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Eating Disorder & Addiction Specialists Counselling for addictions, eating disorders & compulsive behaviour
Chelsea & Harley Street, central London

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How sure are you about change?

This is the question at the heart of motivational interviewing, an approach to counselling focused on identifying, examining, and resolving ambivalence towards changing behaviour.

Motivational interviewing is a “person-centred” form of therapy. This means that it seeks to facilitate a client’s self-actualising tendency through acceptance and empathic understanding.


A complete guide to motivational interviewing

The central principle of motivational interviewing is that “motivation to change should be elicited from people, not imposed on them”. To achieve this, therapists follow four guiding principles: resist the righting reflex; understand the patient's own motivations; listen with empathy; and empower the patient.



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Resist the righting reflex

Among therapists, there is often an urge to give patients advice about the best path or to “right them”. However, while this can undoubtedly have its benefits, it can also produce the opposite effect: the client feels compelled to remain as they are rather than seeking change. An example is where a mother tells her child to do a puzzle in a certain way to complete the picture. Although the puzzle itself is complete, the mother has inadvertently inhibited the learning of the child to solve the problem for themselves.

In motivational interviewing, on the other hand, therapists hold back from the initial righting reflex so that they can explore the client’s own motivations for change. This addresses the ambivalence that clients may feel towards change because it doesn’t fall too heavily on one side of the arguments put forth.

For instance, if a client said they wished to stop smoking but had tried everything to no avail, it would be better for the therapist to focus more on the desired behaviour and skillfully support the client in talking about their reasons to change than to give multiple reasons as to why quitting smoking was a good idea.


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Understand your patient's motivations

This is usually done by considering the client’s interests, concerns, and values with the right degree of curiosity. Doing so can provide a clearer picture of the client, while allowing them to effectively overcome barriers to change.

Listen with empathy

Good listening skills are a fundamental part of motivational interviewing. Above all, they can allow the therapist to understand what motivates the patient. However, good listening skills don’t just mean letting the client speak. They involve taking an empathic approach, often known as “reflective listening”.

Reflective listening starts with an interest in what the client has to say and expresses an obvious desire to understand how the client thinks. The opposite of this is when the therapist becomes trapped in an interrogation of the client, asking question after question with little or no reflection.

As a general rule, a motivational interviewing session should be split 50:50 between listening and talking.


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Empower your patient

When clients become active collaborators in their treatment, outcomes tend to be considerably better.

For this to occur, it’s important for therapists to empower their clients by exploring their own ideas about how they can make changes. They may draw on the client’s personal knowledge about what’s worked before.

Importantly, the client must understand that they are in control of their actions and any desire for change requires them to take the necessary steps.


Find Out More

With the right expertise, motivational interviewing can be a highly effective approach to counselling for a range of addictions, including alcohol, drugs, gambling, and smoking. It is a useful tool because it allows clients to identify the thoughts and feelings that lead to unhealthy or unwanted behaviours. It can also help them form new thought patterns that make changing behaviours easier or even possible.

Thanks to years of experience, we can apply motivational interviewing to produce the best outcomes for our clients. Book a session with one of our trained therapists today.


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