Motivational Interviewing in Social Work Practice Assignment

Assignment Task

Motivational interviewing 

In the early 1980’s, Miller proposed Motivational Interviewing (MI) as an alternate approach rather than direct persuasion for facilitating behaviour change. The conceptualization of MI evolved and developed from Miller’s work of treating Alcohol abuse with the assistance of his colleague Dr Stephan Rollnick in 1991 (Miller & Rollnick,1991). MI has been described as a directive ‘client-centred approach’ enhancing intrinsic motivation to elicit behaviour change by helping clients explore and resolve ambivalence (Rollnick & Miller, 1995). An empathetic counsellor who listens, minimizes resistance, and increases motivation for change (Miller,1983). Practitioners support people through behaviour change by creating a non-judgemental, supportive, and directive environment to explore one’s motivation, readiness, confidence, and ambivalence to change. (Rollnick & Miller, 1995). The intention of assessing motivation, readiness and confidence levels for change allows the practitioner to tailor the intervention accurately to the client's stage of change at any given moment. The approach is constructed in a way where it treats the clients as a responsible adult, capable of making responsible decisions and coming to the right solutions.

MI is done through the four processes of MI including planning, evoking, focusing and engaging. Engagement is a key element as it establishes a constructive working relationship, to build and strengthen the practitioner and client. Engagement with clients is important for positive outcomes (Moyers & Miller, 2013). Through engagement, social workers set the tone through MI spirit of acceptance, collaboration, empathy, autonomy support and evocation, affirmation and summaries. The spirit of MI is conveyed through knowing your clients and their current situations, concerns, hopes and values. Social workers and other professionals believe MI is a client-centred skills but a key aspect is recognising the importance of guiding clients by evoking change talk (Miller & Moyers, 2017). Change talk must have a focus or target behaviour. the aspect of focusing allows an agenda or a goal of the conversation between the practitioner and clients. Social workers then begin with evoking change talk with clients, asking about ‘the whys of change, reasons, and abilities to change. The aim is to allow the clients to discuss their motivations for change and to reflect upon their answers (self-perception theory). Through evoking change talk with clients, the clients will talk themselves into changing (Miller & Rollnick, 2013). The last process is planning, where the question moves from “why” to “how” (Resnicow, McMaster, & Rollnick, 2012). Clients that engage in planning will utilise language that describes commitment, “I think am ready”. Then social workers encourage clients to plan the steps they think are appropriate. Social workers then may add their ideas after the client's ideas have been exhausted with permission to share other thoughts (self-determination theory).

• Assumptions 
• Principles and techniques in MI 

Motivational Interviewing in Social Work

Motivational interviewing skills allow the practitioner to break through to clients who are resistant, uncertain and doubtful to change.

• Empathy is critical in a therapeutic relationship Davis, Ancis, & Ashby, 2014; Miller & Rose, 2009; Moyers & Miller, 2013
• In MI the relationship between the practitioner and client is based upon the Rogerian principles of being client-centred where practitioners demonstrate acceptance and an empathetic understanding (Moyers,2014)
• Explore various outcomes choices with clients with the intention of not influencing them.
• The NASW Code of Ethicsc(2017) lists human relationships as a value along with ethical principle that social workers must prioritise the relationship with clients as it is an important vehicle for change.

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