Abstract
Motivational interviewing (MI), or collaborative conversations that strengthens clients’ motivation and commitment to change (Miller & Rollnick, 2013), is an empirically supported treatment method to address a spectrum of challenges relevant to social workers and clients (Cummings, Cooper, & Cassie, 2009; Lundahl, Kunz, Brownell, Tollefson, & Burke, 2010). Built upon an extensive foundation of empirical research, the Third edition of Motivational Interviewing: Helping People Change contains significant adaptations with almost all new writing. This highly accessible and complete explication of MI integrates the burgeoning empirical research that has appeared since its last edition and describes its four broad “processes”—including engaging, focusing, evoking, and planning—instead of the “phases” and “principles” of prior editions. Despite reorganization, Motivational Interviewing continues its commitment to delineate the process of building collaborative partnerships with clients, honoring and evoking their motivations for change, and accepting their autonomy to select goals and make decisions for change. Miller and Rollnick describe MI as a partnership with clients with the spirit of profound acceptance to evoke the energy for change already present within clients. MI is relevant for a wide array of clinical scenarios and is thought to be particularly useful for clients who may be ambivalent about making changes in the therapeutic process, such as those compelled to mandatory treatment.
This comprehensive resource includes seven parts, which focus on describing MI, its core processes (engaging, focusing, evoking, and planning), the application of the method, and its evaluation through the use of empirical research. A total of 28 chapters are organized within their respective parts, each with clear headings signifying central concepts and key points summarizing the major theses of each chapter. Motivational Interviewing reads in a logical yet organic way with its broad overview and universal processes gaining more specificity, as it focuses on specific applications for different problems, populations, and treatment modalities. Its short and concise chapters partition the extensive knowledge into palatable parts, and the book may be read as a whole or referenced for its distinct components.
Part I provides the context of MI, describing conversations about change, the spirit of MI, and its method. This part delineates the treatment’s hallmark, “conversations about change,” as well as the continuum of therapeutic styles and common pitfalls that helping professionals succumb to, including the “righting reflex.” Engaging is described extensively in Part II with in-depth coverage of engagement and disengagement, listening, core interview skills, and the exploration of values and goals. Listening and types of reflection are covered with the central skills of Open questions, Affirming, Reflecting, and Summarizing (OARS) described in detail. Focusing and finding direction on the horizon of potential goals are next described on Part III with an explanation of how to appropriately exchange information in the client relationship. Focusing enables the selection and maintenance of direction across the spectrum of clinical scenarios with an ethical commitment to honoring client self-determination of goals.
Evoking is analyzed in Part IV, with chapters on ambivalence, evoking motivation, hope, and confidence, change talk and sustain talk, developing discrepancy, and counseling styles. Part V, planning, describes the delicate movement from evocation to planning, with a description of the development of a change plan, strengthening commitment, and supporting change. Experiencing, learning, applying, and integrating MI in everyday practice is described in Part VI. MI is discussed with research on its support along a diverse array of treatment modalities, including telephone and televideo, group counseling, text formats, family consultations, and combinations with other treatments. Finally, an extensive research body is martialed to document the evolution of MI in Part VII, with methods to evaluate motivational conversations.
Motivational Interviewing is incredibly relevant to social work practice, with its application to substance abuse treatment, where it first began, and beyond. A distinct contribution of this book is its focused attention on how a helper’s intention to assist a client can lead to counterproductive and directive styles along with ways to counteract these pitfalls and work “with” clients. The book provides tangible ways to work with ambivalence about change, which may often be labeled as “resistance” in helping relationships. The book exceptionally navigates the intricate terrain of change talk, steering social workers away from the common barriers to engagement. Succinct information and acronyms, such as OARS, make the method highly accessible to social workers in practice. Practical tools, such as the value card sort and agenda mapping, as well as theoretical rationale for its methods make MI a valuable contribution to social work knowledge development and practice. With the ever-increasingly diverse context of social work practice, applications of MI across cultures appear to be promising; more resources and research highlighting cultural considerations will be an important extension of this work.
In sum, Motivational Interviewing is a beautifully written and well-organized resource for social work practitioners, educators, researchers, and students. It offers the conceptual basis, practical strategies, and research supporting the use of MI while providing a complete explication of its application across multiple contexts. One need go no further than Miller and Rollnick’s book for an exceptional foundation in MI; it is an exceptional and complete resource and reference on MI in social work across its varied contexts.