Supplement to Audiobook for

Motivational Interviewing, 4th Edition:

Helping People Change and Grow

by William R. Miller
and
Stephen Rollnick

Copyright © 2023 The Guilford Press. Except as indicated, no part

of this book may be reproduced, translated, stored in a retrieval
system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, microfilming, recording, or otherwise,
without written permission from the publisher.
Contents
Applications of Motivational Interviewing series page.………………………………………………1
Dedications………………………………………………………………………………………………………………..2
About the Authors……………………………………………………………………………………………………..3
Acknowledgments……………………………………………………………………………………………………..4
Book Contents……………………………………………………………………………………………………………5
Notes and References………………………………………………………………………………………………..7
Some Cultural Adaptations of MI………………………………………………………………………………72
Figure 4.1………………………………………………………………………………………………………………….76
Figure 4.2………………………………………………………………………………………………………………….77
Figure 5.1………………………………………………………………………………………………………………….78
Figure 6.1………………………………………………………………………………………………………………….79
Box 7.1………………………………………………………………………………………………………………………80
Box 9.1………………………………………………………………………………………………………………………81
Figure 9.1…………………………………………………………………………………………………………………..85
Glossary……………………………………………………………………………………………………………………..86
 Applications of Motivational Interviewing
Stephen Rollnick, William R. Miller, and Theresa B. Moyers, Series Editors
Since the publication of Miller and Rollnick’s classic Motivational Interviewing,
now in its fourth edition, MI has been widely adopted as a tool for facilitating
change. This highly practical series includes general MI resources as well as books
on specific clinical contexts, problems, and populations. Each volume presents
powerful MI strategies that are grounded in research and illustrated with concrete,
“how-to-do-it” examples.

RECENT VOLUMES

Motivational Interviewing in Schools:

Conversations to Improve Behavior and Learning
Stephen Rollnick, Sebastian G. Kaplan, and Richard Rutschman
Motivational Interviewing with Offenders:
Engagement, Rehabilitation, and Reentry
Jill D. Stinson and Michael D. Clark
Motivational Interviewing and CBT:
Combining Strategies for Maximum Effectiveness
Sylvie Naar and Steven A. Safren
Building Motivational Interviewing Skills:
A Practitioner Workbook, Second Edition
David B. Rosengren
Coaching Athletes to Be Their Best:
Motivational Interviewing in Sports
Stephen Rollnick, Jonathan Fader, Jeff Breckon,
and Theresa B. Moyers
Motivational Interviewing for Leaders in the Helping Professions:
Facilitating Change in Organizations
Colleen Marshall and Anette Søgaard Nielsen
Motivational Interviewing in Social Work Practice, Second Edition
Melinda Hohman
Motivational Interviewing with Adolescents and Young Adults,
Second Edition
Sylvie Naar and Mariann Suarez
Motivational Interviewing in Health Care, Second Edition:
Helping Patients Change Behavior
Stephen Rollnick, William R. Miller, and Christopher C. Butler
Motivational Interviewing, Fourth Edition:
Helping People Change and Grow
William R. Miller and Stephen Rollnick

1
 To my beloved spouse of 50 years,
Kathleen Jackson
—WRM

Looking to the next generation:

for the wonderful and loving Jacob, Stefan,
Maya, and Nathan Rollnick
—SR

2
 About the Authors

William R. Miller, PhD, is Emeritus Distinguished Professor of Psychology

and Psychiatry at the University of New Mexico. He introduced motiva-
tional interviewing (MI) in a 1983 article and in the first edition of Motiva-
tional Interviewing (1991), coauthored with Stephen Rollnick. Dr. Miller’s
research has focused particularly on the treatment and prevention of addic-
tions and more broadly on the psychology of change. He is a recipient of
two career achievement awards from the American Psychological Associa-
tion, the international Jellinek Memorial Award, and an Innovators Award
from the Robert Wood Johnson Foundation, among many other honors.
His publications include 65 books and over 400 articles and chapters. His
website is https://williamrmiller.net.

Stephen Rollnick, PhD, is Honorary Distinguished Professor in the

School of Medicine at Cardiff University, Wales, United Kingdom. He
is cofounder of MI, with a career in clinical psychology and academia
that focused on how to improve conversations about change, and helped
to create the Motivational Interviewing Network of Trainers (http://
motivationalinterviewing.org). He has worked in diverse fields, with spe-
cial interests in mental health and long-term health conditions such as dia-
betes, heart disease, and HIV/AIDS. Dr. Rollnick has published widely
in scientific journals and has written many books on helping people to
change behavior. He has traveled worldwide to train practitioners in many
settings and cultures, and he now works as a trainer and consultant in
health care and sports. His website is www.stephenrollnick.com.

3
 Acknowledgments

W e first acknowledge our indebtedness to Carl Ransom Rogers (1902–1987),

founder of a humane, person- centered approach to counseling, psycho-
therapy, education, and clinical science. MI is a person- centered method built
on the solid foundation of the work provided by Dr. Rogers and his students.
We are grateful to the remarkable community of colleagues known as
MINT—the Motivational Interviewing Network of Trainers—for stimulating
discussions that have informed us over the years as we developed successive
editions of Motivational Interviewing. Professor Theresa Moyers has been at
the forefront of MI process and training research, advancing our understand-
ing of how MI works by applying scientific method while also clearly recog-
nizing its limitations. The MINT members who asked us good questions and
contributed their knowledge and perspectives to this fourth edition are far too
numerous to name here. We tried, and we were quickly overwhelmed just by
the long list of people we recalled, plus troubled that we would surely be omit-
ting important others.
This is the 19th book, including new editions, that we have personally
authored or edited with The Guilford Press, in addition to serving as series
editors for other Guilford books on MI. Having worked with many other pub-
lishers, we continue to be impressed with and grateful for the outstanding level
of care, quality editing, and attention to detail that has been our consistent
experience with Guilford. It has been a great pleasure over the years to work
with Guilford editors like Jim Nageotte, Jane Keislar, Kitty Moore, and Chris
Benton—not necessarily when we are in the midst of yet another rewrite, but
always in the quality of the final product. As before, the copy editor for this
book, Betty Pessagno, was most helpful in getting the language just right.
Finally, we are grateful to Theresa Moyers, David Rosengren, and Allan Zuck-
off for their careful reviews of the manuscript, offering suggestions to improve
its flow and clarity. Like MI itself, this book is the collective work of many
dedicated, generous, and talented people.

4
 Contents

PART I
HELPING PEOPLE CHANGE AND GROW 1

CHAPTER 1 The Mind and Heart When Helping 3

CHAPTER 2 What Is Motivational Interviewing? 15

CHAPTER 3 A Flowing Conversation 34

PART II
PRACTICING MOTIVATIONAL INTERVIEWING 49

CHAPTER 4 Engaging: “Can We Walk Together?” 51

CHAPTER 5 Focusing: “Where Are We Going?” 69

CHAPTER 6 Evoking: “Why Would You Go There?” 83

CHAPTER 7 Planning: “How Will You Get There?” 114

PART III
A DEEPER DIVE
INTO MOTIVATIONAL INTERVIEWING 141

CHAPTER 8 Deeper Listening 143

CHAPTER 9 Focusing: A Deeper Dive 155

xiii

5
 Contents

CHAPTER 10 Evoking: Cultivating Change Talk 174

CHAPTER 11 Offering Information and Advice 191

CHAPTER 12 Supporting Persistence 203

CHAPTER 13 Planting Seeds 214

CHAPTER 14 Responding to Sustain Talk and Discord 229

CHAPTER 15 Practicing Well 253

PART IV
LEARNING AND STUDYING
MOTIVATIONAL INTERVIEWING 265

CHAPTER 16 Learning Motivational Interviewing 267

CHAPTER 17 Learning from Conversations about Change 285

CHAPTER 18 Studying Motivational Interviewing 298

Glossary of Motivational Interviewing Concepts 323

Index 331

Reproducible materials from this book and supplementary

downloadable resources, including two annotated case
examples, reflection questions, and a personal values card sort,
are available at www.guilford.com/miller2-materials for personal
use or use with clients (see copyright page for details).

6
 Chapter 1 Notes and References

Notes and References

1. Perhaps the most extensive research on what makes helpers more helpful is in the
field of psychotherapy, where the therapist who delivers a treatment significantly
influences its outcome. A review of 70 years of research on this subject is provided
in Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
2. See note 1.
3. Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behav-
ioural Psychotherapy, 11, 147–172.
Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: Preparing
people to change addictive behavior. Guilford Press.
4. The website of the international Motivational Interviewing Network of Trainers
(MINT) (https://motivationalinterviewing.org) is a good resource for up-to-date
references and perspectives on MI.
5. We were inspired by a quote from U.S. Supreme Court Justice Oliver Wendell
Holmes Jr. that “I would not give a fig for the simplicity this side of complexity, but
I would give my life for the simplicity on the other side of complexity.”
6. The concept of person- centered counseling was pioneered by Carl Rogers and
his students in the 1950s and 1960s, inspiring patient- centered health care and
student- centered learning.
Rogers, C. R. (1951). Client- centered therapy. Houghton-Mifflin.
Truax, C. B., & Carkhuff, R. R. (1967). Toward effective counseling and psy-
chotherapy. Aldine.
Gordon, T., & Edwards, W. S. (1997). Making the patient your partner: Com-
munication skills for doctors and other caregivers. Auburn House Paperback.
Rakel, D. (2018). The compassionate connection: The healing power of empa-
thy and mindful listening. Norton.
7. Rollnick, S., & Miller, W. R. (1995). What is motivational interviewing? Behav-
ioural and Cognitive Psychotherapy, 23, 325–334.
8. We thank Jeff Allison for suggesting this analogy of dancing rather than wrestling.
9. Orlinsky, D. E., Grawe, K., & Parks, B. K. (1994). Process and outcome in psy-
chotherapy: Noch einmal. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of
psychotherapy and behavior change (pp. 270–376). Wiley.
10. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
11. This perspective lies at the heart of Carl Rogers’s person- centered approach. In his
own words, “The curious paradox is that when I accept myself just as I am, then
I can change.” Rogers, C. R. (1961). On becoming a person: A therapist’s view of
psychotherapy. Houghton Mifflin.

7
 Chapter 1 Notes and References

12. Bloom, P. (2016). Against empathy: The case for rational compassion. Harper Col-
lins.
13. The Dalai Lama, & Vreeland, N. (2001). An open heart: Practicing compassion in
everyday life. Little, Brown.
14. To our dismay, one book describing MI was entitled Instant Influence: How to Get
Anyone to Do Anything—FAST. We recognize that it is usually the publisher, not
the author, who chooses the title of a book.
15. Milner, H. R. (2012). Beyond a test score: Explaining opportunity gaps in educa-
tional practice. Journal of Black Studies, 43(6), 693–718.
16. Miller, W. R., Sovereign, R. G., & Krege, B. (1988). Motivational interviewing
with problem drinkers: II. The Drinker’s Check-up as a preventive intervention.
Behavioural Psychotherapy, 16, 251–268.
17. Ryan, R. M., Deci, E. L., Grolnick, W. S., & La Guardia, J. G. (2006). The sig-
nificance of autonomy and autonomy support in psychological development and
psychopathology. In Developmental psychopathology: Theory and method (Vol.
1, 2nd ed., pp. 795–849). Wiley.
18. Vansteenkiste, M., Williams, G. C., & Resnicow, K. (2012). Toward systematic
integration between self- determination theory and motivational interviewing
as examples of top-down and bottom-up intervention development: Autonomy
or volition as a fundamental theoretical principle. The International Journal of
Behavioral Nutrition and Physical Activity 9, Article 23.
19. Hagger, M. S., & Protogerou, C. Self- determination theory and autonomy support
to change healthcare behavior. In A. Hadler, S. Sutton, & L. Osterberg (Eds.),
Handbook of healthcare treatment engagement: Theory, research, and clinical
practice (pp. 141–158). Wiley.
Chatzisarantis, N. L. D., Hagger, M. S., & Smith, B. (2007). Influences of per-
ceived autonomy support on physical activity within the theory of planned behav-
ior. European Journal of Social Psychology, 37, 934–954.
Deci, E. L., & Ryan, R. M. (2012). Self- determination theory in health care and
its relations to motivational interviewing: A few comments. International Journal
of Behavioral Nutrition and Physical Activity, 9, 24.
20. Avruch, D. O., & Shaia, W. E. (2022). Macro MI: Using motivational interview-
ing to address socially- engineered trauma. Journal of Progressive Human Services,
33(2), 176–204.
21. Pollak, K. I., Nagy, P., Bigger, J., Bilheimer, A., Lyna, P., Gao, X., et al. (2016).
Effect of teaching motivational interviewing via communication coaching on clini-
cian and patient satisfaction in primary care and pediatric obesity-focused offices.
Patient Education and Counseling, 99(2), 300–303.
22. Endrejat, P. C., & Kauffeld, S. (2021). Learning motivational interviewing: Pros-
pects to preserve practitioners’ well-being. International Journal of Workplace
Health Management, 14(1), 1–11.
Pastore, O., & Fortier, M. (2020). Understanding the link between motiva-
tional interviewing and self- compassion. Journal of Counselling and Psychother-
apy, 54(4), 846–860.
23. Magill, M., Martino, S., & Wampold, B. E. (2022). Goal setting and monitoring
with alcohol and other drug use disorders: Principles and practices. Journal of Sub-
stance Abuse Treatment, 132, 108650.

8
 Chapter 2 Notes and References

Notes and References

1. Miller W. R. (2023). The evolution of motivational interviewing. Behavioural
and Cognitive Psychotherapy, 1–17. Advance online publication. https://doi.org/
10.1017/S1352465822000431
2. Atkinson, C., & Woods, K. (2017). Establishing theoretical stability and treatment
integrity for motivational interviewing. Behavioural and Cognitive Psychotherapy,
45, 337–350.
3. Kirschenbaum, H. (2009). The life and work of Carl Rogers. American Counseling
Association.
Miller, W. R., & Moyers, T. B. (2017). Motivational interviewing and the clini-
cal science of Carl Rogers. Journal of Consulting and Clinical Psychology, 85(8),
757–766.
4. Moyers, T. B. (2004). History and happenstance: How motivational interviewing
got its start. Journal of Cognitive Psychotherapy, 18, 291–298.
5. The first description of MI was in this article: Miller, W. R. (1983). Motivational
interviewing with problem drinkers. Behavioural Psychotherapy, 11, 147–172.
6. A classic exploration of how new approaches find their way into practice is Rogers,
E. M. (2003). Diffusion of innovations (5th ed.). Free Press.
7. Miller, W. R. (2022). On second thought: How ambivalence shapes your life. Guil-
ford Press.
8. Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein, M. G., Marcus, B. H.,
Rakowski, W., et al. (1994). Stages of change and decisional balance for 12 problem
behaviors. Health Psychology, 13(1), 39–46.

