Motivational Interviewing: 5 Stages of Change

Written by:

published on:

Updated on:

Contents:

Note: Your support drives Find-A-Therapist. We earn a commission if you purchase services through our ads.

Looking for a therapist?

Motivational interviewing is a conversational approach designed to help individuals resolve their ambivalence about change and enhance their intrinsic motivation toward personal growth.

This technique has its roots in the clinical setting, where it has been proven effective in promoting positive behavior changes, especially in the field of mental health and addiction recovery.

Central to its success is the ability to adapt the approach according to the individual’s stage of change, making the process more effective in guiding them toward a desired outcome.

Understanding Motivational Interviewing

MI Stages of Change

Motivational interviewing (MI) is a widely used counseling technique developed by psychologists William Miller and Stephen Rollnick.

This approach aims to guide individuals through the various stages of change by understanding their motivations and facilitating their self-exploration, ultimately empowering them to make healthier life choices and achieve their goals.

Collaborative Nature

The essence of motivational interviewing lies in its collaborative nature.

The therapist works alongside the client in a non-judgmental and empathic manner, allowing the individual to feel understood and supported.

This fosters a trusting relationship where clients feel comfortable discussing their thoughts, feelings, and behaviors.

Another important element of MI is embracing the client’s autonomy and respecting their own decision-making capabilities.

The therapist does not impose their own solutions but rather encourages the individual to explore various options and choose the path that best aligns with their values and aspirations.

Developing Discrepancy

One key aspect of the MI technique is the focus on developing discrepancy within the client, highlighting the gap between their current situation and desired goals.

This is done through the use of open-ended questions, reflective listening, and providing objective feedback, which allows the client to confront the consequences of their behavior and envision a more desirable future.

Settings

Stages of Motivational Interviewing

In practice, motivational interviewing can be utilized in various settings, such as education, healthcare, and addiction treatment.

Its flexible nature allows it to be adapted to diverse populations, from adolescents and adults to individuals with different cultural backgrounds.

The techniques and principles of MI have been proven effective in fostering positive change, encouraging self-awareness, and promoting personal growth.

Key Elements of Motivational Interviewing

Motivational interviewing is an effective, client-centered approach that aims to help individuals explore and resolve their ambivalence, ultimately leading to behavior change.

There are several key elements to motivational interviewing, including the spirit of MI, OARS, and the four processes.

Spirit of MI

The spirit of MI encompasses its underlying attitude and values. This includes collaboration, acceptance, compassion, and evocation.

ConceptDescription
CollaborationMI is a partnership between the client and the therapist.

It emphasizes working together to identify and explore the client’s goals and values rather than imposing solutions or advice.
AcceptanceAccepting clients as they are, without judgment, is crucial.

This creates an atmosphere of trust and openness, allowing clients to discuss their ambivalence and concerns honestly.
CompassionA fundamental aspect of the spirit of MI is the therapist’s empathetic and non-judgmental attitude.

Clients are more likely to open up and explore change when they feel understood and accepted.
EvocationMI respects the idea that clients have the capacity for change within themselves.

The therapist’s role is to evoke and strengthen the client’s own motivations, ideas, and solutions.

OARS

OARS is an acronym for the core skills in motivational interviewing: Open-ended questions, Affirmations, Reflective listening, and Summaries.

These techniques foster rapport, engagement, and collaboration between the practitioner and the client.

ConceptDescription
Open-ended questionsThese encourage clients to explore their feelings and thoughts, giving them an opportunity to express their perspectives without feeling constrained.
AffirmationsThese provide validation and support, acknowledging clients’ strengths and efforts.
Reflective listeningThis involves actively listening and providing accurate empathy, allowing the practitioner to understand the client’s concerns and experiences.
SummariesThese help organize and condense the client’s narrative, highlighting important journey aspects while promoting deeper exploration and understanding.

Four Processes

Stages of Change Motivational Interviewing

The four processes of motivational interviewing – Engaging, Focusing, Evoking, and Planning – guide the structure and progression of the interview.

ProcessDescription
EngagingEstablishing rapport and building trust with the client; essential for creating a comfortable space for open communication.
FocusingIdentifying the client’s areas of concern or the aspects of their life they wish to change; helps to set a direction for the conversation.
EvokingExploring the client’s motivation and reasons for change; this may involve discussing discrepancies between their current behavior and aspirations.
PlanningDeveloping a strategic plan for change together, while supporting the client’s autonomy and promoting self-efficacy.

Incorporating these key elements in a motivational interview enables practitioners to effectively engage with clients, address their concerns, and support them on their path to positive change.

5 Stages of Change in Motivational Interviewing

Motivational interviewing is a therapeutic approach that helps people move through the different stages of change and make positive life improvements.

