Talk:Motivational interviewing

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Applications?

I just noticed the new additions to the "applications" section and am confused by the inclusion of co-occurring disorders and homeless services. MI is an approach appropriate to discussions of behavior change, which is why substance abuse, adherence to treatment in chronic illness, and health coaching were there before. Gambling is a great example, and why I'm not questioning its inclusion. In co-occurring disorders, the MI components of a patient-practitioner conversation would be changing substance use behavior and adherence to treatment for the mental illness - both of which were already covered. In services to homeless individuals, one would assume that the target behaviors would be similar (adherence to treatment of chronic conditions, substance use, etc.). Why include these separately?Cknoepke (talk) 14:31, 6 September 2011 (UTC)[reply]

Examples of techniques

The article seems to focus on the philosophy more than the techniques of MI. I've just created Decisional balance sheet to explain one example of a technique. Anyone want to work with me on developing more examples of techniques?--Peter cohen (talk) 18:22, 9 December 2011 (UTC)[reply]

I would support that. We should be careful to make sure that the techniques described are in-keeping with MI and it's philosophy (as there are a lot of techniques/therapies out there that use the term "motivational interviewing" without actually utilizing the same principles), however. Decisional balance is a great one to have since it is discussed in a lot of the MI literature and fits rather neatly into the philosophy. Some others that might be useful to incorporate include the "Typical Day Exercise", "Agenda Setting", "Readiness/Confidence/Importance Ruler", etc. Cknoepke (talk) 22:00, 12 December 2011 (UTC)[reply]

The ruler was certainly something I used in my practice, though not as much as the decisional balance. One of my colleagues was very keen on the miracle question which I am sure is mentioned somewhere in the second edition of Miller and Rollnick though I can't find in the index. We should really have an article on that as it's also popuplar in family therapy. Another technique which isn't specifically MI but can be used to elicit motivations is the drink diary which with extra fields can find some of the typical day type things and do more than count units. We've got articles on some therapeutic diaries such as sleep diary. I'll have a think on how to organise these and see what I have the references for.--Peter cohen (talk) 23:08, 12 December 2011 (UTC)[reply]

.

Thank you for doing that research/legwork. A lot of the things you mention are good therapeutic techniques, but might not fall directly into MI in a strict sense. The miracle question is popular in a lot of mixed cognitive therapies and it certainly gets used by people who are "doing" motivational interviewing, but I'm not surprised to hear that it's difficult to find in Miller et Al.'s work. Drinking diary is a popular notion in a lot of harm reduction-type interventions, including Miller's own "Drinker's Check Up" - so it's hard to define what aspects of it are strictly "MI" (especially if you define MI as an interpersonal discursive philosophy, in which the journaling/drink tracking is really only an exercise used to start conversation and raise awareness in the course of developing discrepancy). Good on you to look, though, as I'm interested to see if/where you find anything.

You and I are taking on a bit of a challenge, I think, as describing MI practices is more difficult than you would think. One of the central components of any good MI training is that it is more of a "way of being" or a philosophy of practice than a set of intructable activities (hence the philosophy-heavy nature of the article as it existed before). It is indeed possible to do these exercises with clients without being MI-adherent, but it is also possible to be MI-adherent without doing any of these at all. I don't know if that last point helps, but I think it's good to keep in mind as we work on this. Thanks again.Cknoepke (talk) 16:00, 16 December 2011 (UTC)[reply]