9
 Chapter 2 Notes and References

9. In previous editions we called this the “righting reflex,” and while we regret losing
the alliteration, we think that “fixing reflex” is clearer. Dawn Clifford and Laura
Curtis suggested this change as they prepared a second edition of Motivational
Interviewing in Nutrition and Fitness (Guilford Press). We thank them for the idea
along with Jonathan Lee, who suggested it to them.
10. Brehm, S. S., & Brehm, J. W. (1981). Psychological reactance: A theory of freedom
and control. Academic Press.
de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An
evolutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
11. Miller, W. R., & C’de Baca, J. (2001). Quantum change: When epiphanies and
sudden insights transform ordinary lives. Guilford Press.
12. Farley, W. (2005). The wounding and healing of desire: Weaving heaven and earth
(Kindle Locations 1932–1933). Kindle Edition.
13. Farrell, W. (1974). The liberated man: Beyond masculinity— Freeing men and their
relationships with women. Bantam Books.
14. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
15. Horvath, A. O., Del Re, A. C., Flückinger, C., & Symonds, D. (2011). Alliance in
individual psychotherapy. Psychotherapy, 48(1), 9–16.
16. Bordin, E. S. (1994). Theory and research on the therapeutic working alliance:
New directions. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance:
Theory, research, and practice (pp. 13–37). Wiley.
17. Steinberg, M. P., & Miller, W. R. (2015). Motivational interviewing in diabetes
care. Guilford Press.
18. Wagner, C. C., & Ingersoll, K. S. (2009). Beyond behavior: Eliciting broader
change with motivational interviewing. Journal of Clinical Psychology, 65(11),
1180–1194.
19. Roberts, M. (2001). Horse sense for people. Knopf.
20. Miller, W. R., & Rollnick, S. (2009). Ten things that motivational interviewing is
not. Behavioural and Cognitive Psychotherapy, 37, 129–140.
21. Miller, W. R., & Rose, G. S. (2015). Motivational interviewing and decisional bal-
ance: Contrasting responses to client ambivalence. Behavioural and Cognitive Psy-
chotherapy, 43(2), 129–141.
22. Miller, W. R., Zweben, A., DiClemente, C., & Rychtarik, R. (1992). Motivational
enhancement therapy manual: A clinical research guide for therapist treating indi-
viduals with alcohol abuse and dependence (Vol. 2). National Institute on Alcohol
Abuse and Alcoholism.
Project MATCH Research Group. (1993). Project MATCH: Rationale and
methods for a multisite clinical trial matching patients to alcoholism treatment.
Alcoholism: Clinical and Experimental Research, 17, 1130–1145.
23. Agostinelli, G., Brown, J. M., & Miller, W. R. (1995). Effects of normative feed-
back on consumption among heavy drinking college students. Journal of Drug
Education, 25, 31–40.
Davis, T. M., Baer, J. S., Saxon, A. J., & Kivlahan, D. R. (2003). Brief moti-
vational feedback improves post-incarceration treatment contact among veterans
with substance use disorders. Drug and Alcohol Dependence, 69, 197–203.
Juarez, P., Walters, S. T., Daugherty, M., & Radi, C. (2006). A randomized
trial of motivational interviewing and feedback with heavy drinking college stu-
dents. Journal of Drug Education, 36, 233–246.
24. Atkinson, C., & Woods, K. (2017). Establishing theoretical stability and treatment
integrity for motivational interviewing. Behavioural and Cognitive Psychotherapy,
45, 337–350.

10
 Chapter 2 Notes and References

Draycott, S., & Dabbs, A. (1998). Cognitive dissonance 2: A theoretical

grounding of motivational interviewing. British Journal of Clinical Psychology,
37, 355–364.
25. Caperton, D. D., Atkins, D. C., & Imel, Z. E. (2018). Rating motivational inter-
viewing fidelity from thin slices. Psychology of Addictive Behaviors, 32(4), 434–
441
Hurlocker, M. C., Madson, M. B., & Schumacher, J. A. (2020). Motivational
interviewing quality assurance: A systematic review of assessment tools across
research contexts. Clinical Psychology Review 82, 101909.
Kramer Schmidt, L., Andersen, K., Nielsen, A. S., & Moyers, T. B. (2019). Les-
sons learned from measuring fidelity with the Motivational Interviewing Treatment
Integrity code (MITI 4). Journal of Substance Abuse Treatment, 97, 59–67.
26. Kirschenbaum, H. (2009). The life and work of Carl Rogers. American Counseling
Association.
27. Apodaca, T. R., & Longabaugh, R. (2009). Mechanisms of change in motivational
interviewing: A review and preliminary evaluation of the evidence. Addiction,
104(5), 705–715.
Frey, A. J., Lee, J., Small, J. W., Sibley, M., Owens, J. S., Skidmore, B., et
al. (2021). Mechanisms of motivational interviewing: A conceptual framework to
guide practice and research. Prevention Science, 22(6), 689–700.
Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S.
(2009). From in-session behaviors to drinking outcomes: A causal chain for motiva-
tional interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113–
1124.
28. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
Pirlott, A. G., Kisbu- Sakarya, Y., DeFrancesco, C. A., Elliot, D. L., & MacKin-
non, D. P. (2012). Mechanisms of motivational interviewing in health promotion:
A Bayesian mediation analysis. International Journal of Behavioral Nutrition and
Physical Activity, 9(1), 69.
29. Naar-King, S., Outlaw, A., Green-Jones, M., Wright, K., & Parsons, J. T. (2009).
Motivational interviewing by peer outreach workers: A pilot randomized clinical
trial to retain adolescents and young adults in HIV care. AIDS Care, 21(7), 868–
873.
Nadkarni, A., Weobong, B., Weiss, H. A., McCambridge, J., Bhat, B., Katti, B.,
et al. (2017). Counselling for Alcohol Problems (CAP), a lay counsellor-delivered
brief psychological treatment for harmful drinking in men, in primary care in
India: A randomised controlled trial. Lancet, 389(10065), 186–195.
Phillips, R., Copeland, L., Grant, A., Sanders, J., Gobat, N., Tedstone, S., et
al. (2018). Development of a novel motivational interviewing (MI) informed peer-
support intervention to support mothers to breastfeed for longer. BMC Pregnancy
and Childbirth, 18, Article 90.
Singla, D. R., Weobong, B., Nadkarni, A., Chowdhary, N., Shinde, S., Anand,
A., et al. (2014). Improving the scalability of psychological treatments in develop-
ing countries: An evaluation of peer-led therapy quality assessment in Goa, India.
Behaviour Research and Therapy, 60, 53–55.

11
 Chapter 3 Notes and References

Notes and References

1. This quotation is often and incorrectly attributed to Oscar Wilde. The actual
author is unknown.
2. Csikszentmihalyi, M. (2008). Flow: The psychology of optimal experience: Harper
Collins.
3. Gelso, C. J., Kivlighan, D. M., & Markin, R. D. (2018). The real relationship and its
role in psychotherapy outcome: A meta-analysis. Psychotherapy, 55(4), 434–444.
Kolden, G. G., Wang, C.-C., Austin, S. B., Chang, Y., & Klein, M. H. (2018).
Congruence/genuineness: A meta-analysis. Psychotherapy, 55(4), 424–433.
4. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
5. Rosenberg, M. B. (2015). Nonviolent communication: A language of life. Puddle
Dancer Press.
Moses, G. (1997). Revolution of conscience: Martin Luther King, Jr., and the
philosophy of nonviolence. Guilford Press.
6. Hill, C. E., Knox, S., & Pinto- Coelho, K. G. (2018). Therapist self-disclosure and
immediacy: A qualitative meta-analysis. Psychotherapy, 55(4), 445–460.
Levitt, H. M., Minami, T., Greenspan, S. B., Puckett, J. A., Henretty, J. R.,
Reich, C. M., et al. (2016). How therapist self-disclosure relates to alliance and
outcomes: A naturalistic study. Counselling Psychology Quarterly, 29(1), 7–28.
7. Rachman, A. W. (1990). Judicious self- disclosure in group analysis. Group, 14(3),
132–144.
8. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relation-
ships as developed in the client- centered framework. In S. Koch (Ed.), Psychology:
The study of a science. Vol. 3. Formulations of the person and the social contexts
(pp. 184–256). McGraw-Hill.
Rogers, C. R. (1965). Client- centered therapy. New York: Houghton-Mifflin.
9. Rogers, C. R. (1980). A way of being. Houghton Mifflin, p. 15.
10. See note 3 (Gelso et al., 2018) and Kolden, G. G., Wang, C.-C., Austin, S. B.,
Chang, Y., & Klein, M. H. (2018). Congruence/genuineness: A meta-analysis. Psy-
chotherapy, 55(4), 424–433.
11. Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annual
Review of Clinical Psychology, 1, 91–111.
Villanueva, M., Tonigan, J. S., & Miller, W. R. (2007). Response of Native
American clients to three treatment methods for alcohol dependence. Journal of
Ethnicity in Substance Abuse, 6(2), 41–48.
12. Self, K. J., Borsari, B., Ladd, B. O., Nicolas, G., Gibson, C. J., Jackson, K., et al.
(2023). Cultural adaptations of motivational interviewing: A systematic review.
Psychological Services, 20(Suppl 1), 7–18.
13. Nedjat-Haiem, F. R., Carrion, I. V., Gonzalez, K., Bennett, E. D., Ell, K., O’Connell,
M., et al. (2018). Exploring motivational interviewing to engage Latinos in advance
care planning: A community-based social work intervention. American Journal of
Hospice and Palliative Medicine, 35(8), 1091–1098.
14. Here are just a few examples: Abdull, M. M., McCambridge, J., Evans, J., Muazu,
F., & Clare, G. (2017). Can adapted motivational interviewing improve uptake of

12
 Chapter 3 Notes and References

surgical or laser treatment for glaucoma in Nigeria: Randomized controlled trial.

Journal of Glaucoma, 26(9), 822–828.
Afriwilda, M.
T., & Mulawarman, M. (2021). The effectiveness of motiva-
tional interviewing counseling to improve psychological well-being on students
with online game addiction tendency. Islamic Guidance and Counseling Journal,
4(1), 106–115.
Bai, B., Yan, Z., Hao, Y., Zhang, Z., Li, G., Dekker, J., et al. (2017). A ran-
domised controlled multimodal intervention trial in patients with ischaemic stroke
in Shandong, China: Design and rationale. The Lancet, 390 (Special Issue S13).
Kiene, S. M., Bateganya, M. H., Lule, H., & Wanyenze, R. K. (2016). The effect
of brief motivational interviewing-based counseling during outpatient provider-
initiated HIV testing and counseling in rural Uganda on high risk sexual behavior.
AIDS and Behavior, 20, 1928–1936.
Mojahed, K., & Navidian, A. (2018). The effect of motivational interviewing
on craving and dependence on hookah in suburban pregnant women in south east
of Iran. Issues in Mental Health Nursing, 39(8), 693–699.
Rasekh, B., Saw, Y.
M., Azimi, S., T., K., Yamamoto, E., & Hamajima, N.
(2018). Associations of treatment completion against drug addiction with motiva-
tional interviewing and related factors in Afghanistan. Nagoya Journal of Medical
Science, 80, 329–340.
Rimal, P., Khadka, S., Bogati, B., Chaudhury, J., Rawat, L. K., Bhat, K. C., et
al. (2021). Cross- cultural adaptation of motivational interviewing for use in rural
Nepal. BMC Psychology, 9(1), 52.
Shimada, T., Ohori, M., Inagaki, Y., Shimooka, Y., Sugimura, N., Ishihara,
I., et al. (2018). A multicenter, randomized controlled trial of individualized occu-
pational therapy for patients with schizophrenia in Japan. PLOS ONE, 13(4),
e0193869.
Song, H. Y., Yong, S. J., & Hur, H. K. (2014). Effectiveness of a brief self-care
support intervention for pulmonary rehabilitation among the elderly patients with
chronic obstructive pulmonary disease in Korea. Rehabilitation Nursing, 39(3),
147–156.
15. Venner, K. L., Feldstein, S. W., & Tafoya, N. (2007). Helping clients feel welcome:
Principles of adapting treatment cross culturally. Alcoholism Treatment Quarterly,
25, 11–20.
16. Carroll, K. M., Martino, S., Ball, S. A., Nich, C., Frankforter, T., Anez, L. M., et
al. (2009). A multisite randomized effectiveness trial of motivational enhancement
therapy for Spanish-speaking substance users. Journal of Consulting and Clinical
Psychology, 77(5), 993–999.
Koken, J. A., Naar-King, S., Umasa, S., Parsons, J. T., Saengcharnchai, P., Pha-
nuphak, P., et al. (2012). A cross- cultural three-step process model for assessing
motivational interviewing treatment fidelity in Thailand. Health Education and
Behavior, 39(5), 574–582.
Lee, C. S., Tavares, T., Popat-Jain, A., & Naab, P. (2015). Assessing treatment
fidelity in a cultural adaptation of motivational interviewing. Journal of Ethnicity
in Substance Abuse, 14(2), 208–219.
Schmidt, L. K., Andersen, K., & Nielsen, A. S. (2022). Differences in delivery of
motivational interviewing across three countries. Journal of Ethnicity in Substance
Abuse, 21(3), 823–844.
17. Miller, W. R., Hendrickson, S. M. L., Venner, K., Bisono, A., Daugherty, M., &
Yahne, C. E. (2008). Cross- cultural training in motivational interviewing. Journal
of Teaching in the Addictions, 7, 4–15.

13
 Chapter 4 Notes and References

Notes and References

1. Lennon, R., & Eisenberg, N. (1987). Gender and age differences in empathy and
sympathy. In N. Eisenberg & J. Strayer (Eds.), Empathy and its development (pp.
195–217). Cambridge University Press.
McDonald, N. M., & Messinger, D. S. (2011). The development of empathy:
How, when, and why. In J. J. Sanguineti, A. Acerbi, & J. A. Lombo (Eds.), Moral
behavior and free will: A neurobiological and philosophical approach (pp. 333–
358). IF Press.

14
 Chapter 4 Notes and References

2. Baren-Cohen, S. (2011). The empathy bell curve. Phi Kappa Phi Forum, 91(1),
10–12.
Hojat, M., & Gonnella, J. S. (2015). Eleven years of data on the Jefferson Scale
of Empathy-Medical Student Version (JSE-S): Proxy norm data and tentative cutoff
scores. Medical Principles and Practice, 24, 344–350.
3. Orloff, J. (2018). The empath’s survival guide: Life strategies for sensitive people.
Sounds True.
4. Eastwood, A. P., Penton-Voak, I. S., Munafò, M. R., & Attwood, A. S. (2020).
Effects of acute alcohol consumption on emotion recognition in high and low trait
aggressive drinkers. Journal of Psychopharmacology), 34(11), 1226–1236.
5. Extensive research in psychotherapy, health care, and education links the quality of
working alliance to subsequent outcomes. See Horvath, A. O., & Greenberg, L. S.
(1994). The working alliance: Theory, research, and practice. Wiley.
Fuertes, J. N., Mislowack, A., Bennett, J., Paul, L., Gilbert, T. C., Fontan,
G., et al. (2007). The physician-patient working alliance. Patient Education and
Counseling, 66(1), 29–36.
Lacrose, S., Chaloux, N., Monaghan, D., & Tarabulsy, G. M. (2010). Working
alliance as a moderator of the impact of mentoring relationships among academi-
cally at-risk students. Journal of Applied Social Psychology, 40(10), 2656–2686.
Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical
skills that improve client outcomes. Guilford Press.
Muran, J. C., & Barber, J. P. (Eds.). (2010). The therapeutic alliance: An evi-
dence-based guide to practice. Guilford Press.
6. Increasing attention is being given to “patient activation” that makes people active
partners in their own health care. See: Hibbard, J. H., Stockard, J., Mahoney,
E. R., & Tusler, M. (2004). Development of the patient activation measure (PAM):
Conceptualizing and measuring activation in patients and consumers. Health Ser-
vices Research, 39, 1005–1026.
Hibbard, J. H., Mahoney, E. R., Stock, R., & Tusler, M. (2007). Do increases
in patient activation result in improved self-management behaviors? Health Ser-
vices Research, 42(4), 1443–1463.
Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2022). Behavioral activa-
tion for depression: A clinician’s guide. Guilford Press.
7. Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and
outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology,
38(2), 139–149.
8. Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the
working alliance. Psychotherapy: Theory, Research and Practice, 16(3), 252.
Horvath, A. O. (2000). The therapeutic relationship: From transference to alli-
ance. Journal of Clinical Psychology, 56(2), 163–173.
9. Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in
psychotherapy. Journal of Consulting and Clinical Psychology, 61(4), 561–573.
10. McFall, R. (1991). Manifesto for a science of clinical psychology. The Clinical Psy-
chologist, 44(6), 75–88.
Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The
evidence for what makes psychotherapy work (2nd ed.). Routledge.
11. Miller, S. D., Duncan, B. L., Brown, J., Sorrell, R., & Chalk, M. B. (2006). Using
formal client feedback to improve retention and outcome: Making ongoing, real-
time assessment feasible. Journal of Brief Therapy, 5(1), 5–22.
12. Maeschalck, C. L., Prescott, D. S., & Miller, S. D. (2019). Feedback-informed
treatment. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychother-
apy integration (pp. 105–123). Oxford University Press.