The stages of change model in motivational interviewing is comprised of five key stages: Pre-contemplation, Contemplation, Preparation, Action, and Maintenance.

1. Pre-contemplation

In the Pre-contemplation stage, individuals may not yet acknowledge that there is a need for change.

They might be unaware of the consequences of their behavior, or they may be resistant to change.

During this stage, the therapist’s role is to raise awarenessdevelop a discrepancy between current behavior and desired outcomes, and gently challenge the individual’s thoughts and beliefs.

2. Contemplation

Stages of Motivational Interviewing

During the Contemplation stage, individuals become more aware of the potential benefits of change, but they may still be ambivalent or uncertain about whether they are ready to take action.

They might weigh the pros and cons of change and consider the potential costs and benefits.

The therapist must facilitate the exploration of ambivalence, help the individual identify potential barriers to change, and enhance their readiness to change.

3. Preparation

In the Preparation stage, individuals have made the decision to change and are actively exploring strategies and options for taking action.

They may set specific goals, create plans, or seek out resources to support their change process.

The therapist’s role is to help individuals clarify their goals, develop a realistic and achievable plan, and bolster their commitment to change.

4. Action

The Action stage involves the implementation of the chosen strategies and plans to facilitate change. Individuals actively engage in behavioral changes and work towards achieving their goals.

During this stage, the therapist provides ongoing supportencouragement, and guidance to help individuals overcome obstacles and maintain their commitment to change.

5. Maintenance

The Maintenance stage focuses on sustaining the positive changes made during the Action stage.

Individuals will continue to implement their strategies and plans while also monitoring for potential setbacks or relapses.

Therapists work with individuals to reinforce the importance of maintaining change, develop coping strategies to handle challenges, and identify potential trigger situations to prevent relapses.

Throughout the stages of change, motivational interviewing emphasizes the importance of change talk, which involves expressing the desire, ability, reasons, and need for change.

By recognizing and understanding these stages, therapists can better tailor their approach to support each individual’s unique change process.

Applications of Motivational Interviewing

Applications of Motivational Interviewing

Motivational interviewing (MI) is a therapeutic approach commonly used in the treatment of addiction, but its applications extend beyond substance use disorders.

Some applications of motivational interviewing include:

Health Behavior Change

MI is widely used in healthcare settings to facilitate behavior change related to health habits such as smoking cessation, weight management, medication adherence, and exercise promotion.

It helps individuals explore and resolve ambivalence about changing their behaviors by eliciting intrinsic motivation and enhancing their readiness for change.

Mental Health Treatment

MI techniques can be integrated into various mental health interventions to address issues such as depression, anxiety, bipolar disorder, and schizophrenia.

By focusing on clients’ intrinsic motivation and values, therapists can help them explore and resolve ambivalence about treatment adherence, symptom management, and lifestyle changes.

Chronic Disease Management

MI is effective in supporting individuals with chronic medical conditions, such as diabetes, hypertension, and heart disease, in making and sustaining health-related behavior changes.

It encourages collaboration between patients and healthcare providers to set achievable goals and develop strategies for managing their conditions effectively.

Counseling and Therapy

MI principles can enhance the effectiveness of counseling and psychotherapy across diverse populations and presenting concerns.

Therapists use MI techniques to engage clients in the therapeutic process, explore their goals and values, promote self-efficacy, and address resistance or ambivalence toward change.

Criminal Justice System

MI is increasingly utilized in the criminal justice system, including probation and parole settings, to address problematic behaviors, reduce recidivism, and promote desistance from criminal activities.

By fostering autonomy and self-reflection, MI helps individuals recognize the consequences of their actions and consider alternatives.

Parenting and Family Interventions

Motivational Interviewing Stages of Change

MI techniques can be applied in parenting education programs and family therapy to improve parent-child communication, promote positive parenting practices, and address family conflicts.

By exploring parents’ motivations and values, MI helps them identify and pursue strategies for nurturing healthy family relationships.

The Role of the Therapist

In motivational interviewing, a therapist plays a crucial role in guiding the client through the stages of change. The therapist adopts a client-centered approach, focusing on creating a strong working alliance with the client.

Therapists maintain a neutral and empathetic attitude by using open-ended questions, affirmations, reflective listening, and summaries.

They actively show that they understand and accept the client’s perspective, fostering an environment where the client is more likely to explore their ambivalence towards change.

One crucial aspect of the therapist’s role is to respect the client’s autonomy, allowing them to control the pace and direction of the conversation.

Rather than behaving as an expert, the therapist acknowledges the client as the expert of their life and guides them in discovering their own motivations for change.

