Motivational interviewing with problem drinkers

Motivational interviewing is an approach based on principles of experimental social psychology, applying processes such as attribution, cognitive dissonance, and self-efficacy. Motivation is conceptualized not as a personality trait but as an interpersonal process. The model deemphasizes labeling and places heavy emphasis on individual responsibility and internal attribution of change. Cognitive dissonance is created by contrasting the ongoing problem behavior with salient awareness of the behavior's negative consequences. Empathic processes from the methods of C. Rogers, social psychological principles of motivation, and objective assessment feedback are used to channel this dissonance toward a behavior change solution, avoiding the "short circuits" of low self-esteem, low self-efficacy, and denial. This motivational process is understood within a larger developmental model of change in which contemplation and determination are important early steps that can be influenced by therapist interventions. A schematic diagram of the motivational process and a 6-step sequence for implementing motivational interviewing are suggested. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)