15
 Chapter 4 Notes and References

Miller, S. D., Duncan, B. L., Brown, J., Sorrell, R., & Chalk, M. B. (2006).
Using formal client feedback to improve retention and outcome: Making ongoing,
real-time assessment feasible. Journal of Brief Therapy, 5(1), 5–22.
13. Bohart, A. C., Elliott, R., Greenberg, L. S., & Watson, J. C. (2002). Empathy. In
J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 89–108). Oxford
University Press.
Carkhuff, R. R. (2008). The art of helping (9th ed.). Possibilities Publishing.
Truax, C. B., & Carkhuff, R. R. (1976). Toward effective counseling and psy-
chotherapy: Training and practice. Aldine Transaction.
14. Miller, W. R. (2000). Rediscovering fire: Small interventions, large effects. Psychol-
ogy of Addictive Behaviors, 14, 6–18.
Bien, T. H., Miller, W. R., & Tonigan, J. S. (1993). Brief interventions for alco-
hol problems: A review. Addiction, 88, 315–336.
Rollnick, S., Miller, W. R., & Butler, C. C. (2023). Motivational interviewing
in health care: Helping patients change behavior (2nd ed.). Guilford Press.
15. A list of 12 such roadblocks to listening was originally described by Thomas Gor-
don in his 1970 classic Parent Effectiveness Training (Crown).
16. For more in-depth discussion of reflective listening, see: Miller, W. R. (2018). Lis-
tening well: The art of empathic understanding. Wipf & Stock.
Nichols, M. P., & Straus, M. B. (2021). The lost art of listening: How learning
to listen can improve relationships (3rd ed.). Guilford Press.
Rakel, D. (2018). The compassionate connection: The healing power of empa-
thy and mindful listening. W. W. Norton.
17. We thank psychotherapist James Finley for this phrase: “A therapist is someone
who encourages you to slow down and listen to what you just said.”
18. Grant, A. (2021). Think again: The power of knowing what you don’t know.
Viking.
Carr, S. (2021). Learning how not to know: Pragmatism, (in)expertise, and
the training of American helping professionals. American Anthropologist, 123(3),
526–538.
19. Karpiak, C. P., & Benjamin, L. S. (2004). Therapist affirmation and the process
and outcome of psychotherapy: Two sequential analytic studies. Journal of Clinical
Psychology, 60(6), 659–656.
20. Epton, T., Harris, P. R., Kane, R., van Konigsbruggen, G. M., & Sheeran, P. (2015).
The impact of self-affirmation on health-behavior change: A meta-analysis. Health
Psychology, 34(3), 187–196.
21. Farber, B. A., Suzuki, J. Y., & Lynch, D. A. (2018). Positive regard and psycho-
therapy outcome: A meta-analytic review. Psychotherapy, 55(4), 411–423.
22. Looking first for strengths is sometimes called asset framing. See Shorters, T., &
Hudson, T. (2016). Black men love family and community. In L. Burton, D. Burton,
S. McHale, V. King, & J. Van Hook (Eds.), Boys and men in African American
families (Vol. 7, pp. 243–247). Springer.
Milner, H. R. (2012). Beyond a test score: Explaining opportunity gaps in edu-
cational practice. Journal of Black Studies, 43(6), 693–718.

16
 Chapter 5 Notes and References

Notes and References

1. Schofield, W. (1964). Psychotherapy: The purchase of friendship. Prentice-Hall.
2. Ford, M. E. (1992). Motivating humans: Goals, emotions, and personal agency
beliefs. SAGE.

17
 Chapter 5 Notes and References

Locke, E. A., & Latham, G. P. (1990). A theory of goal setting and task per-
formance. Prentice-Hall.
3. Miller, W. R., & Moyers, T. B. (2021). Focus. In Effective psychotherapists: Clini-
cal skills that improve client outcomes (pp. 66–79). Guilford Press.
4. Flückiger, C., Del Re, A. C., Wlodasch, D., Horvath, A. O., Solomonov, N., &
Wampold, B. E. (2020). Assessing the alliance– outcome association adjusted for
patient characteristics and treatment processes: A meta-analytic summary of direct
comparisons. Journal of Counseling Psychology, 67(6), 706–711.
Horvath, A. O., & Greenberg, L. S. (1994). The working alliance: Theory,
research, and practice. Wiley.
Tryon, G. S., & Winograd, G. (2011). Goal consensus and collaboration. Psy-
chotherapy, 48(1), 50–57.
5. Bamatter, W., Carroll, K. M., Añez, L. M., Paris, M. J., Ball, S. A., Nich, C., et al.
(2010). Informal discussions in substance abuse treatment sessions with Spanish-
speaking clients. Journal of Substance Abuse Treatment, 39(4), 353–363.
6. This was an early surprise from research, showing that after an MI session often
people proceed to make the change on their own. MI was clearly more effective
than no help at all, and often it was just as effective as longer interventions.
Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motiva-
tional interviewing: A meta-analysis of controlled clinical trials. Journal of Con-
sulting and Clinical Psychology, 71(5), 843–861.
Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing.
Annual Review of Clinical Psychology, 1, 91–111.
7. Steinberg, M. P., & Miller, W. R. (2015). Motivational interviewing in diabetes
care. Guilford Press.
8. Susan Gilmore in The counselor-in- training (1973, Prentice-Hall) described three
broad potential goals in counseling: choice, change, and confusion reduction.
9. Monahan, J. (Ed.). (1980). Who is the client? The ethics of psychological interven-
tion in the criminal justice system. American Psychological Association.
10. Gleghorn, A., Rosesnbaum, M., & Garcia, B. A. (2001). Bridging the gap in San
Francisco: The process of integrating harm reduction and traditional substance
abuse services. Journal of Psychoactive Drugs, 33, 1–7.
Miller, W. R. (2008). The ethics of harm reduction. In C. M. A. Geppert &
L. W. Roberts (Eds.), The book of ethics: Expert guidance for professionals who
treat addiction (pp. 41–53). Hazelden.
Tatarsky, A., & Marlatt, G. A. (2010). State of the art in harm reduction psy-
chotherapy: An emerging treatment for substance misuse. Journal of Clinical Psy-
chology, 66, 117–122.
11. Wherever actual case material is used in this book, names and other details are
disguised to protect confidentiality.
12. Simpson, T. L., & Miller, W. R. (2002). Concomitance between childhood sexual
and physical abuse and substance use disorders. Clinical Psychology Review, 22,
27–77.
13. Henson, C., Truchot, D., & Canevello, A. (2021). What promotes post traumatic
growth? A systematic review. European Journal of Trauma and Dissociation, 5(4),
100195.
Jayawickreme, E., Infurna, F. J., Alajak, K., Blackie, L. E., Chopik, W. J., Chung,
J. M., et al. (2021). Post-traumatic growth as positive personality change: Challenges,
opportunities, and recommendations. Journal of Personality, 89(1), 145–165.
Michael, C., & Cooper, M. (2013). Post-traumatic growth following bereave-
ment: A systematic review of the literature. Counselling Psychology Review, 28(4),
18–33.

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 Chapter 5 Notes and References

14. Avruch, D. O., & Shaia, W. E. (2022). Macro MI: Using motivational interview-
ing to address socially- engineered trauma. Journal of Progressive Human Services,
1–29.
Greenwald, R. (2009). Treating problem behaviors: A trauma- informed
approach. Routledge.
Motivational Interviewing and Intimate Partner Violence Workgroup. (2010).
Guiding as practice: Motivational interviewing and trauma-informed work with
survivors of intimate partner violence. Partner Abuse, 1(1), 92–104.
Sypniewski, R. (2016). Motivational Interviewing: A practical intervention
for school nurses to engage in trauma informed care. NASN School Nurse, 31(1),
40–44.
15. See the section “Trauma-Informed Practice and MI” in Hohman, M. (2021). Inno-
vative applications of motivational interviewing. In Motivational interviewing in
social work practice (pp. 204–223). Guilford Press.
16. Darnell, D., O’Connor, S., Wagner, A., Russo, J., Wang, J., Ingraham, L., et al.
(2016). Enhancing the reach of cognitive-behavioral therapy targeting posttrau-
matic stress in acute care medical settings. Psychiatric Services, 68(3), 258–263.
Murphy, R. T., Thompson, K. E., Murray, M., Rainey, Q., & Uddo, M. M.
(2009). Effect of a motivation enhancement intervention on veterans’ engagement
in PTSD treatment. Psychological Services, 6(4), 264–278.
Seal, K. H., Abadjian, L., McCamish, N., Shi, Y., Tarasovsky, G., & Wein-
gardt, K. (2012). A randomized controlled trial of telephone motivational inter-
viewing to enhance mental health treatment engagement in Iraq and Afghanistan
veterans. General Hospital Psychiatry, 34(5), 450–459.
17. Bell, K. R., Temkin, N. R., Esselman, P. C., Doctor, J. N., Bombardier, C. H., Fra-
ser, R. T., et al. (2005). The effect of a scheduled telephone intervention on outcome
after moderate to severe traumatic brain injury: A randomized trial. Archives of
Physical Medicine and Rehabilitation, 86, 851–856.
Bombardier, C. H., Bell, K. R., Temkin, N. R., Fann, J. R., Hoffman, J. M.,
& Dikmen, S. (2009). The efficacy of a scheduled telephone intervention for ame-
liorating depressive symptoms during the first year after traumatic brain injury.
Journal of Head Trauma Rehabilitation, 24(4), 230–238.
18. Kohl, K. S. (2022). The stalemate: Motivational interviewing at a carceral junction.
Incarceration: An International Journal of Imprisonment, Detention and Coer-
cive Confinement, 3(1), 1–18. This report by a sociologist reads like an exposé of
the practice.
19. Miller, W. R. (1994). Motivational interviewing: III. On the ethics of motivational
intervention. Behavioural and Cognitive Psychotherapy, 22, 111–123.
20. See note 18 (Kohl, 2022, p. 11).

19
 Chapter 6 Notes and References

Notes and References

1. Miller, W. R. (2022). On second thought: How ambivalence shapes your life. Guil-
ford Press.
2. Carey, K. B., Maisto, S. A., Carey, M. P., & Purnine, D. M. (2001). Measuring
readiness-to- change substance misuse among psychiatric outpatients: I. Reliability
and validity of self-report measures. Journal of Studies on Alcohol, 62(1), 79–88.
3. Moyers, T. B., Martin, T., Christopher, P. J., Houck, J. M., Tonigan, J. S., &
Amrhein, P. C. (2007). Client language as a mediator of motivational interviewing
efficacy: Where is the evidence? Alcoholism: Clinical and Experimental Research,
31(10, Suppl.), 40s–47s.
4. Glynn, L. H., & Moyers, T. B. (2010). Chasing change talk: The clinician’s role
in evoking client language about change. Journal of Substance Abuse Treatment,
39(1), 65–70.
Vader, A. M., Walters, S. T., Prabhu, G. C., Houck, J. M., & Field, C. A. (2010).
The language of motivational interviewing and feedback: Counselor language, client
language, and client drinking outcomes. Psychology of Addictive Behaviors, 24(2),
190–197.
5. Miller, W. R., & Rollnick, S. (2004). Talking oneself into change: Motivational
interviewing, stages of change, and the therapeutic process. Journal of Cognitive
Psychotherapy, 18, 299–308.
6. We are particularly indebted to our psycholinguist colleague Dr. Paul Amrhein, who
helped attune our ears to and develop coding systems for what we now call “change
talk.” See Amrhein, P. C. (1992). The comprehension of quasi-performance verbs in
verbal commitments: New evidence for componential theories of lexical meaning.
Journal of Memory and Language, 31, 756–784.
Amrhein, P. C., Miller, W. R., Yahne, C. E., Palmer, M., & Fulcher, L. (2003).
Client commitment language during motivational interviewing predicts drug use
outcomes. Journal of Consulting and Clinical Psychology, 71, 862–878.
Moyers, T. B., Martin, T., Catley, D., Harris, K. J., & Ahluwalia, J. S. (2003).
Assessing the integrity of motivational interventions: Reliability of the Motivational
Interviewing Skills Code. Behavioural and Cognitive Psychotherapy, 31, 177–184.
7. Farley, W. (2005). The wounding and healing of desire: Weaving heaven and earth.
Westminster John Knox.
8. Amrhein, P. C., Miller, W. R., Yahne, C. E., Palmer, M., & Fulcher, L. (2003).
Client commitment language during motivational interviewing predicts drug use
outcomes. Journal of Consulting and Clinical Psychology, 71, 862–878.
Daeppen, J.-B., Bertholet, N., Gmel, G., & Gaume, J. (2007). Communica-
tion during brief intervention, intention to change, and outcome. Substance Abuse,
28(3), 43–51.

20
 Chapter 6 Notes and References

9. Martin, T., Christopher, P. J., Houck, J. M., & Moyers, T. B. (2011). The struc-
ture of client language and drinking outcomes in Project MATCH. Psychology of
Addictive Behaviors, 25(3), 439–445.
Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S.
(2009). From in-session behaviors to drinking outcomes: A causal chain for motiva-
tional interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113–
1124.
Vader, A. M., Walters, S. T., Prabhu, G. C., Houck, J. M., & Field, C. A. (2010).
The language of motivational interviewing and feedback: Counselor language, cli-
ent language, and client drinking outcomes. Psychology of Addictive Behaviors,
24(2), 190–197.
10. Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S. (2009).
From in-session behaviors to drinking outcomes: A causal chain for motivational
interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113–1124.
11. Magill, M., Apodaca, T. R., Barnett, N. P., & Monti, P. M. (2010). The route
to change: Within-session predictors of change plan completion in a motivational
interview. Journal of Substance Abuse Treatment, 38(3), 299–305.
Moyers, T. B., Martin, T., Christopher, P. J., Houck, J. M., Tonigan, J. S., &
Amrhein, P. C. (2007). Client language as a mediator of motivational interviewing
efficacy: Where is the evidence? Alcoholism: Clinical and Experimental Research,
31(10, Suppl.), 40s–47s.
Vader, A. M., Walters, S. T., Prabhu, G. C., Houck, J. M., & Field, C. A. (2010).
The language of motivational interviewing and feedback: Counselor language, cli-
ent language, and client drinking outcomes. Psychology of Addictive Behaviors,
24(2), 190–197.
12. Gaume, J., Bertholet, N., Faouzi, M., Gmel, G., & Daeppen, J. B. (2010). Coun-
selor motivational interviewing skills and young adult change talk articulation dur-
ing brief motivational interventions. Journal of Substance Abuse Treatment, 39(3),
272–281.
Glynn, L. H., & Moyers, T. B. (2010). Chasing change talk: The clinician’s role
in evoking client language about change. Journal of Substance Abuse Treatment,
39(1), 65–70.
Moyers, T. B., Houck, J. M., Glynn, L. H., Hallgren, K. A., & Manual, J. K.
(2017). A randomized controlled trial to influence client language in substance use
disorder treatment. Drug and Alcohol Dependence, 172, 43–50.
13. Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S. (2009).
From in-session behaviors to drinking outcomes: A causal chain for motivational
interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113–1124.
14. Miller, W. R., & Rose, G. S. (2015). Motivational interviewing and decisional bal-
ance: Contrasting responses to client ambivalence. Behavioural and Cognitive Psy-
chotherapy, 43(2), 129–141.
15. Magill, M., Stout, R. L., & Apodaca, T. R. (2013). Therapist focus on ambivalence
and commitment: A longitudinal analysis of motivational interviewing treatment
ingredients. Psychology of Addictive Behaviors, 27(3), 754–762.
16. Prochaska, J. O. (1994). Strong and weak principles for progressing from precon-
templation to action on the basis of twelve problem behaviors. Health Psychology,
13, 47–51.
17. Resnicow, K., & McMaster, F. (2012). Motivational interviewing: Moving from
why to how with autonomy support. International Journal of Behavioral Nutrition
and Physical Activity, 9(19), 1–9.
18. Carcone, A. I., Naar, S., Clark, J., MacDonell, K., & Zhang, L. (2020). Provider
behaviors that predict motivational statements in adolescents and young adults

