Along with widespread acceptance within the addictions community (both those with addictions and helping professionals), there are many misunderstandings and misconceptions about motivational interviewing -- a type of counseling in which empathy and a building up of confidence are used to change behaviors.
1. Motivational Interviewing Is Confrontational
It is not clear how the myth that motivational interviewing involves confronting clients with their behavior came about; perhaps it somehow got confused with the “intervention” approach, which does involve confronting people with addictions. However, this idea couldn’t be further from the truth.
Motivational interviewing is gentle and respectful, and focuses in the initial stages on building rapport and understanding what the addictive behavior is doing for the person. With this understanding, the therapist can work with the person to gain a fuller understanding of how his or her behavior may be affecting other parts of life. That can help the patient establish personal goals around change.
2. Motivational Interviewing Is Too “Soft” -- Addicts Need "Tough Love"
Some other approaches, often called "tough love approaches to treating addiction can be confrontational, and there is a widespread belief -- promoted in large part by 12-step programs -- that being confronted with the darker side of their behavior is necessary to overcoming addiction.
The motivational interviewing approach does not share this viewpoint, and recognizes that the judgmental and shaming elements of confrontation can sometimes worsen the situation for the person with the addiction. With motivational interviewing, the individual’s point of view about his or her own behavior is central to recovery.
3. Motivational Interviewing Is Part of the Transtheoretical ModelThe transtheoretical or “stages of change” model goes hand-in-hand with the motivational interviewing approach. Although they were developed and became popular around the same time, they are separate theories developed by different research teams.
4. Motivational Interviewing Doesn’t Work Because It Allows People to RelapseOne of the most controversial aspects of motivational interviewing is the fact that relapse is not only tolerated, but is actually expected. Although relapse is by no means encouraged, it is recognized that relapse can occur during recovery, and that this does not automatically lead to failure. In fact, honesty about relapses can allow the therapist and the person with the addiction to better understand that person’s triggers. It can also provide learning opportunities to help avoid and cope with relapse in the future.
5. Motivational Interviewing Is for Treating Addiction OnlyAlthough motivational interviewing is widely used for treating addictions, it has also been successfully applied to a range of other types of behavior change, including treatment for eating disorders, improving compliance with medication regimens, and establishing healthy behaviors such as exercise.
6. Motivational Interviewing Is Just a FadMotivational interviewing has been around for a few decades. It is true that it has become popular, and is considered a leading approach for addictions treatment. While other therapies may also become popular in the future, that does not negate the effectiveness of motivational interviewing for problems of addiction as they are being experienced at the present time.
7. Motivational Interviewing Is the Only Approach That WorksAlthough motivational interviewing is effective in treating addictions, other approaches are also effective. In fact, research shows that the approach used is less important to successfully overcoming an addiction than the relationship between the therapist and the person with the addiction.
8. Motivational Interviewing Is UnethicalMotivational interviewing takes ethical issues so seriously that it actually has its own guidelines for ethical practice. This outlines potential for ethical dilemmas that might occur in therapy, and ways that therapists can overcome them, along with examples of situations that might occur in the course of therapy.
9. There Is No Proof That Motivational Interviewing WorksOver the past two decades, there have been numerous research studies showing that motivational interviewing works in many different contexts.
10. Motivational Interviewing Is Only Available in Expensive Treatment CentersMotivational interviewing is available in a variety of treatment centers targeted at a range of economic groups. It is not only available in private treatment facilities.