Tip #128 The Spirit of Motivational Interviewing

The specific skills we employ in our sessions allow us to effectively guide our clients toward positive health behavior changes. Most of these Tips are devoted to strategies and skills.

In the right light, at the right time,
everything is extraordinary.

Aaron Rose 

There are two ways of spreading light;
to be the candle or the mirror that reflects it.

Edith Wharton

Our way of being or our stance with clients also affects our ability to guide them toward a sustainable healthy lifestyle. Here we look at the overall spirit that pervades the most effective client interactions. This is the spirit of motivational interviewing as described in the most recent edition of Miller and Rollnick’s MI textbook (“Motivational Interviewing: Helping People Change,” Third Edition, The Guilford Press: 2013).

The spirit of MI is captured in four terms:

  • Partnership
  • Acceptance
  • Compassion
  • Evocation

Partnership implies working together, working with and for the client. The old model of being the expert and telling the client what is best for her is one of the things we leave behind when we learn MI. We partner with our client to find the ways that she will uniquely walk down the path toward true health. We have information and advice that may be useful to the client. Our expertise is secondary to what the client knows about herself and to the process she will go through on her journey.

To understand acceptance, it can be further broken down:

Worth: A key tenant of MI is a rock-solid belief that the client has value and worth just for being alive. In nutrition counseling this includes that the worth is not tied to weight or lab values.

Empathy: This means accurately “getting” our client, truly seeing her world as she sees it. This part may be a challenge if much of what we hear is rooted in myths or fears. We can work to carefully hear how the client sees the world while also evoking deeper yearnings that come from a broader concept of health.

Autonomy: This means accepting that all people have a right and ability to direct their own lives, make their own choices. Our clients can and will choose the path that seems right to them. If we attempt to force our view and beliefs on them, we will ultimately fail. This includes trying to force a specific way of eating.

Affirmation means intentionally choosing to focus on what is right and what is working. Adopting a strengths perspective is both respectful of our clients and most effective. It assumes that much of what a client is already doing is health-promoting and it encourages us to build on what is working already to guide the client toward health and self-esteem.

Compassion is not sympathy. It is being and acting fully for the benefit of the other person. We focus on the best interests of our clients, setting aside our interests. It takes into account the full person and all her best interests.

Evocation speaks to both the spirit with which we engage with a client as well as the process. An evocative spirit implies that the majority of the answers are in the client, not in us. By our words and actions we say to our clients that they have what is needed to move toward greater health and that together we will find it.

Posted in Tips