Promoting Behavior Changes through Motivational Interviewing

Naima Cozier, a JSI Senior Consultant, answers questions about motivational interviewing—a style of interviewing she was recently trained in and has been incorporating in her work on projects such as Healthy Start. Motivational interviewing is a communication style that is focused on the concept that individuals have their own autonomy and they determine if, when, and how they will change their own behavior. The approach is collaborative and goal-oriented. It is about change within an atmosphere of acceptance and compassion between the participant and the practitioner.

How is motivational interviewing different than traditional counseling?

There are elements of traditional counseling in motivational interviewing. However, in traditional counseling, the objective is to identify the problem and create a plan to fix it, while in motivational interviewing, having a plan is not the most important factor.

Behavior change is difficult; motivational interviewing helps work with people who struggle with change and are resistant to it. People make their own decisions and with motivational interviewing, participants identify and do what is feasible for themselves as they set the pace. They also decide how much they want to push and challenge themselves.

How do you decide if this is a good method to use with an individual?

Motivational interviewing is not for everyone and is just one option to support behavior change. According to the Transtheoretical Model,1 individuals can be at various levels of readiness when it comes to behavior change (i.e., precontemplation, contemplation, preparation, action, or maintenance). There is also a sixth stage, which is a relapse. However, just because an individual relapses, it is not assumed that they go back to stage one of precontemplation. Motivational interviewing is most effective for individuals in the precontemplation and contemplation stages because, at those early stages, we are not as receptive to being told what to do and may even feel stuck.

How effective have you seen this method?

I have personally seen this method to be effective through volunteering with a harm reduction organization that works with active drug users. It allows the counselor or motivational interviewing practitioner to meet clients where they are with their behavior change and present multiple options. It also acknowledges that behavior change is difficult for everyone and is something you have to continually work on even when you achieve your goal and reach the action stage of change.

What are some JSI projects that are using this method?

JSI’s Supporting Healthy Start Performance Project provides support to Healthy Start grantees to ensure program effectiveness in reducing infant mortality and health disparities and improving perinatal health outcomes. One of the initiatives of this project is to provide community workshops. Motivational interviewing was one of the trainings offered to Healthy Start grantees. My colleague, Juli Powers and I were trained on motivational interviewing by Jim Sacco, who is a member of the Motivational Interviewing Network of Trainers (MINT) and was trained by the founders of motivational interviewing. We began by observing his training and working with him to tailor his curriculum to the Healthy Start project. As we co-trained with Sacco, we began piloting our training. Later, he observed us doing it on our own and provided feedback. The training took a couple of months, but now Juli and I have successfully trained the Healthy Start grantees.

JSI is also working with the Centers for Disease Control and Prevention (CDC) to provide capacity building assistance to community-based organizations across the U.S. to support CDC’s high-impact approach to HIV prevention for populations who need it most. Through this project, we also offer motivational interviewing training, tailored from the Healthy Start curriculum, to help organizations meet their HIV prevention goals. Overall, I have witnessed motivational interviewing as an effective tool that can help promote behavior change.

1 Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change: Applications to the addictive behaviors. American Psychologist, 47, 1102-1114. PMID: 1329589.

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