21
 Chapter 6 Notes and References

with HIV: A study of clinical communication using the motivational interviewing

framework. AIDS Care, 32(9), 1069–1077.
Carcone, A.
I., Naar-King, S., Brogan, K.
E., Albrecht, T., Barton, E., Fos-
ter, T., et al. (2013). Provider communication behaviors that predict motivation to
change in black adolescents with obesity. Journal of Developmental and Behav-
ioral Pediatrics, 34(8), 599–608.
19. Apodaca, T. R., Jackson, K. M., Borsari, B., Magill, M., Longabaugh, R., Mastro-
leo, N. R., et al. (2016). Which individual therapist behaviors elicit client change
talk and sustain talk in motivational interviewing? Journal of Substance Abuse
Treatment, 61, 60–65.
20. Miller, S. D., & Berg, I. K. (1996). The miracle method: A radically new approach
to problem drinking. Norton.
21. Angelini, F. J., & Efran, J. S. (2021). Motivational interviewing: Contributions
from structure determinism. Professional Psychology: Research and Practice,
52(4), 368–375.
Angelini, F. J., & Efran, J. S. (in press). Orthogonal interaction: Motivational
interviewing’s key ingredient. Journal of Psychotherapy Integration.
Bem, D. J. (1967). Self-perception: An alternative interpretation of cognitive
dissonance phenomena. Psychological Review, 74, 183–200.
Christopher, P. J., & Dougher, M. J. (2009). A behavior-analytic account of
motivational interviewing. Behavior Analyst, 32, 149–161.
Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational inter-
viewing. American Psychologist, 64(6), 527–537.
de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An
evolutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
Vansteenkiste, M., & Sheldon, K. M. (2006). There’s nothing more practical
than a good theory: Integrating motivational interviewing and self-determination
theory. British Journal of Clinical Psychology, 45(1), 63–82.
22. Kanfer, F. H. (1970). Self-regulation: Research, issues, and speculation. In C. Neu-
ringer & J. L. Michael (Eds.), Behavior modification in clinical psychology (pp.
178–220). Appleton- Century- Crofts.
Miller, W. R., & Brown, J. M. (1991). Self-regulation as a conceptual basis for
the prevention and treatment of addictive behaviours. In N. Heather, W. R. Miller,
& J. Greeley (Eds.), Self- control and the addictive behaviours (pp. 3–79). Maxwell
Macmillan Publishing Australia.
23. Wagner, C. C., & Sanchez, F. P. (2002). The role of values in motivational inter-
viewing. In W. R. Miller & S. Rollnick, Motivational interviewing: Preparing
people for change (2nd ed., pp. 284–298). Guilford Press.
24. Miller, W. R., Zweben, A., DiClemente, C. C., & Rychtarik, R. G. (1992). Moti-
vational enhancement therapy manual: A clinical research guide for therapists
treating individuals with alcohol abuse and dependence (Vol. 2, Project MATCH
Monograph Series). National Institute on Alcohol Abuse and Alcoholism.
25. Agostinelli, G., Brown, J. M., & Miller, W. R. (1995). Effects of normative feed-
back on consumption among heavy drinking college students. Journal of Drug
Education, 25, 31–40.
Cislaghi, B., & Berkowitz, A. D. (2021). The evolution of social norms interven-
tions for health promotion: Distinguishing norms correction and norms transfor-
mation. Journal of Global Health, 11, 03065.
Miller, W. R., Toscova, R. T., Miller, J. H., & Sanchez, V. (2000). A theory-
based motivational approach for reducing alcohol/drug problems in college. Health
Education and Behavior, 27, 744–759.
26. Christopher, P. J., & Dougher, M. J. (2009). A behavior-analytic account of moti-
vational interviewing. Behavior Analyst, 32, 149–161.

22
 Chapter 6 Notes and References

27. Angelini, F. J., & Efran, J. S. (in press). Orthogonal interaction: Motivational inter-
viewing’s key ingredient. Journal of Psychotherapy Integration,
Angelini, F. J., & Efran, J. S. (2021). Motivational interviewing: Contribu-
tions from structure determinism. Professional Psychology: Research and Practice,
52(4), 368–375.
28. de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An evo-
lutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
29. Weegmann, M. (2002). Motivational interviewing and addiction—A psychody-
namic appreciation. Psychodynamic Practice, 8(2), 179–195.
30. Deci, E. L., & Ryan, R. M. (2012). Self- determination theory in health care and its
relations to motivational interviewing: A few comments. International Journal of
Behavioral Nutrition and Physical Activity, 9(Article 24).
Markland, D., Ryan, R. M., Tobin, V. J., & Rollnick, S. (2005). Motivational
interviewing and self-determination theory. Journal of Social and Clinical Psychol-
ogy, 24(6), 811–831.
31. Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behav-
ioural Psychotherapy, 11, 147–172.
32. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relation-
ships as developed in the client- centered framework. In S. Koch (Ed.), Psychology:
The study of a science. Vol. 3. Formulations of the person and the social contexts
(pp. 184–256). McGraw-Hill.
33. Festinger, L. (1957). A theory of cognitive dissonance. Stanford University Press.
34. Bem, D. J. (1967). Self-perception: An alternative interpretation of cognitive dis-
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35. Engle, D. E., & Arkowitz, H. (2006). Ambivalence in psychotherapy: Facilitating
readiness to change. Guilford Press.
36. Berry, K., Palmer, T., Gregg, L., Barrowclough, C., & Lobban, F. (2018). Attach-
ment and therapeutic alliance in psychological therapy for people with recent onset
psychosis who use cannabis. Clinical Psychology and Psychotherapy, 25(3), 440–
445.
Westra, H. A. (2012). Motivational interviewing in the treatment of anxiety.
Guilford Press.
37. Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing.
American Psychologist, 64(6), 527–537.
Moyers, T. B., Martin, T., Houck, J. M., Christopher, P. J., & Tonigan, J. S.
(2009). From in-session behaviors to drinking outcomes: A causal chain for motiva-
tional interviewing. Journal of Consulting and Clinical Psychology, 77(6), 1113–
1124.
38. Karpiak, C. P., & Benjamin, L. S. (2004). Therapist affirmation and the process
and outcome of psychotherapy: Two sequential analytic studies. Journal of Clinical
Psychology, 60(6), 659–656.
39. Apodaca, T. R., Jackson, K. M., Borsari, B., Magill, M., Longabaugh, R., Mastro-
leo, N. R., & Barnett, N. P. (2016). Which individual therapist behaviors elicit cli-
ent change talk and sustain talk in motivational interviewing? Journal of Substance
Abuse Treatment, 61, 60–65.
40. Magill, M., Bernstein, M. H., Hoadley, A., Borsari, B., Apodaca, T. R., Gaume,
J., et al. (2019). Do what you say and say what you are going to do: A preliminary
meta-analysis of client change and sustain talk subtypes in motivational interview-
ing. Psychotherapy Research, 29(7), 860–869.
Magill, M., Gaume, J., Apodaca, T. R., Walthers, J., Mastroleo, N. R., Borsari,
B., et al. (2014). The technical hypothesis of motivational interviewing: A meta-
analysis of MI’s key causal model. Journal of Consulting and Clinical Psychology,
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23
 Chapter 6 Notes and References

41. Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E. F.,
et al. (2018). A meta-analysis of motivational interviewing process: Technical, rela-
tional, and conditional process models of change. Journal of Consulting and Clini-
cal Psychology, 86(2), 140–157.
42. An alternative metaphor from our colleague Dr. Theresa Moyers is that each bit
of change talk is a tasty chocolate and that a summary is like assembling a box of
chocolates that you periodically show to your client.
43. Miller, W. R., Rollnick, S., & Moyers, T. B. (2013). The committed smoker. In
Motivational interviewing: Helping people change (DVD series). The Change
Companies.
44. Moyers, T. B., Houck, J. M., Glynn, L. H., Hallgren, K. A., & Manual, J. K.
(2017). A randomized controlled trial to influence client language in substance use
disorder treatment. Drug and Alcohol Dependence, 172, 43–50.
Moyers, T. B., & Martin, T. (2006). Therapist influence on client language
during motivational interviewing sessions. Journal of Substance Abuse Treatment,
30(3), 245–252.
Walthers, J., Janssen, T., Mastroleo, N. R., Hoadley, A., Barnett, N. P., Colby,
S. M., et al. (2019). A sequential analysis of clinician skills and client change state-
ments in a brief motivational intervention for young adult heavy drinking. Behav-
ior Therapy, 50(4), 732–742.
45. Gollwitzer, P. M. (1999). Implementation intentions: Simple effects of simple plans.
American Psychologist, 54(7), 493–503.
Gollwitzer, P. M., Wieber, F., Myers, A. L., & McCrea, S. M. (2010). How
to maximize implementation intention effects. In C. R. Agnew, D. E. Carlston,
W. G. Graziano, & J. R. Kelly (Eds.), Then a miracle occurs: Focusing on behavior
in social psychological theory and research (pp. 137–161). Oxford University Press.
46. Gollwitzer, P. M. (1999). Implementation intentions: strong effects of simple plans.
American Psychologist, 54(7), 493.
47. Frankl, V. E. (2006). Man’s search for meaning. Beacon Press.
48. Cialdini, R. B. (2021). Influence: The psychology of persuasion (rev. ed.). Harper
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49. Bordin, E. S. (1994). Theory and research on the therapeutic working alliance:
New directions. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance:
Theory, research, and practice (pp. 13–37). Wiley.
Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in
psychotherapy. Journal of Consulting and Clinical Psychology, 61(4), 561–573.
50. Miller, W. R., & Rose, G. S. (2015). Motivational interviewing and decisional bal-
ance: Contrasting responses to client ambivalence. Behavioural and Cognitive Psy-
chotherapy, 43(2), 129–141.
51. Lemaitre, T., Carrier, N., Farrands, A., Gosselin, V., Petit, G., & Gagneur, A.
(2019). Impact of a vaccination promotion intervention using motivational inter-
view techniques on long-term vaccine coverage: The PromoVac strategy. Human
Vaccines and Immunotherapeutics, 15(3), 732–739.
52. Alison, L., & Alison, E. (2017). Revenge versus rapport: Interrogation, terrorism,
and torture. American Psychologist, 72(3), 266–277.
Alison, E., Humann, M., Alison, L., Tejeiro, R., Ratcliff, J., & Christiansen, P.
(2022). Observing Rapport-Based Interpersonal Techniques (ORBIT) to generate
useful information from child sexual abuse suspects. Investigative Interviewing
Research and Practice, 12(1), 24–39.
53. Quick, R. (2003). Changing community behaviour: Experience from three African
countries. International Journal of Environmental Health Research, 13, S115–
S121.
54. Kouwenhoven-Pasmooij, T. A., Robroek, S. J. W., Nieboer, D., Helmhout, P. H.,

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 Chapter 6 Notes and References

Wery, M. F., Hunink, M., et al. (2018). Quality of motivational interviewing mat-
ters: The effect on participation in health-promotion activities in a cluster random-
ized controlled trial. Scandinavian Journal of Work and Environment and Health,
44(4), 414–422.
55. Miller, W. R., Toscova, R. T., Miller, J. H., & Sanchez, V. (2000). A theory-based
motivational approach for reducing alcohol/drug problems in college. Health Edu-
cation and Behavior, 27, 744–759.
Sobell, L. C., Sobell, M. B., Leo, G. I., Agrawal, S., Johnson-Young, L., & Cun-
ningham, J. A. (2002). Promoting self- change with alcohol abusers: A community-
level mail intervention based on natural recovery studies. Alcoholism: Clinical and
Experimental Research, 26, 936–948.
56. Tagkaloglou, S., & Kasser, T. (2018). Increasing collaborative, pro- environmental
activism: The roles of motivational interviewing, self-determined motivation, and
self- efficacy. Journal of Environmental Psychology, 58(August), 86–92.
57. Miller, W. R. (2014). Interactive journaling as a clinical tool. Journal of Mental
Health Counseling, 36(1), 31–42.
58. Duggan, G. B. (2016). Applying psychology to understand relationships with tech-
nology: From ELIZA to interactive healthcare. Behaviour and Information Tech-
nology, 35(7), 536–547.

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 Chapter 7 Notes and References

Notes and References

1. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills that
improve client outcomes. Guilford Press.
2. Rollnick, S., Fader, J., Breckon, J., & Moyers, T. B. (2020). Coaching athletes to be
their best: Motivational interviewing in sports. Guilford Press.
Rollnick, S., Kaplan, S. G., & Rutschman, R. (2016). Motivational interviewing
in schools: Conversations to improve behavior and learning. Guilford Press.
Rollnick, S., Miller, W. R., & Butler, C. C. (2023). Motivational interviewing in
health care: Helping patients change behavior (2nd ed.). Guilford Press.
3. Miller, W. R. (1985). Motivation for treatment: A review with special emphasis on
alcoholism. Psychological Bulletin, 98, 84–107.
4. Kuerbis, A. N., Neighbors, C. J., & Morgenstern, J. (2011). Depression’s moderation
of the effectiveness of intensive case management with substance-dependent women
on temporary assistance for needy families: Outpatient substance use treatment uti-
lization and outcomes. Journal of Studies on Alcohol and Drugs, 72(2), 297–307.
Peters, L., Romano, M., Byrow, Y., Gregory, B., McLellan, L. F., Brockveld, K.,
et al. (2019). Motivational interviewing prior to cognitive behavioural treatment for
social anxiety disorder: A randomised controlled trial. Journal of Affective Disor-
ders, 256, 70–78.
Rohsenow, D. J., Monti, P. M., Martin, R. A., Colby, S. M., Myers, M. G.,

