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Does Motivational Interviewing operationalise the helping relationship? - Oceania Mini Forum 2023

Motivational Interviewing Network of Trainers - Oceania Mini Forum, Melbourne 2023.


Does Motivational Interviewing operationalise the helping relationship?


This was the question I was left pondering after I recently attended the MINT-Oceania Mini Forum in Melbourne, after hearing Bill Miller speak about the upcoming changes in MI-4, the 4th edition of the MI text, due out in August this year (available for pre-order now at https://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781462552795).

Helping people change and grow. A reconceptualisation of MI in many respects perhaps, with a move away from just considering MI as a tool in our tool belt to be drawn upon when preparing people for change, engaging people into treatment, or helping people to resolve ambivalence about a particular target behaviour, with a broadening out of MI's application to maybe something more than that. Perhaps this is just catching up to how it is already applied by many of us who practice and teach MI.


MI as a way of being with people, in any helping capacity. MI as a way of doing everything else that you do.


It is now well documented that when “different” bona fide therapies are compared with each other, there is usually no clinically meaningful difference in client outcomes. Whereas therapists’ outcomes do vary significantly. Therapist factors account for far more variance in outcome than do treatment methods.


When we look at the clinical skills that matter, and compare them with MI, what do we see?

1. Accurate Empathy - Foundational in MI

2. Positive Regard - Affirmation is key in MI

3. Genuineness/Congruence - Not emphasised before 4th ed, but is included in 4th ed.

4. Acceptance - Key element of MI Spirit

5. Focus - Focusing is a key process in MI

6. Hope - In MI we evoke hope & support self-efficacy

7. Evocation - Evoking is a key process in MI

8. Offering Information and Advice - Included in MI


Is this what we have been studying the whole time in MI?


Perhaps MI is not meant to be done instead of other treatments. We know MI is now commonly combined with other treatments. Maybe MI can be a way of doing what ever else you do.


The factors that ‘bring an intervention to life’ are central in MI.


So my thoughts are that if we want to ensure good and effective practice, no matter the treatment approach or helping environment, we need to ensure our practitioners/helpers embody the factors that are necessary to make it so. If those factors are central to MI, then MI may operationalise the helping relationship. Developing competent MI practitioners appears an effective way to ensure good practice, no matter the helping environment or treatment method.


Cant wait to read to the 4th Edition of the text!



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