Initially created for smoking cessation, MI has a lot to do with the relationship you build with your client. Someone will not change unless they are motivated to do something. Figuring out what could potentially motivate the client is your job as the counselor. When communicating with the client you will be listening for their values and goals. You will be their motivator to change. The dialogue you have with your client will resemble an interview, where you will discover their opinions, experience, values, and goals. These finding will be used to motivate change in their lives.

Assumptions of MI

• Ambivalence about change is normal and constitutes an important motivational obstacle in new behavior.
• Ambivalence can be resolved by working with your client's intrinsic motivations and values.
• The alliance between you and your client is a collaborative partnership to which you each bring important expertise.
• An empathic, supportive, yet directive, counseling style provides conditions under which change can occur. (Direct argument and aggressive confrontation may tend to increase client defensiveness and reduce the likelihood of behavioral change.)

5 Principles of MI

1. Express empathy through reflective listening.
2. Develop discrepancy between clients' goals or values and their current behavior. Motivation for change is enhanced when clients perceive discrepancies between their current situation and their hopes for the future.   
3. Avoid argument and direct confrontation. Trying to convince a client that a problem exists or that change is needed could precipitate even more resistance. If you try to prove a point, the client predictably takes the opposite side.
4. Adjust to client resistance rather than opposing it directly. This requires you to understand your client's perspective and proceed from there. Resistance is a signal to you to change direction or listen more carefully. Resistance actually offers you an opportunity to respond in a new, perhaps surprising, way and to take advantage of the situation without being confrontational.
5. Support self-efficacy and optimism.

5 Strategies

1. Ask open-ended questions
2. Listen Reflectively
3. Summarize
4. Affirm
5. Elicit Self-Motivational Statements

5 Stages of Change in MI

Precontemplation

• don't realize there is a problem
• 0 self-awareness
• may not be interested at all
• tell you facts but aren't going to apply them to life
• external pressure put on these people from others
• they usually go along with it because of an ultimatum from someone else
• no internal motivation to change
• trying to get someone off their back
• use MI to help them gain an internal sense of control
• have them read a book about someone in a similar stage as them (resource, guidance)

Contemplation

• can work with these people a little more than those in precontemplation
• know changes need to be made, don't know how to make them
• interested, but doesn't mean commitment
• weighing pros and cons
• they will try to come up with a lot of cons
• playing with the idea in their head, aren't there yet

Preparation

• say they're making an intention to change, but haven't yet
• keep pushing things back
• haven't committed, want to, but they are scared or reluctant
• if not today, then when?

Action

• finally taking action
• often fail when they first begin
• decide to jump ship because they are not truly ready
• a lot of data collection
• modify their behavior, thoughts, etc.

Maintenance

• trying to prevent relapse or backsliding
• build on information
• give clients the knowledge that they may potentially relapse
• it's common
• it's not that you don't believe in them
• we haven't thought of every single barrier they may face