26
 Chapter 7 Notes and References

Gulliver, S. B., et al. (2004). Motivational enhancement and coping skills training
for cocaine abusers: Effects on substance use outcomes. Addiction, 99(7), 862–874.
5. Gutnick, D., Reims, K., Davis, C., Gainforth, H., Jay, M., & Cole, S. (2014). Brief
action planning to facilitate behavior change and support patient self-management.
Journal of Clinical Outcomes Management, 21(1), 17–29.
6. Cole, S., Sannidhi, D., Y., J., & Rozanski, A. (in press). Using motivational inter-
viewing and brief action planning for adopting and maintaining positive health
behaviors. Progress in Cardiovascular Diseases.
Döbler, A., Herbeck Belnap, B., Pollmann, H., Farin, E., Raspe, H., & Mittag,
O. (2018). Telephone-delivered lifestyle support with action planning and motiva-
tional interviewing techniques to improve rehabilitation outcomes. Rehabilitation
Psychology, 63(2), 170–181.
7. Prentice-Dunn, S., & Rogers, R. W. (1986). Protection motivation theory and pre-
ventive health: Beyond the health belief model. Health Education Research, 1(3),
153–161.
8. Meyers, R. J., Miller, W. R., Hill, D. E., & Tonigan, J. S. (1999). Community
reinforcement and family training (CRAFT): Engaging unmotivated drug users in
treatment. Journal of Substance Abuse, 10(3), 1–18.
Miller, W. R., Meyers, R. J., & Tonigan, J. S. (1999). Engaging the unmotivated
in treatment for alcohol problems: A comparison of three strategies for interven-
tion through family members. Journal of Consulting and Clinical Psychology, 67,
688–697.
9. The treatment that we developed and tested with concerned family members is
described in Smith, J. E., & Meyers, R. J. (2004). Motivating substance abus-
ers to enter treatment: Working with family members. Guilford Press. The same
approach is described in this method for family members themselves:
Smith, J. E., & Meyers, R. J. (2023). The CRAFT treatment manual for sub-
stance use problems: Working with family members. Guilford Press.
Meyers, R. J., & Wolfe, B. L. (2004). Get your loved one sober: Alternatives to
nagging, pleading and threatening. Hazelden Publishing and Educational Services.
10. We had a painful experience of losing this momentum in a study where we gave
counselors a manual to follow in single-session MI with people suffering from sub-
stance use disorders. We overprescribed what to do and required a change plan to be
developed by the end of the session. Listening to recordings of the sessions later, we
found two groups of people. Those in Group 1, the largest group, showed increas-
ing change talk through the session and were happy to discuss a change plan. Those
in Group 2 showed similar growth of motivational self-talk until it was time for a
change plan and weren’t ready to proceed. Our obedient counselors nevertheless
pushed ahead with a change plan, and motivation for change crashed to the ground.
At follow-up, Group 1 showed large change in drug use, whereas those in Group
2 did not. The mistake was ours in requiring counselors to push ahead regardless
of client reluctance—a definite no-no in MI. The study was Miller, W. R., Yahne,
C. E., & Tonigan, J. S. (2003). Motivational interviewing in drug abuse services:
A randomized trial. Journal of Consulting and Clinical Psychology, 71, 754–763.
11. Corno, L. Y. N. (1993). The best-laid plans: Modern conceptions of volition and
educational research. Educational Researcher, 22(2), 14–22.
12. Lila, M., Gracia, E., & Catalá-Miñana, A. (2018). Individualized motivational
plans in batterer intervention programs: A randomized clinical trial. Journal of
Consulting and Clinical Psychology, 86(4), 309–320.
Lee, C. S., Baird, J., Longabaugh, R., Nirenberg, T. D., Mello, M. J., &
Woolard, R. (2010). Change plan as an active ingredient of brief motivational inter-
ventions for reducing negative consequences of drinking in hazardous drinking

27
 Chapter 7 Notes and References

emergency- department patients. Journal of Studies on Alcohol and Drugs, 71,

726–733.
Döbler, A., Herbeck Belnap, B., Pollmann, H., Farin, E., Raspe, H., & Mittag,
O. (2018). Telephone-delivered lifestyle support with action planning and motiva-
tional interviewing techniques to improve rehabilitation outcomes. Rehabilitation
Psychology, 63(2), 170–181.
13. Amrhein, P. C., Miller, W. R., Yahne, C. E., Palmer, M., & Fulcher, L. (2003).
Client commitment language during motivational interviewing predicts drug use
outcomes. Journal of Consulting and Clinical Psychology, 71, 862–878.
14. Gollwitzer, P. M. (1999). Implementation intentions: Simple effects of simple plans.
American Psychologist, 54(7), 493–503.
15. Bertholet, N., Faouzi, M., Gmel, G., Gaume, J., & Daeppen, J. B. (2010). Change
talk sequence during brief motivational intervention, towards or away from drink-
ing. Addiction, 105, 2106–2112.
Campbell, S. D., Adamson, S. J., & Carter, J. D. (2010). Client language dur-
ing motivational enhancement therapy and alcohol use outcome. Behavioural and
Cognitive Psychotherapy, 38(4), 399–415.
Vader, A. M., Walters, S. T., Prabhu, G. C., Houck, J. M., & Field, C. A. (2010).
The language of motivational interviewing and feedback: Counselor language, cli-
ent language, and client drinking outcomes. Psychology of Addictive Behaviors,
24(2), 190–197.
16. Magill, M., Apodaca, T. R., Barnett, N. P., & Monti, P. M. (2010). The route
to change: Within-session predictors of change plan completion in a motivational
interview. Journal of Substance Abuse Treatment, 38(3), 299–305.
17. Albert Bandura described these as “general efficacy” (the belief that it is possible)
and “self- efficacy” (the belief that it is possible for me). Bandura, A. (1997). Self-
efficacy: The exercise of control. Freeman.
18. Chariyeva, Z., Golin, C. E., Earp, J. A., Maman, S., Suchindran, C., & Zimmer, C.
(2013). The role of self- efficacy and motivation to explain the effect of motivational
interviewing time on changes in risky sexual behavior among people living with
HIV: A mediation analysis. AIDS and Behavior, 17(2), 813–823.
Hevey, D., Smith, M. L., & McGee, H. M. (1998). Self- efficacy and health
behaviour: A review. The Irish Journal of Psychology, 19(2–3), 248–273.
Schunk, D. H. (199). Self- efficacy, motivation, and performance. Journal of
Applied Sport Psychology, 7(2), 112–137.
19. Bandura, A. (1982). Self- efficacy mechanism in human agency. American Psycholo-
gist, 37, 122–147.
Bandura, A. (1997). Self- efficacy: The exercise of control. Freeman.
20. Ajzen, I., & Madden, T. J. (1986). Prediction of goal- directed behavior: Attitudes,
intentions, and perceived behavioral control. Journal of Experimental Social Psy-
chology, 22(5), 453–474.
Madden, T. J., Ellen, P. S., & Ajzen, I. (1992). A comparison of the theory of
planned behavior and the theory of reasoned action. Personality and Social Psy-
chology Bulletin, 18(1), 3–9.
21. Ashford, S., Edmunds, J., & French, D. P. (2010). What is the best way to change
self- efficacy to promote lifestyle and recreational physical activity? A systematic
review with meta-analysis. British Journal of Health Psychology, 15(2), 265–288.
Hyde, J., Hankins, M., Deale, A., & Marteau, T. M. (2008). Interventions to
increase self- efficacy in the context of addiction behaviours: A systematic literature
review. Journal of Health Psychology, 13(5), 607–623.
22. Burleson, J. A., & Kaminer, Y. (2005). Self- efficacy as a predictor of treatment out-
come in adolescent substance use disorders. Addictive Behaviors, 30(9), 1751–1764.

28
 Chapter 7 Notes and References

O’Leary, A. (1985). Self- efficacy and health. Behaviour Research and Therapy,
23(4), 437–451.
Robinson, A. L., Strahan, E., Girz, L., Wilson, A., & Boachie, A. (2013). ‘I
know I can help you’: Parental self- efficacy predicts adolescent outcomes in fa m-
ily-based therapy for eating disorders. European Eating Disorders Review, 21(2),
108–114.
23. Weiner, B. (2018). The legacy of an attribution approach to motivation and emo-
tion: A no- crisis zone. Motivation Science, 4(1), 4–14.

29
 Chapter 8 Notes and References

Notes and References

1. Simply counting reflective listening responses does not predict treatment outcome.
What matters is the quality of empathic understanding. See Elliott, R., Bohart,
A., Larson, D. B., Smoliak, O., & Mintigl, P. (in press). Empathic reflection. In
C. E. Hill & J. C. Norcross (Eds.), Psychotherapy skills and methods that work.
Oxford University Press.
2. Adam Grant clearly explains the value of not knowing or assuming in his book
Think Again: The Power of Knowing What You Don’t Know. (2021, Viking)
3. Elliott, R., Bohart, A. C., Watson, J. C., & Murphy, D. (2018). Therapist empathy
and client outcome: An updated meta-analysis. Psychotherapy, 55(4), 399–410.
Larson, D. G. (2020). The helper’s journey: Empathy, compassion and the chal-
lenge of caring (2nd ed.). Research Press.
Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
4. Although clients in treatment will sometimes consent to be videotaped for demon-
stration purposes, we as psychotherapists have been reluctant to impose on their
vulnerability in the midst of stress and suffering. An alternative that we have used
successfully for demonstration purposes is to interview an actor who presents with a
prepared role. There is no script; the actor is told only to react naturally within the
role, and both know little about what the other will say. This creates a spontaneity
that looks and feels very much like a first clinical interview. “John” was a profes-
sional actor whom I (Bill) had never met until we sat down together in front of the
cameras. My assignment was just to demonstrate empathic listening, and 30 seconds

30
 Chapter 8 Notes and References
154 A DEEPER DIVE INTO MI

into the interview I was dismayed because I had a very nonverbal client who did not
even look at me. It nevertheless turned out to be a clear demonstration of engag-
ing skills. This is a transcription of the interview. Originally recorded in 1998, the
video interview is included in Miller, W. R., Rollnick, S., & Moyers, T. B. (2013).
Motivational interviewing: Helping people change (DVD series). The Change
Companies. www.changecompanies.net/products/motivational- interviewing-
videos. Copyright © 2013 William R. Miller, Theresa B. Moyers, and Stephen
Rollnick. Used by permission.
5. Truax, C. B., & Carkhuff, R. R. (1967). Toward effective counseling and psycho-
therapy. Aldine.
6. The common human experience of ambivalence is explored in Miller, W. R. (2022).
On second thought: How ambivalence shapes your life. Guilford Press.
7. Nichols, M. P., & Straus, M. B. (2021). The lost art of listening: How learning to
listen can improve relationships (3rd ed.). Guilford Press.
Rakel, D. (2018). The compassionate connection: The healing power of empa-
thy and mindful listening. Norton.
Miller, W. R. (2018). Listening well: The art of empathic understanding. Wipf
& Stock.
8. Gordon, T. (1970). Parent effectiveness training. Wyden.
9. Gilmore, S. K. (1973). The counselor-in- training. Prentice-Hall.
10. Miller, W. R., Hedrick, K. E., & Orlofsky, D. (1991). The Helpful Responses Ques-
tionnaire: A procedure for measuring therapeutic empathy. Journal of Clinical Psy-
chology, 47, 444–448.
11. Miller, W. R., Taylor, C. A., & West, J. (1980). Focused versus broad- spectrum
behavior therapy for problem drinkers. Journal of Consulting and Clinical Psy-
chology, 48(5), 590–601.
Miller, W. R., & Baca, L. M. (1983). Two-year follow-up of bibliotherapy and
therapist- directed controlled drinking training for problem drinkers. Behavior
Therapy, 14, 441–448.
12. Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behav-
ioural Psychotherapy, 11, 147–172.

31
 Chapter 9 Notes and References

Notes and References

1. Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making: Pinnacle of
patient- centered care. New England Journal of Medicine, 366(9), 780–781.
Elwyn, G., & Frosch, D. L. (2016). Shared decision making and motivational
interviewing: Achieving patient- centered care across the spectrum of health care
problems. Annals of Family Medicine, 12(3), 270–275.
2. Miller, W. R. (2022). On second thought: How ambivalence shapes your life. Guil-
ford Press.
3. Kang, E., Kim, M. Y., Lipsey, K. L., & Foster, E. R. (2022). Person- centered goal
setting: A systematic review of intervention components and level of active engage-
ment in rehabilitation goal setting interventions. Archives of Physical Medicine and
Rehabilitation, 103(1), 121–130.

32
 Chapter 9 Notes and References

4. Danish police, for example, tried to use MI to persuade refugees who had been
denied asylum to leave the country. It was not only ineffective but also distasteful to
both the interviewers and the refugees. Kohl, K. S. (2022). The stalemate: Motiva-
tional interviewing at a carceral junction. Incarceration: An international Journal
of Imprisonment, Detention and Coercive Confinement, 3(1), 1–18.
5. Maslow, A. H. (1970). Motivation and personality (2nd ed.). Harper & Row.
6. Rokeach, M. (1973). The nature of human values. Free Press.
7. Epton, T., Harris, P. R., Kane, R., van Konigsbruggen, G. M., & Sheeran, P. (2015).
The impact of self-affirmation on health-behavior change: A meta-analysis. Health
Psychology, 34(3), 187–196.
Steele, C. M. (1988). The psychology of self-affirmation: Sustaining the integ-
rity of the self. Advances in Experimental Social Psychology, 21, 261–302.
8. Kirschenbaum, H. (2013). Values clarification: Practical strategies for individual
and group settings. Oxford University Press.
Rokeach, M. (1973). The nature of human values. Free Press.
9. Miller, W. R. (1994). Motivational interviewing: III. On the ethics of motivational
intervention. Behavioural and Cognitive Psychotherapy, 22, 111–123.
10. Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behav-
ioural Psychotherapy, 11, 147–172.
11. Miller, W. R. (1994). Motivational interviewing: III. On the ethics of motivational
intervention. Behavioural and Cognitive Psychotherapy, 22, 111–123. We also dis-
cussed this issue in more detail in our third edition of this book.
U.S. National Commission for the Protection of Human Subjects of Biomedi-
cal and Behavioral Research. (2017). The Belmont report: Ethical principles and
guidelines for the protection of human subjects of research. Forgotten Books.
12. Horvath, A. O., & Greenberg, L. S. (1994). The working alliance: Theory, research,
and practice. Wiley.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic
alliance with outcome and other variables: A meta-analytic review. Journal of Con-
sulting and Clinical Psychology, 68(3), 438–450.
13. Franklin, B. (1904). Moral or prudential algebra: Letter to Joseph Priestly (Septem-
ber 19, 1772). In J. Bigelow (Ed.), The works of Benjamin Franklin (Vol. V): Let-
ters and misc. writings 1768–1772. Putnam.
14. Janis, I. L., & Mann, L. (1977). Decision making: A psychological analysis of
conflict, choice and commitment. Free Press.
15. Glynn, L. H., & Moyers, T. B. (2010). Chasing change talk: The clinician’s role
in evoking client language about change. Journal of Substance Abuse Treatment,
39(1), 65–70.
16. Stott, N. C. H., Rees, M., Rollnick, S., Pill, R. M., & Hackett, P. (1996). Profes-
sional responses to innovation in clinical method: Diabetes care and negotiating
skills. Patient Education and Counseling, 29(1), 67–73.
17. Gobat, N., Kinnersley, P., Gregory, J., Pickles, T., Hood, K., & Robling, M. (2015).
Measuring clinical skills in agenda-mapping (EAGL-I). Patient Education and
Counseling, 98(10), 1214–1221.

