Please review the original and current MI principles.

Question

What will be an ideal response?

Answer 1

Originally, Miller and Rollnick (1991) discussed five principles of Motivational Interviewing. These were not actually techniques but rather represented a philosophy via which MI was conducted. Principle 1 was to avoid argumentation, as such confrontation only enhances client resistance. Principle 2 was to roll with resistance. Here, resistance is not directly confronted but rather “rolled with,” in that the resistance is discussed while valuing the client’s perspective on the matter. This approach to resistance led to new perspectives on the issue while also demonstrating counselor empathy. Principle 3 was expressing empathy. The creation of a welcoming and understanding environment with unconditional acceptance assists the client to uncover personal reasons for desiring a behavioral change. Principle 4 was developing discrepancy and was based on Festinger’s theory of cognitive dissonance (Miller &Rollnick, 1991) where individuals experience dissonance when behaviors, values, and goals do not line up or move in the same direction. Dissonance is reduced, and motivation is enhanced, when a greater degree of consistency develops between what is desired by the client and the client behaviors that support this goal. Principle 5 was the support of self-efficacy. MI reinforces hope and optimism, and helps the client believe the targeted behavioral change is indeed possible.
However, the principles of MI have evolved since the onset of these principles over two decades ago. Recent discussions of the MI principles utilize the acronym RULE (Rollnick, 2010), which stands for: Resisting the righting reflex—Clinicians cannot make right what is going wrong in the client’s life; Understanding the client’s own motivations—For any behavioral change to work, the desire for such change needs to intrinsically come from the client; Listen with empathy, which remains a defining characteristic of MI as well as any other counseling theory; and Empower the client—Basically, the counselor must support and nurture the client’s sense of self-efficacy.