30 Years of Motivational Interviewing: An Updated Overview

Motivational interviewing (MI) is a collaborative conversation style designed to strengthen personal motivation for and commitment to change by eliciting and exploring the person's own reasons for change. Originated from the field of addiction treatment MI has seen a steady rise in popularity worldwide in treating health-related and psychiatric problems. During the last 3 decades more than 200 randomized controlled trials on MI have been carried out and MI underwent several modifications of its basic concepts. Theoretical advancements concern the restructuring of MI around 4 processes (engaging, focusing, evoking, planning). 4 principles of intervention (like expressing empathy), 7 groups of methods (like reflective listening) and - most important - a special kind of spirit (collaborative, evocative, honoring autonomy, compassionate) are assigned to these processes. 10 meta-analyses show that MI works moderately well for almost every problem area, and that there is often no difference in effectiveness between MI and other treatments. As an important active ingredient of MI in-session client speech in favor of change (i.e., change/commitment talk) has received research support. For an effective use of MI extensive trainings and supervision of professionals as well as changes in organizational processes are needed.