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 Chapter 10 Notes and References

Notes and References

1. The most famous is Carl Rogers, pioneer of client- centered counseling, which he
originally called “nondirective,” a term he subsequently abandoned in favor of a
“person- centered” way of being. Kirschenbaum, H. (2009). The life and work of
Carl Rogers. American Counseling Association.
Rogers, C. R. (1980). A way of being. Houghton Mifflin.
2. Forman, D. P., & Moyers, T. B. (2021). Should substance use counselors choose a
direction for their clients? Motivational interviewing trainers may be ambivalent.
Alcoholism Treatment Quarterly, 39(4), 446–454.
3. The interviewer here is Dr. Theresa Moyers. This is one of 14 demonstration inter-
views in Miller, W. R., Rollnick, S., & Moyers, T. B. (2013). Motivational Inter-
viewing: Helping People Change (DVD series). The Change Companies. www.
changecompanies.net/products/motivational- interviewing- videos. Used by permis-
sion.
4. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills that
improve client outcomes. Guilford Press.
5. Gendlin, E. T. (1961). Experiencing: A variable in the process of therapeutic change.
American Journal of Psychotherapy, 15(2), 233–245.
6. Klein, M. H., Mathieu- Coughlan, P., & Kiesler, D. J. (1986). The experiencing
scales. In L. S. Greenberg & W. M. Pinsof (Eds.), The psychotherapeutic process: A
research handbook (pp. 21–71). Guilford Press.
7. Stiles, W. B., McDaniel, S. H., & Gaughey, K. (1979). Verbal response mode cor-
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797.
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10. Tsai, M., Yard, S., & Kohlenberg, R. J. (2014). Functional analytic psychotherapy:
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motivational interviewing intervention reduces drinking and alcohol-related conse-

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 Chapter 11 Notes and References

Notes and References

1. de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An evolu-
tionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
2. Attributed to Bernard Williams.
3. Brehm, S. S., & Brehm, J. W. (1981). Psychological reactance: A theory of freedom
and control. Academic Press.
de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An
evolutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
Rains, S. A. (2013). The nature of psychological reactance revisited: A meta-
analytic review. Human Communication Research, 39(1), 47–73.
4. “The confused artist” interview in Miller, W. R., Rollnick, S., & Moyers, T. B.
(2013). Motivational interviewing: Helping people change (DVD series). The
Change Companies. Available from www.changecompanies.net/products/
motivational- interviewing- videos. Reprinted with permission.
5. Kendler, K. S., Gardner, C. O., & Prescott, C. A. (2002). Toward a comprehensive
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Notes and References

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17. Miller, W. R., & Forcehimes, A. (2021). Getting back on track: An interactive
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person at a time. In W. O’Donohue & A. Maragakis (Eds.), Quality improvement
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Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating moti-

vational interviewing with cognitive-behavioral therapy for severe generalized
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mitment therapy and supported with motivational interviewing affects levels of
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22. Engle, D. E., & Arkowitz, H. (2006). Ambivalence in psychotherapy: Facilitating
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dynamic appreciation. Psychodynamic Practice, 8(2), 179–195.
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Giordano, A. L., & Cashwell, C. S. (2014). Entering the sacred: Using motiva-
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direction in addiction treatment: Two clinical trials. Journal of Substance Abuse
Treatment, 35, 434–442.
26. Moe, E. L., Elliot, D. L., Goldberg, L., Kuehl, K. S., Stevens, V. J., Breger, R. K.,
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Indredavik, B., et al. (2019). Adherence to a long-term physical activity and exercise

40
 Chapter 12 Notes and References

program after stroke applied in a randomized controlled trial. Physical Therapy,

99(1), 74–85.
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O., et al. (2019). Enhancing statin adherence using a motivational interviewing
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viewing and treatment adherence among psychiatric and dually diagnosed patients.
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that improve client outcomes. Guilford Press.

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 Chapter 13 Notes and References

Notes and References

1. Johnson, W. (2008). Gardening at the dragon’s gate: At work in the wild and culti-
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Miller, W. R., Meyers, R. J., & Tonigan, J. S. (1999). Engaging the unmotivated
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through family members. Journal of Consulting and Clinical Psychology, 67, 688–697.
3. Meyers, R. J., & Wolfe, B. L. (2004). Get your loved one sober: Alternatives to
nagging, pleading and threatening. Hazelden Publishing and Educational Services.
4. There is now a large body of research on working through family members and con-
cerned significant others when their loved one seems unwilling to seek help.
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Kirby, K. C., Marlowe, D. B., Festinger, D. S., Garvey, K. A., & McMonaca,

42
 Chapter 13 Notes and References

V. (1999). Community reinforcement training for family and significant others of

drug abusers: A unilateral intervention to increase treatment entry of drug users.
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5. Miller, W. R. (2022). On second thought: How ambivalence shapes your life. Guil-
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tional interviewing: Helping people change (DVD series). The Change Companies.
www.changecompanies.net/products/motivational- interviewing- videos.
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quo and a client’s important goals and values.
10. Miller, W. R., & Moyers, T. B. (2021). Offering information and advice. In Effec-
tive psychotherapists: Clinical skills that improve client outcomes (pp. 109–118).
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with problem drinkers: II. The Drinker’s Check-up as a preventive intervention.
Behavioural Psychotherapy, 16, 251–268.
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nal of Consulting and Clinical Psychology, 61, 455–461.
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eHealth model for the prevention of problem behavior during the middle school
years. Development and Psychopathology, 31(5), 1873–1886.
14. Miller, W. R., Zweben, A., DiClemente, C., & Rychtarik, R. (1992). Motivational
enhancement therapy manual: A clinical research guide for therapist treating indi-
viduals with alcohol abuse and dependence (Vol. 2). National Institute on Alcohol
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Maintenance check-ups following treatment for cannabis dependence. Journal of
Substance Abuse Treatment, 56, 11–15.

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Walker, D. D., Roffman, R. A., Stephens, R. S., Wakana, K., Berghuis, J. P.,
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L. E., et al. (2000). Using information, motivational enhancement, and skills train-
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randomized clinical trial. Health Psychology, 19, 3–11.
DiClemente, R. J., Rosenbaum, J. E., Rose, E. S., Sales, J. M., Brown, J. L.,
Renfro, T. L., et al. (2021). Horizons and group motivational enhancement therapy:
HIV prevention for alcohol-using young Black women, a randomized experiment.
American Journal of Preventive Medicine, 60(5), 629–638.
19. Morrill, M. I., Eubanks-Fleming, C. J., Harp, A. G., Sollenberger, J. W., Darling,
E. V., & Cordova, J. V. (2011). The marriage check-up: Increasing access to marital
health care. Family Process, 50, 471–485.
20. Dishion, T. J., Brennan, L. M., Shaw, D. S., McEachern, A. D., Wilson, M. N., &
Jo, B. (2014). Prevention of problem behavior through annual family check-ups in
early childhood: Intervention effects from home to early elementary school. Journal
of Abnormal Psychology, 42(3), 343–354.
Uebelacker, L. A., Hecht, J., & Miller, I. W. (2006). The family check-up: A
pilot study of a brief intervention to improve family functioning in adults. Family
Process, 45, 223–236.
Van Ryzin, M. J., Stormshak, E. A., & Dishion, T. J. (2012). Engaging parents
in the family check-up in middle school: Longitudinal effects on family conflict
and problem behavior through the high school transition. Journal of Adolescent
Health, 50(6), 627–633.
21. Kopp, C. B. (1982). The antecedents of self-regulation: A developmental perspec-
tive. Developmental Psychology, 18, 99–214.
Miller, W. R., & Brown, J. M. (1991). Self-regulation as a conceptual basis for
the prevention and treatment of addictive behaviours. In N. Heather, W. R. Miller,
& J. Greeley (Eds.), Self- control and the addictive behaviours (pp. 3–79). Maxwell
Macmillan Publishing Australia.
Vohs, K. D., & Baumeister, R. F. (Eds.). (2016). Handbook of self- regulation:
Research, theory, and applications (3rd ed.). Guilford Press.
22. Reid, A. E., Cialdini, R. B., & Aiken, L. S. (2010). Social norms and health behav-
ior. In A. Steptoe (Ed.), Handbook of behavioral medicine: Methods and applica-
tions (pp. 263–274). Springer.
Agostinelli, G., Brown, J. M., & Miller, W. R. (1995). Effects of normative
feedback on consumption among heavy drinking college students. Journal of Drug
Education, 25, 31–40.

44
 Chapter 14 Notes and References

Notes and References

1. Miller, W. R. (2022). On second thought: How ambivalence shapes your life. Guil-
ford Press.
2. Brown, B. (2018). Dare to lead: Brave work, tough conversations, whole hearts.
Random House, p. 96.
3. Brehm, S. S., & Brehm, J. W. (1981). Psychological reactance: A theory of freedom
and control. Academic Press.
de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An
evolutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
Rains, S. A. (2013). The nature of psychological reactance revisited: A meta-
analytic review. Human Communication Research, 39(1), 47–73.
4. de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An evo-
lutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
5. Patterson, G. R., & Forgatch, M. S. (1985). Therapist behavior as a determinant for
client noncompliance: A paradox for the behavior modifier. Journal of Consulting
and Clinical Psychology, 53(6), 846–851.
Glynn, L. H., & Moyers, T. B. (2010). Chasing change talk: The clinician’s role
in evoking client language about change. Journal of Substance Abuse Treatment,
39(1), 65–70.
6. Chamberlain, P., Patterson, G., Reid, J., Kavanagh, K., & Forgatch, M. S. (1984).
Observation of client resistance. Behavior Therapy, 15, 144–155.
7. Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E. F.,
et al. (2018). A meta-analysis of motivational interviewing process: Technical, rela-
tional, and conditional process models of change. Journal of Consulting and Clini-
cal Psychology, 86(2), 140–157.
8. We acknowledge that within the context of an empathic and compassionate rela-
tionship, an occasional confrontation or disagreeing response can sometimes have
a positive effect on change.
9. In prior editions we called this strategy a “running head start.” The pendulum
metaphor works better because moving in one direction naturally leads to a coun-
terbalancing swing in the opposite direction.
10. This dialogue is from Lewis, J. (2001). Motivational interviewing with Dr. William
R Miller. Copyright © 2001 by Pearson Education. Reprinted by permission of
Pearson Education, Inc. The video recording from which it is transcribed is avail-
able for purchase from www.psychotherapy.net.
11. Join-Up is a term that Monty Roberts uses for the method and moment of

45
Chapter 14 Notes and References

collaborative union between horse and trainer. There are some differences in
method to be sure, but there are many interesting similarities between Join-Up and
MI.
Miller, W. R. (2000). Motivational interviewing: IV. Some parallels with horse
whispering. Behavioural and Cognitive Psychotherapy, 28, 285–292.
Roberts, M. (2001). Horse sense for people. Knopf.
Roberts, M. (2008). The man who listens to horses: The story of a real-life
horse whisperer. Random House.

46
 Chapter 15 Notes and References

Notes and References

1. Endrejat, P. C., & Kauffeld, S. (2021). Learning motivational interviewing: pros-
pects to preserve practitioners’ well-being. International Journal of Workplace
Health Management, 14(1), 1–11.
Norman, Å., Lundberg, U., Farbring, C. Å., Källmén, H., & Forsberg, L. (2020).
The feasibility and potential of training correctional officers in flexible styles of com-
munication to reduce burnout: A multiple baseline trial in real-life settings. Scandi-
navian Journal of Work and Organizational Psychology, 5(1), Article 12.
Ogunmilugba, B. J. (2021). Effects of motivational interviewing and mindfulness

47
 Chapter 15 Notes and References

based cognitive therapies on academic burnout among extra-mural students in

Ekiti state, Nigeria. Dissertation, University of Ibadan, Nigeria.
Pollak, K. I., Nagy, P., Bigger, J., Bilheimer, A., Lyna, P., Gao, X., et al. (2016).
Effect of teaching motivational interviewing via communication coaching on clini-
cian and patient satisfaction in primary care and pediatric obesity-focused offices.
Patient Education and Counseling, 99(2), 300–303.
2. Brehm, S. S., & Brehm, J. W. (1981). Psychological reactance: A theory of freedom
and control. Academic Press.
de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An
evolutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
3. Rogers, C. R. (1980). A way of being. Houghton Mifflin.
4. Davis, D. M., & Hayes, J. A. (2011). What are the benefits of mindfulness? A
practice review of psychotherapy-related research. Psychotherapy, 48(2), 198–208.
Thich Nhat Hanh. (2015). The miracle of mindfulness: An introduction to the
practice of meditation (Mobi Ho, Trans.). Beacon Press.
5. Fuertes, J. N., Mislowack, A., Bennett, J., Paul, L., Gilbert, T. C., Fontan, G., &
Boylan, L. S. (2007). The physician-patient working alliance. Patient Education
and Counseling, 66(1), 29–36.
Haug, T., Nordgreen, T., Öst, L.-G., Tangen, T., Kvale, G., Hovland, O. J., et
al. (2016). Working alliance and competence as predictors of outcome in cogni-
tive behavioral therapy for social anxiety and panic disorder in adults. Behaviour
Research and Therapy, 77, 40–51.
Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance
and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychol-
ogy, 38(2), 139–149.
Lacrose, S., Chaloux, N., Monaghan, D., & Tarabulsy, G. M. (2010). Working
alliance as a moderator of the impact of mentoring relationships among academi-
cally at-risk students. Journal of Applied Social Psychology, 40(10), 2656–2686.
6. Cialdini, R. B. (2021). Influence: The psychology of persuasion (rev. ed.). Harper
Collins.
7. Markland, D., Ryan, R. M., Tobin, V., & Rollnick, S. (2005). Motivational inter-
viewing and self- determination theory. Journal of Social and Clinical Psychology,
24, 811–831.
Ryan, R. M., & Deci, E. L. (2017). Self- determination theory: Basic psycho-
logical needs in motivation, development, and wellness. Guilford Press.
Vansteenkiste, M., & Sheldon, K. M. (2006). There’s nothing more practical
than a good theory: Integrating motivational interviewing and self-determination
theory. British Journal of Clinical Psychology, 45(1), 63–82.
8. Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making— Pinnacle of
patient- centered care. New England Journal of Medicine, 366(9), 780–781.
Elwyn, G., & Frosch, D. L. (2016). Shared decision making and motivational
interviewing: Achieving patient- centered care across the spectrum of health care
problems. Annals of Family Medicine, 12(3), 270–275.
9. de Almeida Neto, A. C. (2017). Understanding motivational interviewing: An evo-
lutionary perspective. Evolutionary Psychological Science, 3(4), 379–389.
10. Miller, S. D., Bargmann, S., Chow, D., Seidel, J., & Maeschalck, C. (2016). Feed-
back Informed Treatment (FIT): Improving the outcome of psychotherapy one per-
son at a time. In W. O’Donohue & A. Maragakis (Eds.), Quality improvement in
behavioral health (pp. 247–262). Springer.
Miller, S. D., Duncan, B. L., Brown, J., Sorrell, R., & Chalk, M. B. (2006).
Using formal client feedback to improve retention and outcome: Making ongoing,
real-time assessment feasible. Journal of Brief Therapy, 5(1), 5–22.

48
 Chapter 16 Notes and References

Notes and References

1. As of this writing, our bibliography of MI outcome literature included more than
2,000 controlled trials.
2. Miller, W. R., & Mount, K. A. (2001). A small study of training in motivational
interviewing: Does one workshop change clinician and client behavior? Behavioural
and Cognitive Psychotherapy, 29, 457–471.
3. The MI Skills Code is available at https://casaa.unm.edu/codinginst.html. For early
studies of this instrument, see: DeJonge, J. J. M., Schippers, G. M., & Schaap,

49
 Chapter 16 Notes and References

C. P. D. R. (2005). The Motivational Interviewing Skill Code: Reliability and a criti-

cal appraisal. Behavioural and Cognitive Psychotherapy, 33, 1–14.
Moyers, T. B., Martin, T., Catley, D., Harris, K. J., & Ahluwalia, J. S. (2003).
Assessing the integrity of motivational interventions: Reliability of the Motivational
Interviewing Skills Code. Behavioural and Cognitive Psychotherapy, 31, 177–184.
Welch, G., Rose, G., Hanson, D., Lekarcyk, J., Smith- Ossman, S., Gordon, T., et
al. (2003). Changes in Motivational Interviewing Skills Code (MISC) scores follow-
ing motivational interviewing training for diabetes educators. Diabetes, 52(Suppl.
1), A421.
4. This is sometimes called the Dunning– Kruger effect: overvaluing your skills because
you don’t know what you don’t know. It is more common for novices, and some
people outgrow it while others do not. Dunning, D. (2011). The Dunning– Kruger
effect: On being ignorant of one’s own ignorance. In J. M. Olson & M. P. Zanna
(Eds.), Advances in experimental social psychology (Vol. 44, pp. 247–296). Aca-
demic Press.
5. Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J., & Pirritano, M. (2004).
A randomized trial of methods to help clinicians learn motivational interviewing.
Journal of Consulting and Clinical Psychology, 72(6), 1050–1062.
6. Fixsen, D. L., Blase, K. A., & Van Dyke, M. K. (2019). Implementation practice and
science. Active Implementation Research Network.
Miller, W. R., Sorensen, J. L., Selzer, J. A., & Brigham, G. S. (2006). Dissemi-
nating evidence-based practices in substance abuse treatment: A review with sugges-
tions. Journal of Substance Abuse Treatment, 31(1), 25–39.
7. Barwick, M. A., Bennett, L. M., Johnson, S. N., McGowan, J., & Moore, J. E.
(2012). Training health and mental health professionals in motivational interview-
ing: A systematic review. Children and Youth Services Review, 34(9), 1786–1795.
de Roten, Y., Zimmerman, G., Ortega, D., & Despland, J. N. (2013). Meta-
analysis of the effects of MI training on clinicians’ behavior. Journal of Substance
Abuse Treatment, 45, 155–162.
Hall, K., Staiger, P. K., Simpson, A., Best, D., & Lubman, D. I. (2016). After 30
years of dissemination, have we achieved sustained practice change in motivational
interviewing? Addiction, 111(7), 1144–1150.
Kaczmarek, T., Kavanagh, D., Lazzarini, P. A., Warnock, J., & Van Netten, J. J.
(2022). Training diabetes healthcare practitioners in motivational interviewing: A
systematic review. Health Psychology Review, 16(3), 430–449.
Madson, M. B., Loignon, A. C., & Lane, C. (2009). Training in motivational
interviewing: A systematic review. Journal of Substance Abuse Treatment, 36(1),
101–109.
Maslowski, A. K., Owens, R. L., LaCaille, R. A., & Clinton-Lissell, V. (2021). A
systematic review and meta-analysis of motivational interviewing training effective-
ness among students-in-training. Training and Education in Professional Psychol-
ogy, 16(4), 354–361.
Schwalbe, C. S., Oh, H. Y., & Zweben, A. (2014). Sustaining motivational inter-
viewing: A meta-analysis of training studies. Addiction, 109(8), 1287–1294.
Soderlund, L. L., Madson, M. B., Rubak, S., & Nilsen, P. (2011). A systematic
review of motivational interviewing training for general health care practitioners.
Patient Education and Counseling, 84(1), 16–26.
8. Schwalbe, C. S., Oh, H. Y., & Zweben, A. (2014). Sustaining motivational inter-
viewing: A meta-analysis of training studies. Addiction, 109(8), 1287–1294.
9. Miller, W. R., Moyers, T. B., Arciniega, L., Ernst, D., & Forcehimes, A. (2005).
Training, supervision and quality monitoring of the COMBINE Study behavioral
interventions. Journal of Studies on Alcohol, 15(Suppl.), 188–195.