A key objective of therapists in motivational interviewing is to evoke the client’s own reasons for change. They do this by drawing the client’s attention to their goals, values, and concerns, thereby increasing their intrinsic motivation for change.

The clinicians hone in on the client’s “change talk” – verbal signals that indicate a willingness to change – and work to amplify and solidify those expressions.

To find a motivational interviewing trained therapist, you can utilize various online directories such as Find-a-Therapist that list licensed and certified mental health professionals.

Frequently Asked Questions

Frequently Asked Questions

What techniques are used to address ambivalence in the stages of change?

There are several techniques used to address ambivalence in the stages of change.

Techniques include open-ended questionsreflective listening, and summarizing to help individuals resolve ambivalence and work through the change process.

These methods build rapport and trust while guiding them to make appropriate choices for personal growth and adaptation.

What are the key principles of motivational interviewing?

Motivational interviewing is based on five key principles that guide the therapeutic process.

These principles are:

  1. Expressing empathy through reflective listening.
  2. Developing discrepancy between the individual’s current behavior and their goals.
  3. Avoiding argumentation to prevent resistance.
  4. Rolling with resistance to maintain a supportive atmosphere.
  5. Supporting self-efficacy to build confidence in one’s ability to change.

These principles work together to create an environment that encourages people to move through the stages of change while overcoming barriers and ambivalence.

What is the goal of Motivational Interviewing within the Stages of Change model?

The primary goal is to help individuals move through the stages of change by resolving ambivalence and increasing intrinsic motivation for behavior change.

References

Apodaca, T. R., & Longabaugh, R. (2009). Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence. Addiction104(5), 705-715. Link.

Krebs, P., Norcross, J. C., Nicholson, J. M., & Prochaska, J. O. (2018). Stages of change and psychotherapy outcomes: A review and meta‐analysis. Journal of clinical psychology74(11), 1964-1979. Link.

Noonan, W. C., & Moyers, T. B. (1997). Motivational interviewing. Journal of Substance Misuse2(1), 8-16. Link.

Zimmerman, G. L., Olsen, C. G., & Bosworth, M. F. (2000). A ‘stages of change’approach to helping patients change behavior. American family physician61(5), 1409-1416. Link.

Additional Resources

Prioritizing our mental well-being is paramount in today’s fast-paced world. The digital age has redefined therapy and psychiatric care, making support more accessible than ever. To guide you towards a healthier state of mind, we’ve partnered with pioneering names in mental health.
Note: We collaborate with top-tier mental health companies and we earn a commission if you purchase services through our ads.

Online Therapy

Discover a path to emotional well-being with BetterHelp – your partner in convenient and affordable online therapy. With a vast network of 30,000+ licensed therapists, they’re committed to helping you find the one to support your needs. Take advantage of their Free Online Assessment, and connect with a therapist who truly understands you. Begin your journey today.

Relationship Counceling

Whether you’re facing communication challenges, trust issues, or simply seeking to strengthen your connection, ReGain’s experienced therapists are here to guide you and your partner toward a healthier, happier connection from the comfort of your own space. Get started.

Therapist Directory

Discover the perfect therapist who aligns with your goals and preferences, allowing you to take charge of your mental health. Whether you’re searching for a specialist based on your unique needs, experience level, insurance coverage, budget, or location, our user-friendly platform has you covered. Search here.

About the author

Eliana Galindo
Eliana is a dedicated psychologist from Colombia who has gained extensive experience and made significant contributions in child development, clinical psychology, and rehabilitation psychology.Her work as a rehabilitation psychologist with disabled children has been transformative and compassionate. In the child development field, she creates nurturing environments through assessments, interventions, and collaboration with families.In clinical psychology, she supports individuals overcoming mental health challenges with empathy and evidence-based approaches. Inspired by her experiences, Eliana is motivated to write about mental health, aiming to raise awareness and advocate for a compassionate and inclusive approach to well-being.

You might also be interested in

Disclaimers

In some articles, we include products we think are useful for our readers. When you buy through these links on our site, we may earn an affiliate commission at no cost to you.

Information on our website is for educational and informational purposes only. You should not rely on this information as a substitute, nor does it replace professional medical advice, diagnosis, or treatment.

If you have any concerns or questions about your health, you should always consult with a mental healthcare professional.

If you need an immediate assistance:

Medical Emergency (US) – 911
Medical Emergency (Global) – 112
Suicide & Crisis Lifeline – 988
Full List of Emergency Resources 

Online Therapy, Your Way

Discover the ease of starting therapy with BetterHelp. Complete the assessment and connect with a licensed professional therapist online.
Note: We earn a commission if you purchase services through our ads.