Toward a theory of motivational interviewing

Miller, William R.; Rose, Gary S.

doi:10.1037/a0016830

Cited by 1,603Psychotherapy Techniques and ApplicationsSubstance Abuse Treatment and OutcomesBehavioral Health and Interventions

Toward a theory of motivational interviewing

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Miller, William R., Rose, Gary S.·2009·American Psychologist

DOI 10.1037/a0016830PMC PMC2759607

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Abstract

The widely disseminated clinical method of motivational interviewing (MI) arose through a convergence of science and practice. Beyond a large base of clinical trials, advances have been made toward "looking under the hood" of MI to understand the underlying mechanisms by which it affects behavior change. Such specification of outcome-relevant aspects of practice is vital to theory development and can inform both treatment delivery and clinical training. An emergent theory of MI is proposed that emphasizes two specific active components: a relational component focused on empathy and the interpersonal spirit of MI, and a technical component involving the differential evocation and reinforcement of client change talk. A resulting causal chain model links therapist training, therapist and client responses during treatment sessions, and posttreatment outcomes.

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Motivational interviewing is superior to no treatment in decreasing substance use in the short term, but its long-term effects appear less robust.
“It is superior to no treatment in decreasing sub stance use in the short term, but its long- term effects appear less robust 221 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [221]
The ‘Drinker’s Check-Up’ section reports an abrupt reduction in drinking after an MI-based intervention compared with a waiting-list control. The ‘New Terrain’ section says effects were more enduring when MI was added to active treatment, but it does not establish that MI’s long-term effects on substance use are less robust than its short-term effects when compared with no treatment. Page numbers are unavailable in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Individual education is more effective than face-to-face or web and mobile phone education.
“Regarding the education method, individual education is more effective than face-to-face or web and mobile phone education.375”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [375]
Adding exercise intervention combined with psychological support to diet recommendations is more effective than diet education alone.
“Adding exercise intervention combined with psychological support to diet recommendations is more effective than diet education alone.375”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [375]
MI is a patient-centered method for enhancing intrinsic motivation to change and facilitating behavior change.
“MI is a patient-centered method for enhancing intrinsic motivation to change and facilitating behavior change [110].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [110]
MI has been utilized for many years to successfully address a variety of health behaviors, including physical activity, diet, and medication adherence.
“Furthermore, it has been utilized for many years to successfully address an incredible variety of health behaviors, including physical activity, diet, and medication adherence [110].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [110]

MI is a patient-centered approach specifically focused on having patients generate reasons for change and assisting them in resolving ambivalence about changing their behavior.
“First, it is a patient-centered approach, specifically focused on having patients generate reasons for change and assisting them in resolving ambivalence about changing their behavior.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [110]
MI can be used with patients at any stage of change, from those not motivated to increase activity to those highly motivated but who have failed on prior attempts.
“First, MI can be used with patients at any stage of change, from those who feel that they currently are not motivated to increase their activity to those who are highly motivated to increase activity but have failed on prior attempts [113].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [113]
MI leads to decreased ambivalence, greater intention to change, and increased feelings of control, all of which are consistently associated with greater physical activity.
“Furthermore, MI itself leads to decreased ambivalence, greater intention to change, and increased feelings of control (pathway C1) [113, 133–137], all of which are consistently associated with greater physical activity (pathway C2) [138–140].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [113]
Both MI and the effects of PP on mood, well-being, and optimism are associated with greater self-efficacy, confidence, and motivation, which are in turn linked to physical activity.
“In addition, both MI (pathway D1) [113, 133, 141–145] and the previously described effects of PP on mood, well-being, and optimism (pathway E) [52, 95, 146] are associated with greater self-efficacy, confidence, and motivation, which are in turn linked to physical activity (pathway D2) [139, 147–151].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [113]

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The comprehension of quasi-performative verbs in verbal commitments: New evidence for componential theories of lexical meaning
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Arkowitz H Westra HA Miller WR Rollnick S Motivational interviewing in treating psychological problems 2008 New York Guilford Press
Aubrey LL Motivational interviewing with adolescents presenting for outpatient substance abuse treatment Unpublished Doctoral dissertation 1998 Albuquerque University of New Mexico
Longabaugh R Wirtz PW Project MATCH hypotheses: Results and causal chain analyses 2001 Vol. Project MATCH Monograph Series, Vol. 8 Bethesda, Maryland National Institute on Alcohol Abuse and Alcoholism
Miller WR Muñoz RF Controlling your drinking 2005 New York Guilford Press
Miller WR Zweben A DiClemente CC Rychtarik RC Motivational Enhancement Therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence 1992 Vol. Project MATCH Monograph Series, Vol. 2 Rockville, Maryland National Institute on Alcohol Abuse and Alcoholism
Rollnick S Miller WR Butler CC Motivational interviewing in health care 2008 New York Guilford Press

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Authors: Miller, W. R., & Rose, G. S.
Affiliations: University of New Mexico (US)
William James College (US)
ORCID: Miller, William R.
Rose, Gary S.
Venue: American Psychologist
Publisher: American Psychological Association (APA)
Published: 2009
Volume: 64
Issue: 6
Pages: 527-537
ISSN: 0003-066X (ISSN-L)
1935-990X
DOI: 10.1037/a0016830
PMC: PMC2759607
OpenAlex: W1985386799
Cited by: 1,603
References: 91
Citations by year: 2026: 41 · 2025: 49 · 2024: 58 · 2023: 90 · 2022: 114 · 2021: 108 · 2020: 139 · 2019: 93 · 2018: 94 · 2017: 95 · 2016: 113 · 2015: 118 · 2014: 120 · 2013: 117 · 2012: 112
FWCI: 88.26
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Psychologist (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (K05-AA00133)
Robert Wood Johnson Foundation (049533)
National Institute on Drug Abuse (U10-DA01583)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords: motivational interviewing, theory development, behavior change, empathy, change talk, therapist training, interpersonal processes, clinical teaching
MeSH terms: Alcoholism, Counseling, Humans, Models, Psychological, Motivation, Substance-Related Disorders

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