50
 Chapter 16 Notes and References

10. https://motivationalinterviewing.org.
11. See note 5.
12. Langlois, S., & Goudreau, J. (in press). “From health experts to health guides”:
Motivational interviewing learning processes and influencing factors. Health Edu-
cation and Behavior.
13. See note 4.
14. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
that improve client outcomes. Guilford Press.
Truax, C. B., & Carkhuff, R. R. (1976). Toward effective counseling and psy-
chotherapy: Training and practice. Aldine Transaction.
15. Miller, W. R. (2018). Listening well: The art of empathic understanding. Wipf &
Stock.
Nichols, M. P., & Strauss, M. B. (2021). The lost art of listening: How learning
to listen can improve relationships (3rd ed.). Guilford Press.
Rakel, D. (2018). The compassionate connection: The healing power of empa-
thy and mindful listening. Norton.
16. Egan, G., & Reese, R. J. (2019). The skilled helper: A problem- management and
opportunity- development approach to helping (11th ed.). Cengage.
Rosengren, D. B. (2018). Building motivational interviewing skills: A practitio-
ner workbook (2nd ed.). Guilford Press.
17. Miller, W. R. (2018). Listening well in conflict. In Listening well: The art of
empathic understanding (pp. 84–94). Wipf & Stock.
18. Here we consciously say “directional” rather than “directive.” The focusing pro-
cess (Chapters 4 and 8) is necessarily a collaborative one to arrive at shared change
goals. Evoking processes then intentionally move in the chosen direction.
19. Indeed, Carl Rogers originally called his counseling approach “nondirective,” but
later he dropped this term in favor of “client- centered.” Kirschenbaum, H. (2009).
The life and work of Carl Rogers. American Counseling Association.
In practice, Rogers may not have been truly “unconditional” in his counsel-
ing responses, but he differentially reinforced certain positive change directions.
Truax, C. B. (1966). Reinforcement and non-reinforcement in Rogerian psycho-
therapy. Journal of Abnormal Psychology, 71, 1–9.
Bowen, M. V.-B. (1996). Commentary: The myth of non- directiveness—The
case of Jill. In B. A. Farber, D. C. Brink, & P. M. Raskin (Eds.), The psychotherapy
of Carl Rogers: Cases and commentary (pp. 84–94). Guilford Press.
20. The technical skills of MI have been differentiated from the relational skills of
engaging. Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational
interviewing. American Psychologist, 64(6), 527–537.
21. Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., & Andrews,
W. P. (2015). The role of deliberate practice in the development of highly effective
psychotherapists. Psychotherapy, 52(3), 337–345.
Miller, S. D., Hubble, M. A., & Chow, D. (2020). Better results: Using deliber-
ate practice to improve therapeutic effectiveness. American Psychological Associa-
tion.
22. Manuel, J. K., Ernst, D., Vaz, A., & Rousmaniere, T. (2022). Deliberate practice in
motivational interviewing. American Psychological Association.
Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., &
Andrews, W. P. (2015). The role of deliberate practice in the development of highly
effective psychotherapists. Psychotherapy, 52(3), 337–345.
Miller, W. R., & Moyers, T. B. (2021). Developing expertise. In Effective psy-
chotherapists: Clinical skills that improve client outcomes (pp. 127–144). Guilford
Press.

51
 Chapter 16 Notes and References

23. Hershberger, P. J., Pei, Y., Bricker, D. A., Crawford, T. N., Shivakumar, A., Vasoya,
M., et al. (2021). Advancing motivational interviewing training with artificial intel-
ligence: Read, MI. Advances in Medical Education and Practice, 12, 613–618.
24. There are various such observational codes. Currently, the most commonly used
system is the Motivational Interviewing Treatment Integrity coding system, which
also has normative data for practice and for changes with training. Moyers, T. B.,
Rowell, L. N., Manuel, J. K., Ernst, D., & Houck, J. M. (2016). The Motivational
Interviewing Treatment Integrity code (MITI 4): Rationale, preliminary reli-
ability and validity. Journal of Substance Abuse Treatment, 65, 36–42. See the
MINT website for resources: https://motivationalinterviewing.org/motivational-
interviewing- resources. Depending on the trainee’s level of development, it can also
be as simple as just counting questions and reflections.
25. Miller, W. R., & Moyers, T. B. (2006). Eight stages in learning motivational inter-
viewing. Journal of Teaching in the Addictions, 5, 3–17.
26. Larson, E., & Martin, B. A. (2021). Measuring motivational interviewing self-
efficacy of pre-service students completing a competency-based motivational inter-
viewing course. Exploratory Research in Clinical and Social Pharmacy, 1, 100009.

52
 Chapter 17 Notes and References

Notes and References

1. Bischoff, M. M., & Tracey, T. J. G. (1995). Client resistance as predicted by thera-
pist behavior: A study of sequential dependence. Journal of Consulting and Clinical
Psychology, 42(4), 487–495.
Drage, L., Masterson, C., Tober, G., Farragher, T., & Bewick, B. (2019). The
impact of therapists’ responses to resistance to change: A sequential analysis of
therapist- client interactions in motivational interviewing. Alcohol and Alcoholism,
54(2), 173–176.
Magill, M., Walthers, J., Mastroleo, N. R., Gaume, J., Longabaugh, R., &
Apodaca, T. R. (2016). Therapist and client discussions of drinking and coping: a
sequential analysis of therapy dialogues in three evidence-based alcohol use disorder
treatments. Addiction, 111(6), 1011–1020.
2. Rosengren, D. B. (2018). Building motivational interviewing skills: A practitioner
workbook (2nd ed.). Guilford Press.

53
 Chapter 17 Notes and References

Manuel, J. K., Ernst, D., Vaz, A., & Rousmaniere, T. (2022). Deliberate prac-
tice in motivational interviewing. American Psychological Association.
The MI Network of Trainers also freely shares its Training of New Trainers Man-
ual: https://motivationalinterviewing.org/motivational- interviewing- resources.
3. Kirschenbaum, H. (2009). The life and work of Carl Rogers. American Counseling
Association.
4. Truax, C. B., & Carkhuff, R. R. (1967). Toward effective counseling and psycho-
therapy. Aldine.
5. See note 4.
6. Hurlocker, M. C., Madson, M. B., & Schumacher, J. A. (2020). Motivational inter-
viewing quality assurance: A systematic review of assessment tools across research
contexts. Clinical Psychology Review, 82, 101909.
Madson, M. B., & Campbell, T. C. (2006). Measures of fidelity in motivational
enhancement: A systematic review. Journal of Substance Abuse Treatment, 31(1),
67–73.
7. Miller, W. R., & Mount, K. A. (2001). A small study of training in motivational
interviewing: Does one workshop change clinician and client behavior? Behav-
ioural and Cognitive Psychotherapy, 29, 457–471.
8. The MITI scale is freely available at https://casaa.unm.edu/codinginst.html or
https://motivationalinterviewing.org.
Moyers, T. B., Rowell, L. N., Manuel, J. K., Ernst, D., & Houck, J. M. (2016,
June). The Motivational Interviewing Treatment Integrity code (MITI 4): Ratio-
nale, preliminary reliability and validity. Journal of Substance Abuse Treatment,
65, 36–42.
Atkinson, C., & Woods, K. (2017). Establishing theoretical stability and treat-
ment integrity for motivational interviewing. Behavioural and Cognitive Psycho-
therapy, 45, 337–350.
9. Lane, C., Huws-Thomas, M., Hood, K., Rollnick, S., Edwards, K., & Robling, M.
(2005). Measuring adaptations of motivational interviewing: The development and
validation of the behavior change counseling index (BECCI). Patient Education
and Counseling, 56(2), 166–173.
10. Martino, S., Ball, S. A., Nich, C., Frankforter, T. L., & Carroll, K. M. (2008). Com-
munity program therapist adherence and competence in motivational enhancement
therapy. Drug and Alcohol Dependence, 96(1–2), 37–48.
11. Wagner, C. C., & Ingersoll, K. S. (2018). Development and initial validation of the
Assessment of Motivational Interviewing Groups— Observer Scales (AMIGOS).
International Journal of Group Psychotherapy, 68(1), 69–79.
12. Rosengren, D. B., Baer, J. S., Hartzler, B., Dunn, C. W., & Wells, E. A. (2005). The
video assessment of simulated encounters (VASE): Development and validation of
a group-administered method for evaluating clinician skills in motivational inter-
viewing. Drug and Alcohol Dependence, 79, 321–330.
13. Barsky, A., & Coleman, H. (2001). Evaluating skill acquisition in motivational
Interviewing: The development of an instrument to measure practice skills. Journal
of Drug Education, 31, 69–82.
14. Madson, M. B., Campbell, T. C., Barrett, D. E., Brondino, M. J., & Melchert, T. P.
(2005). Development of the Motivational Interviewing Supervision and Training
Scale. Psychology of Addictive Behaviors, 19, 303–310.
15. A more challenging adaptation keeps track of the sequence in which specific pro-
vider and client behaviors occur, allowing detailed analysis of communication pat-
terns within MI sessions and their relationship to outcomes.
Houck, J. M., & Moyers, T. B. (2015). Within-session communication pat-
terns predict alcohol treatment outcomes. Drug and Alcohol Dependence, 157,
205–209.

54
 Chapter 17 Notes and References

Hannover, W., Blaut, C., Kniehase, C., Martin, T., & Hannich, H. J. (2013).
Interobserver agreement of the German translation of the Motivational Interview-
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of Addictive Behaviors, 27(4), 1196–1200.
16. The MITI coding manual itself is freely available, offering more detailed definitions
and decision rules.
Moyers, T. B., Manuel, J. K., & Ernst, D. (2015). Motivational Interview-
ing Treatment Integrity Coding Manual 4.2.1. Center on Alcoholism, Substance
Abuse and Addiction (CASAA), University of New Mexico. Available at https://
casaa.unm.edu/download/MITI4_ 2.pdf.
17. Atkins, D. C., Steyvers, M., Imel, Z. E., & Smyth, P. (2014). Scaling up the evalu-
ation of psychotherapy: Evaluating motivational interviewing fidelity via statistical
text classification. Implementation Science, 9(1), 49.
Idalski Carcone, A., Hasan, M., Alexander, G. L., Dong, M., Eggly, S., Brogan
Hartlieb, K., et al. (2019). Developing machine learning models for behavioral cod-
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Imel, Z. E., Pace, B. T., Soma, C. S., Tanana, M., Hirsch, T., Gibson, J., et al.
(2019). Design feasibility of an automated, machine-learning based feedback sys-
tem for motivational interviewing. Psychotherapy, 56(2), 318–328.
18. Tanana, M., Hallgren, K. A., Imel, Z. E., Atkins, D. C., & Srikumar, V. (2016). A
comparison of natural language processing methods for automated coding of moti-
vational interviewing. Journal of Substance Abuse Treatment, 65, 43–50.
19. Hasan, M., Carcone, A. I., Naar, S., Eggly, S., Alexander, G. L., Hartlieb, K. E. B.,
et al. (2019). Identifying effective motivational interviewing communication
sequences using automated pattern analysis. Journal of Healthcare Informatics
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(2019). Design feasibility of an automated, machine-learning based feedback sys-
tem for motivational interviewing. Psychotherapy, 56(2), 318–328.
20. Nakano, Y. I., Hirose, E., Sakato, T., Okada, S., & Martin, J.-C. (2022). Detect-
ing change talk in motivational interviewing using verbal and facial information.
Paper presented at the International Conference on Multimodal Interaction, Ben-
galuru, India. https://doi.org/10.1145/3536221.3556607.
21. Miller, W. R., & Meyers, R. J. (1995). Beyond generic criteria: Reflections on life
after clinical science wins. Clinical Science (Spring), 4–6.
22. Baca, C. T., & Manuel, J. K. (2007). Satisfaction with long- distance motivational
interviewing for problem drinking. Addictive Disorders and Their Treatment, 6(1),
39–41.
Magill, M., Mastroleo, N. R., Apodaca, T. R., Barnett, N. P., Colby, S. M., &
Monti, P. M. (2010). Motivational interviewing with significant other participa-
tion: Assessing therapeutic alliance and patient satisfaction and engagement. Jour-
nal of Substance Abuse Treatment, 39(4), 391–398.
Miller, S. D., Bargmann, S., Chow, D., Seidel, J., & Maeschalck, C. (2016).
Feedback Informed Treatment (FIT): Improving the outcome of psychotherapy one
person at a time. In W. O’Donohue & A. Maragakis (Eds.), Quality improvement
in behavioral health (pp. 247–262). Springer.
Pollak, K. I., Nagy, P., Bigger, J., Bilheimer, A., Lyna, P., Gao, X., et al. (2016).
Effect of teaching motivational interviewing via communication coaching on clini-
cian and patient satisfaction in primary care and pediatric obesity-focused offices.
Patient Education and Counseling, 99(2), 300–303.
23. Carkhuff, R. R., & Truax, C. B. (1965). Training in counseling and psychotherapy:
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29. For example, clients entering this study later and receiving MI fared better than
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Notes and References

1. Kirschenbaum, H. (2009). The life and work of Carl Rogers. American Counseling
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that improve client outcomes. Guilford Press.
4. A bibliography of controlled trials involving MI is available under “Other Resources”
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35. Rollnick, S., Miller, W. R., & Butler, C. C. (2023). Motivational interviewing in
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37. Spencer, J. C., & Wheeler, S. B. (2016). A systematic review of motivational inter-
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38. Alperstein, D., & Sharpe, L. (2016). The efficacy of motivational interviewing in
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39. Ekong, G., & Kavookjian, J. (2016). Motivational interviewing and outcomes in
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40. Ghizzardi, G., Arrigoni, C., Dellafiore, F., Vellone, E., & Caruso, R. (2021). Effi-
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46. Wong-Anuchit, C., Chantamit-O-Pas, C., Schneider, J. K., & Mills, A. C. (2019).
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47. Rollnick, S., Kaplan, S. G., & Rutschman, R. (2016). Motivational interviewing in
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55. Cushing, C. C., Jensen, C. D., Miller, M. B., & Leffingwell, T. R. (2014). Meta-
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2190–2199.

