: 0003-066X; 1935-990X
• DOI: 10.1037/a0016830

The widely disseminated clinical method of motivational interviewing (MI) arose through a convergence of science and practice. Beyond a large base of clinical trials, advances have been made toward "looking under the hood" of MI to understand the underlying mechanisms by which it affects behavior change. Such specification of outcome-relevant aspects of practice is vital to theory development and can inform both treatment delivery and clinical training. An emergent theory of MI is proposed that emphasizes two specific active components: a relational component focused on empathy and the interpersonal spirit of MI, and a technical component involving the differential evocation and reinforcement of client change talk. A resulting causal chain model links therapist training, therapist and client responses during treatment sessions, and posttreatment outcomes.