Motivational Interviewing to Activate Change in Ambivalent Clients: Is it Right for You?

Motivational Interviewing to Activate Change in Ambivalent Clients: Is it Right for You?

Motivational Interviewing (MI): A Timely Topic

Nearly two and a half years have passed since CASAT OnDemand published its first blog post on February 16, 2018: So You Want to Be a Motivational Interviewing (MI) Trainer. That article was an exploration of the MI journey of Mary Minten, PhD, MFT, CST, LCADC, who shared her experiences in becoming a member of the Motivational Interviewing Network of Trainers (MINT). The post contains information about some of the client concerns for which MI is useful and some literature recommended by Dr. Minten for becoming familiar with MI and planning to pursue becoming a MINT trainer.

As a follow-up to that post, we invited Jennifer Hettema, PhD to write a guest blog with more details about becoming a “MINTie” in the article How Can a Professional Become a MINT Trainer? Dr. Hettema is an Associate Professor in the Department of Family and Community Medicine (DFCM) at the University of New Mexico and a MINT member. Information in this post includes training required to become a MINT trainer, insights into the formal application process, recommendations for a few things to do prior to applying, and some tips for increasing your chances of being accepted int the program.

Motivational Interviewing: The One Tool Every Behavioral Health Provider Needs was published on August 8, 2019 to provide a brief history of MI, a few statistics, the four main principles of MI, some of the empirical evidence of the effectiveness of MI, and MI resources. CASAT OnDemand Resources & Downloads contains additional MI resources and tools, and the Motivational Interviewing Learning Lab contains thousands of research articles, links to websites, training opportunities, and tools for those wanting to take a “deep dive” into the topic.

Why Use MI?

While research efforts for MI are ongoing to expand the knowledge base, there are already many reasons to use this counseling approach, among them the following:

  • MI is a versatile counseling approach. To date in 2020 alone there are 271 published journal articles about MI in the PubMed database of the National Library of Medicine. In addition to the many physical disease applications of MI, a few of the many behavioral health related topic areas already supported by existing research include:
    • Ethnic populations
    • Chronic pain
    • Addiction
    • Child welfare
    • Social anxiety
    • Smoking cessation
    • Suicidal ideation
    • ADHD management
    • Gambling disorder
  • MI is effective. “In a meta-analysis of 72 randomized clinical trials on the effectiveness of motivational interviewing in eliciting behavior change such as smoking cessation, weight loss, decreased alcohol use, and cholesterol level control, it was found that motivational interviewing had a significant and clinically relevant effect in modifying behaviors in approximately 75% of the studies, with an approximate equal effect on those with physiologic and psychologic diseases” (Rubak, et al., 2005).
  • MI can be used for a variety of ethnic groups. A systematic review of the literature found that with cultural acknowledgment as a part of the counseling process, MI was effective with most ethnic groups (Bahafzallah, et al., 2019).
  • MI can be used in both treatment and prevention settings. One recent experimental study for mental health prevention in a school setting documented “significant increases in behavioral and emotional functioning, self-efficacy to regulate behaviors, positive expectations for success, academic motivation, and grades in mathematics” for participants in the experimental condition of the study (Terry, et al., 2020).
  • MI can be used for a variety of age groups. MI has been studied for use with older adults at risk for dementia, and for rehabilitation of stroke patients (Han, et al., 2020; Chen, et al., 2020). MI has been used with elementary aged school children in disciplinary alternative education program settings (Ratanavivan & Ricard, 2020). Parent-child dyads with 3-4 years old children were provided with health education efforts combined with MI communication tools for prevention of dental caries that resulted in significantly greater reductions is plaque score in that group (Jiang, et al., 2020).

According to Psychology Today, “Motivational interviewing is a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes” (2020).

If you are looking for a counseling approach to help clients make the difficult decision to confidently enter treatment for a behavioral health disorder or substance use disorder, MI could be just what you are looking for. And if you are looking for training, CASAT Training has a 4-Week Live Online Webinar Series coming up. The series will run from August 28 – September 18, 2020, Every Friday from 12:00-3:00 pm PST. The presenter will be Mary Minten, PhD, MFT, CST, LCADC. This training opportunity will “introduce participants to the theory, spirit, four processes, and key strategies of Motivational Interviewing (MI). Particular attention will be paid to using MI basic skills and support clients in moving through the change process to identify and reach their goals. Participants will have several opportunities for practice and skills development through the use of role-plays, real-plays, and interactive group exercises. Video and live demonstrations will also be used to enhance the learning process. The training will be highly interactive and include several opportunities for practice.” For more information and to register, contact CASAT Training.

Additional MI Training Opportunities

CASAT Training:

Motivational Interviewing Changing the Conversation: Peers & CHWs on the Frontlines
Presented by:  Kate Speck, PhD MAC LADC – Self-Paced, Online Video

This 90-minute online video course is intended to support and strengthen the conversational skills of behavioral health peer support specialists and community helpers in the use of Motivational Interviewing. Peer specialists and community helpers are on the front lines in providing understanding and support for clients experiencing a variety of mental health and substance use disorders. The session will introduce the basic components of Motivational Interviewing, focus on helpful tools and resources to enhance conversations about change to and work through the difficulty of indecision about change.

