The Psychiatrist's Guide to Motivational Interviewing

Motivational interviewing (MI) is a technique that can be used to inspire patients who have virtually any level of enthusiasm for change, from almost none to nearly enough, to move toward improvements that can make their life better. The driving goal in MI is to move the patient from a position of complacency to one of more ambivalence about their particular version of toxic habit and then on to a personal desire for change. The approach of MI is one of collaboration in which the psychiatrist seeks to evoke the patient's own recognition of the desirability of change. The technique of the decisional balance sheet to lay out both sides of a patient's ambivalence will be exemplified, using alcohol dependence as one example. The stages of treatment are discussed, with associated interventions that reflect the patients' locations in their journeys toward change.