This article discusses current and potential uses for motivational interviewing in rehabilitation counseling. Motivational interviewing is an evidence-based practice that addresses consumer motivation, reluctance, and barriers to change.
Motivational interviewing and rehabilitation counseling are both based on the assumption that ambivalence, or difficulty making decisions, is normal and can be resolved through a shared and supportive counseling process. Counselors and consumers work together to help the consumer identify their own hopes and strengths, and to decide what they want for themselves. Together, the counselor and consumer set achievable goals and cultivate the consumer’s self-reliance and independence. The counseling process builds consumers’ confidence by providing them with information and supporting them to develop problem-solving and decision-making skills. This research highlights that:
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Motivational Interviewing and Decision-making
- Support consumers to choose between options.
- Keep an open mind about the rationale behind consumer behaviors. View them as predictable, moldable, and situationally responsive.
- View options from the consumer’s point of view, recognize their values, and focus on positive traits.
The Four Principles of Motivational Interviewing
- Remain empathetic—put yourself in the consumer’s shoes–to provide a safe environment for decision-making.
- Build trust by expressing understanding and acceptance. This enables consumers to explore their own resistance to change, be vulnerable, and take risks.
- Point out ways that their effective behavior choices are helping them achieve their goals.
- Support consumer efforts toward building confidence, achieving goals, and celebrating milestones to change.
Remember “OARS” to Develop Good Counseling Relationships
- Open-ended questions help clients come to their own conclusions about change.
- Affirmations reinforce the consumer’s subjective experiences, values, and points-of-view.
- Reflections on the part of the counselor help maintain a consumer-centered focus on behavior changes.
- Summarizing is a reflective listening method the counselor uses to make sure both parties are on the same page regarding goal-setting, and decision-making.
More About the Research
This research clarifies the similarities between vocational rehabilitation counseling and motivational interviewing. Motivational interviewing is an effective tool for addressing issues and achieving positive outcomes. The motivational interviewing process guides consumers through the five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Motivational interviewing has been proven to be effective in resolving addictive behaviors, facilitating health behavior change, treating psychiatric/mental health issues, and helping with vocational issues.
Wagner, C. C. & McMahon, B. T. (2004). Motivational Interviewing and Rehabilitation Counseling Practice. Rehabilitation Counseling Bulletin, 47(3), 152–161.
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