Miller - Motivational Interviewing for Addictions

Question 1

Miller mentions four main components (?) of motivational interviewing, which are these + brief explanation?

Answer 1

1. Engaging - Understand client experience/perspective, establishing trust and a working relationship (also helps with having the client return)
2. Focusing - Exploring what changes people are willing to consider and then developing agreed-upon goals (of course, concerns should be brought up)
3. Evoking - Eliciting the client’s own reasons for change
4. Planning

Question 2

Within the four components of motivational interviewing, what are challenges/issues within each?

Miller

Answer 2

1. Engaging - Often overlooked, which is problematic considering it is important for returning clients
2. Focusing - Reactance & generally raising sensitive topics that the client did not expect may elicit the former
3. Evoking - Pushing for change/skipping to planning + decisional balance intervention (specifically in change ambivalent people)
4. Planning - Again, jumping into this too quickly + insufficient planning

Question 3

What is a decisional balance intervention? When is this problematic?

Answer 3

To ask/explore all pros and cons of substance use (and/or to change or not), problematic in ambivalent clients as this tends to decrease commitment to change