The Ethics of Motivational Interviewing

Do you ever feel like Motivational Interviewing can border on manipulation?

A while back, I received a text from a colleague about concerns over the use of MI. I immediately gave her a call, curious what she is hearing.

Essentially, when it came down to it, the concern was coming from utilizing MI without the spirit. 

Here’s an example that came up in a training I provided.

I was training a cohort of veterans who were now working in peer support roles, several of whom had worked as interrogators in the military. As they learned about MI OARS skills and methods for evoking change talked, several commented that MI was a lot like interrogations.

Wait, WHAT?!

I had to get curious here, because that’s not how I view MI!

But when you apply the spirit of MI to the OARS and methods for evoking change talk, MI is about working in the best interest of the client, not us.

The nature of interrogating is the reverse- we are asking questions and using methods to gain information for our purposes. Using Motivational Interviewing, we are ALWAYS working in the best interest of the client. 

The spirit of MI is foundational to staying in an ethical territory. 

What does this mean?

MI spirit means that the attitude that we approach our clients comes from a place of:

1. Compassion. Everything we do is in the best interest of the client. We approach clients with unconditional positive regard.
2. Acceptance. This means that we believe in the absolute worth of every individual, we honor their autonomy, we affirm and support the growth of their strengths, and we do our very best to practice empathy. This means striving to see the world through their lens, not ours. It means being aware of how our values and beliefs (and biases) muck up empathy and can taint the process of supporting our clients.
3. Evocation. This means we don’t assume we know. We learn about the client from the client, we get curious and draw forth their motivation for change (not our motivation for them). We elicit their ideas for how to change, & we evoke their values and beliefs. Practice humility. Or, as MI trainer Allan Zuckoff beautifully summed up, we strive to “Come from below rather than from above.”
4. Partnership. This means we recognize we are not the expert in our clients’ lives– they are! Our goal is to partner with them, & collaborate on the goals that they want to work toward. Again, respecting and honoring their strengths, expertise, and autonomy in the process. We can be partners in the change process, not the authority. Change is up to them, after all!

Utilizing Motivational Interviewing techniques without the spirit is risky territory, and is most certainly not practicing MI!

Using OARS skills and methods to cultivate change talk from clients without these spirit elements isn’t MI.

You can’t have Motivational Interviewing without the spirit. 

Motivational Interviewing Tip of the Week: If we wander into the territory of trying to get people to do what we want them to do, we have stepped out of Motivational Interviewing. It’s not MI without the spirit! What will bring you back into compassion, acceptance, evocation, and partnership with your clients?

 
Watch my full video here!