Northwest ATTC:

New episode of the Talking to Change MI Podcast:
Episode 7: The Development, Future, and Practice of MI with Stephen Rollnick, PhD

Glenn Hinds and Sebastian Kaplan: In this episode, Stephen Rollnick, the co-founder of Motivational Interviewing, describes the development and future direction of MI and explores his journey with Bill Miller in translating MI from a world of specialist psychology to one of everyday practice.  Find this and previous episodes here!

Northwest ATTC:

Motivational Interviewing: Communication Skills to Support Patient-Centered Care

This training module for support staff includes PowerPoint slides and a trainer’s guide for delivering a 60-90-minute interactive presentation for support staff (i.e. front desk, schedulers) working in medical settings. The module introduces staff to the practice of Motivational Interviewing as a way to support patient-centered care and handle “challenging” patient interactions, and is intended to support MI implementation efforts in medical settings. Find out more here.

Pacific Southwest ATTC (PSATTC):

Motivational Interviewing – Into Practice Enhanced Professional Learning Series – Facilitators:

  • Paul Warren, LMSW
  • Kate Speck, PhD, MAC, LADC

Would you like to enhance your current knowledge and practice on how to effectively use Motivational Interviewing (MI)? This online Enhanced Professional Learning (EPL) interactive series will cover topics and provide interactive practice opportunities essential to the development and/or refinement of MI skills and relational style. Emphasis is placed on the “intentional use” of MI skills to identify a change goal, resolve ambivalence, and increase motivation for change.

– Weekly sessions offered on the same day and start time between July 30-September 24, 2020. Day and time will depend on your location. Click ‘REGISTER NOW’ below to view the full schedule for your specific location.
– Behavioral health, substance use disorders, and recovery service providers located in the Pacific Southwest ATTC region (HHS Region 9)

Participant Commitment & Expectations:

  • To be eligible to register for this series, applicants are required to first complete either (1) an Intro to MI live virtual or face-to-face training offered by the PSATTC or (2) the 4-hour, free self-paced, online course Tour of MI: An Interprofessional Road Map for Behavior Change and submit the electronic copy of your certificate of completion from either of these trainings during the registration process
  • Attend a 1-hour online Orientation
  • Commit to 8-weeks of live online training for 1.5 hours weekly
  • Complete weekly self-study learning activities
  • Access to appropriate technology to utilize videoconferencing platform (internet connection, webcam, laptop/tablet, speakers, and microphone)
  • Be prepared and actively engage during scheduled series time

– Space is limited to the first 40 registrants who will receive a grant-funded scholarship that covers the entire $350 cost of participation.
For questions, please contact the NFARtec Workwise Staff at or by phone at 775-784-6265 or 866-617-2816 (toll-free).

Nevada Primary Care Association:

Adolescent Focused Motivational Interviewing – Live Virtual MI Workshop:

This interactive 2-day workshop equips all levels of professionals to use MI strategies, improving youth risk identification, effective communication and evidence-based coaching toward positive, healthier decisions.

There are two 2-day options to participate (Choose one option below):

Is Motivational Interviewing in your toolkit? Share a success story about MI in the comments below!

Visit CASAT OnDemand Resources & Downloads and Learning Labs for more resources for Motivational Interviewing and other timely topics.


Bahafzallah, L., Hayden, K.A., Raffin Bouchal, S. et al. Motivational Interviewing in Ethnic Populations. J Immigrant Minority Health 22, 816–851 (2020).

Chen, H. M., Lee, H. L., Yang, F. C., Chiu, Y. W., & Chao, S. Y. (2020). Effectiveness of Motivational Interviewing in Regard to Activities of Daily Living and Motivation for Rehabilitation among Stroke Patients. International Journal of Environmental Research and Public Health, 17(8), 2755.

Han, A., Park, M., Kim, S., Hong, H., & Choi, E. (2020). The use of motivational interviewing during an interdisciplinary service-learning activity for older adults at risk for dementia. Gerontology & Geriatrics Education, 41(2), 206-218.

Jiang, S., McGrath, C., Lo, E. C., Ho, S. M., & Gao, X. (2020). Motivational interviewing to prevent early childhood caries: A randomized controlled trial. Journal of Dentistry, 103349.

Ratanavivan, W., & Ricard, R. J. (2020). Making positive changes counseling (MPCC) program: A creative adaptation of motivational interviewing for use with children in school settings. Journal of Creativity in Mental Health, 15(2), 162-175.

Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract 2005;55:305–12.

Terry, J.D., Weist, M.D., Strait, G.G. et al. Motivational Interviewing to Promote the Effectiveness of Selective Prevention: an Integrated School-Based Approach. Prev Sci (2020).

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