65
 Chapter 18 Notes and References

56. Erickson, S. J., Gerstle, M., & Feldstein, S. W. (2005). Brief interventions and
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57. Snape, L., & Atkinson, C. (2016). The evidence for student-focused motivational
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58. Miller, W. R., & Moyers, T. B. (2021). Effective psychotherapists: Clinical skills
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59. Kuerbis, A., Houser, J., Levak, S., Shao, S., & Morgenstern, J. (2018). Exploration
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63. Project MATCH Research Group. (1993). Project MATCH: Rationale and meth-
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enhancement therapy manual: A clinical research guide for therapist treating indi-
viduals with alcohol abuse and dependence (Vol. 2). National Institute on Alcohol
Abuse and Alcoholism.

66
 Chapter 18 Notes and References

65. Longabaugh, R., Zweben, A., LoCastro, J. S., & Miller, W. R. (2005). Origins,
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81. Wagner, C. C., & Ingersoll, K. S. (with contributors). (2013). Motivational inter-
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85. Apodaca, T. R., Jackson, K. M., Borsari, B., Magill, M., Longabaugh, R., Mastro-
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89. Agostinelli, G., Brown, J. M., & Miller, W. R. (1995). Effects of normative feed-
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68
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92. Walters, S. T., Vader, A. M., Harris, T. R., Field, C. A., & Jouriles, E. N. (2009).
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93. Britton, P. C., Williams, G. C., & Conner, K. R. (2008). Self-determination the-
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94. Schmidt, L. K., Andersen, K., & Søgaard Nielsen, A. (2022). Differences in the
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95. O’Halloran, P. D., Blackstock, F., Shields, N., Holland, A., Iles, R., Kingsley,
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3rd, et al. (2018). Impact of motivational interviewing on outcomes of an adoles-

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107. Longabaugh, R., Zweben, A., LoCastro, J. S., & Miller, W. R. (2005). Origins,
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108. Moyers, T. B., Houck, J. M., Rice, S. L., Longabaugh, R., & Miller, W. R. (2016).
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Effect of teaching motivational interviewing via communication coaching on

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clinician and patient satisfaction in primary care and pediatric obesity-focused

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 Some Cultural Adaptations of MI

Some Cultural Adaptations of MI

The past few decades have seen a burgeoning of scholarly work on the role
of culture in mental health, human services, education, and related fields.
If you’re interested, here are some resources that adapt MI with specific
populations.

With Asian Populations

Hughes, S. C., Corcos, I., Hovell, M., & Hofstetter, C. R. (2017). Feasibility pilot
of a randomized faith-based intervention to reduce secondhand smoke expo-sure
among Korean Americans. Preventing Chronic Disease 14, E19.
Hughes, S. C., & Obayashi, S. (2017). Faith-based intervention to increase fruit
and vegetable intake among Koreans in the USA: A feasibility pilot. Public
Health Nutrition, 20(2), 357–362.
Kandula, N. R., Dave, S., De Chavez, P. J., Bharucha, H., Patel, Y., Seguil, P., et al.
(2015). Translating a heart disease lifestyle intervention into the community:
The South Asian Heart Lifestyle Intervention (SAHELI) study; A randomized
control trial. BMC Public Health 15, 1064.
Khetan, A., Hejjaji, V., Hughes, J., Gupta, P., Barbhaya, D., Mohan, S. K. M., et al.
(2019). Rationale and design of a study to test the effectiveness of a combined
community health worker and text messaging-based intervention for smoking
cessation in India (Project MUKTI). mHealth, 5(15), 1–11.
Kianinezhad, S., Sadaghifard, M., Esmaeeli, M., Zarei, E., & Forozanfar, A.
(2021). Comparison of the effectiveness of motivational interview and moti-
vational interview with the orientation of Islamic ontology on the motivation
to change domestic violence. Iranian Evolutionary and Educational Psychol-
ogy Journal, 3(4), 447–456.
Li, M., & Ren, Y. (2019). Intervention effects of motivation interviewing Chinese
modified on the mental health of college students with exercise dependence.
Psychiatric Quarterly, 90(2), 447–459.
Reich, H., Zürn, D., & Mewes, R. (2021). Engaging Turkish immigrants in psy-
chotherapy: Development and proof-of- concept study of a culture-tailored,
web-based intervention. Clinical Psychology in Europe, 3(4), e5583.
Rongkavilit, C., Naar-King, S., Koken, J. A., Bunupuradah, T., Chen, X.,
Saengcharnchai, P., et al. (2014). A feasibility study of motivational interview-
ing for health risk behaviors among Thai youth living with HIV. Journal of
the Association of Nurses in AIDS Care, 25(1), 92–97.
Vlaar, E. M. A., Nierkens, V., Nicolaou, M., Middelkoop, B. J. C., Busschers, W.
B., Stronks, K., et al. (2017). Effectiveness of a targeted lifestyle intervention
in primary care on diet and physical activity among South Asians at risk for

72
 Some Cultural Adaptations of MI

diabetes: 2-year results of a randomized controlled trial in the Netherlands.

BMJ Open, 7(6), e012221.
Wu, D., Ma, G. X., Zhou, K., Zhou, D., Liu, A., & Poon, A. N. (2009). The effect
of a culturally tailored smoking cessation for Chinese American smokers.
Nicotine and Tobacco Research 11(12), 1448–1457.

With Black Populations

Bogart, L. M., Mutchler, M. G., McDavitt, B., Klein, D. J., Cunningham, W. E.,
Goggin, K. J., et al. (2017). A randomized controlled trial of Rise, a commu-
nity-based culturally congruent adherence intervention for Black Americans
living with HIV. Annals of Behavioral Medicine, 51(6), 868–878.
Boutin-Foster, C., Scott, E., Rodriguez, A., Ramos, R., Kanna, B., Michelen, W.,
et al. (2013). The trial using motivational interviewing and positive affect and
self-affirmation in African-Americans with hypertension (TRIUMPH): From
theory to clinical trial implementation. Contemporary Clinical Trials, 35(1),
8–14.
Cukor, D., Pencille, M., Ver Halen, N., Primus, N., Gordon-Peters, V., Fraser, M.,
et al. (2018). An RCT comparing remotely delivered adherence promotion for
sleep apnea assessment against an information control in a Black community
sample. Sleep Health, 4(4), 369–376.
Longshore, D., & Grills, C. (2000). Motivating illegal drug use recovery: Evidence
for a culturally congruent intervention. Journal of Black Psychology, 26,
288–301.
Nicolaidis, C., Wahab, S., Trimble, J., Mejia, A., Mitchell, S. R., Raymaker, D.,
et al. (2013). The interconnections project: Development and evaluation of a
community-based depression program for African American violence survi-
vors. Journal of General Internal Medicine, 28(4), 530–538.
Resnicow, K., Campbell, M. K., Carr, C., McCarty, F., Wang, T., Periasamy, S., et
al. (2004). Body and soul: A dietary intervention conducted through African-
American churches. American Journal of Preventive Medicine, 27, 97–105.
Schoenthaler, A. M., Lancaster, K. J., Chaplin, W., Butler, M., Forsyth, J., & Oge-
degbe, G. (2018). Cluster randomized clinical trial of FAITH (Faith based
approaches in the treatment of hypertension) in Blacks. Circulation: Cardio-
vascular Quality and Outcomes, 11(10), e004691.
Thevos, A. K., Quick, R. E., & Yanjuli, V. (2000). Motivational interviewing
enhances the adoption of water disinfection practices in Zambia. Health Pro-
motion International, 15, 207–214.

With Indigenous Populations

Britt, E. F., Gregory, D., Tohiariki, T., & Huriwai, T. (2014). Takitaki mai: A
guide to motivational interviewing for Māori. Matua Raki, The National
Addiction Workforce Programme. Available at https://takitaki-mai-a-guide-
to- motivational- interviewing-for-maori.pdf.
Choi, W. S., Beebe, L. A., Nazir, N., Kaur, B., Hopkins, M., Talawyma, M., et al.
(2016). All Nations Breath of Life: A randomized trial of smoking cessation

73
 Some Cultural Adaptations of MI

for American Indians. American Journal of Preventive Medicine, 51(5), 743–

751.
Cordisco Tsai, L., & Seballos-Llena, I. F. (2020). Reflections on adapting motiva-
tional interviewing to the Filipino cultural context. Practice, 32(1), 43–57.
Dickerson, D. L., Brown, R. A., Johnson, C. L., Schweigman, K., & D’Amico, E.
J. (2016). Integrating motivational interviewing and traditional practices to
address alcohol and drug use among urban American Indian/Alaska Native
youth. Journal of Substance Abuse Treatment, 65, 26–35.
Field, C., Ramirez, S. O., Juarez, P., & Castro, Y. (2019). Process for developing a
culturally informed brief motivational intervention. Addictive Behaviors, 95,
129–137.
Gilder, D. A., Geisler, J. R., Luna, J. A., Calac, D., Monti, P. M., Spillane, N. S., et
al. (2017). A pilot randomized trial of motivational interviewing compared to
psycho- education for reducing and preventing underage drinking in American
Indian adolescents. Journal of Substance Abuse Treatment, 82, 74–81.
Jamieson, L., Bradshaw, J., Lawrence, H., Broughton, J., & Venner, K. (2016).
Fidelity of motivational interviewing in an early childhood caries intervention
involving indigenous Australian mothers. Journal of Health Care for the Poor
and Underserved, 27(1), 125–138.
Morris, S. L., Hospital, M. M., Wagner, E. F., Lowe, J., Thompson, M. G., Clarke,
R., et al. (2021). SACRED connections: A university-tribal clinical research
partnership for school-based screening and brief intervention for substance
use problems among Native American Youth. Journal of Ethnic and Cultural
Diversity in Social Work, 30(1–2), 149–162.
Nagel, T., & Thompson, C. (2008). Motivational care planning: Self management
in indigenous mental health. Australian Family Physician, 37(12), 996–1000.
Venner, K. L., Greenfield, B. L., Hagler, K. J., Simmons, J., Lupee, D., Homer,
E., et al. (2016). Pilot outcome results of culturally adapted evidence-based
substance use disorder treatment with a Southwest tribe. Addictive Behaviors
Reports 3, 21–27.

With Latinx Populations

Añez, L. M., Silva, M. A., Paris, M., Jr., & Bedregal, L. E. (2008). Engaging Lati-
nos through the integration of cultural values and motivational interviewing
principles. Professional Psychology: Research and Practice, 39(2), 153.
Borrelli, B., McQuaid, E. L., Novak, S. P., Hammond, S. K., & Becker, B. (2010).
Motivating Latino caregivers of children with asthma to quit smoking: A ran-
domized trial. Journal of Consulting and Clinical Psychology, 78(1), 34–43.
Coronado, G. D., Beresford, S. A. A., McLerran, D., Jimenez, R., Patrick, D. L.,
Ornelas, I., et al. (2016). Multilevel intervention raises Latina participation in
mammography screening: Findings from ¡fortaleza Latina! Cancer Epidemi-
ology, Biomarkers and Prevention, 25(4), 584–592.
Corsino, L., Rocha- Goldberg, M. P., Batch, B. C., Ortiz-Melo, D. I., Bosworth, H.
B., & Svetkey, L. P. (2012). The Latino health project: Pilot testing a culturally
adapted behavioral weight loss intervention in obese and overweight Latino
adults. Ethnicity and Disease, 22(1), 51–57.

74
 Some Cultural Adaptations of MI

Interian, A., Martinez, I., Rios, L., Krejci, J., & Guarnaccia, P. J. (2010). Adapta-
tion of a motivational interviewing intervention to improve antidepressant
adherence among Latinos. Cultural Diversity and Ethnic Minority Psychol-
ogy, 16(2), 215–225.
Kurth, A. E., Chhun, N., Cleland, C. M., Crespo-Fierro, M., Pares-Avila, J. A.,
Lizcano, J. A., et al. (2016). Linguistic and cultural adaptation of a com-
puter-based counseling program (CARE+ Spanish) to support HIV treatment
adherence and risk reduction for people living with HIV/AIDS: A randomized
controlled trial. Journal of Medical Internet Research, 18(7), e195.
Lee, C. S., López, S. R., Colby, S. M., Rohsenow, D., Hernández, L., Borrelli, B.,
et al. (2013). Culturally adapted motivational interviewing for Latino heavy
drinkers: Results from a randomized clinical trial. Journal of Ethnicity in
Substance Abuse, 12(4), 356–373.
Lewis-Fernández, R., Balán, I. C., Patel, S. R., Sánchez-Lacay, J. A., Alfonso, C.,
Gorritz, M., et al. (2013). Impact of motivational pharmacotherapy on treat-
ment retention among depressed Latinos. Psychiatry, 76(3), 210–222.
Moore, A. A., Karno, M. P., Ray, L., Ramirez, K., Barenstein, V., Portillo, M. J.,
et al. (2016). Development and preliminary testing of a promotora-delivered,
Spanish language, counseling intervention for heavy drinking among male,
Latino day laborers. Journal of Substance Abuse Treatment, 62, 96–101.
Osborn, C. Y., Amico, K. R., Cruz, N., O’Connell, A. A., Perez-Escamilla, R., Kali-
chman, S. C., et al. (2010). A brief culturally tailored intervention for Puerto
Ricans with type 2 diabetes. Health Education and Behavior, 37(6), 849–862.
Rocha- Goldberg, M. P., Corsino, L., Batch, B., Voils, C. I., Thorpe, C. T., Bos-
worth, H. B., et al. (2010). Hypertension Improvement Project (HIP) Latino:
Results of a pilot study of lifestyle intervention for lowering blood pressure in
Latino adults. Ethnicity and Health, 15(3), 269–282.
Sánchez, J., De La Rosa, M., & Serna, C. A. (2013). Project salud: Efficacy of a
community-based HIV prevention intervention for Hispanic migrant workers
in south Florida. AIDS Education and Prevention, 25(5), 363–375.

75
 Speaker Listener

2 3
What is What is
said heard

1 4
Speaker’s Interpreted
meaning meaning

F I G U R E 4 .1. The process of communication. Based on Thomas Gordon (1970),

Parent Effectiveness Training.

76
 Speaker Listener

2 3
What is What is
said heard

1 4
Speaker’s Reflection Interpreted
meaning meaning

F I G U R E 4 . 2 . The role of reflection in communication. Based on Thomas Gordon

(1970), Parent Effectiveness Training.

77
 Diabetes Health Topics

Physical Checking
Healthy
activity and my blood
eating
exercise sugar

Managing Blood
stress pressure

Mood
and Smoking Foot care
depression

Insulin Alcohol use

Medications
other than Eye care ?
insulin

F I G U R E 5 .1. A sample bubble sheet. From Marc P. Steinberg and William R. Miller
(2015, p. 17), Motivational Interviewing in Diabetes Care. Copyright © 2015 The Guilford
Press. Reprinted by permission.

78
 0 1 2 3 4 5 6 7 8 9 10
Not at all Extremely
important important

0 1 2 3 4 5 6 7 8 9 10
Not at all Completely
confident confident

F I G U R E 6 . 1 . Importance and confidence rulers.

79
 B
OX 7.1. Some Characteristics of Successful Changers

Accepting Committed Flexible Persevering Stubborn

Active Competent Focused Persistent Thankful
Adaptable Concerned Forgiving Positive Thorough
Adventuresome Confident Forward-looking Powerful Thoughtful
Affectionate Considerate Free Prayerful Tough
Affirmative Courageous Happy Quick Trusting
Alert Creative Healthy Reasonable Trustworthy
Alive Decisive Hopeful Receptive Truthful
Ambitious Dedicated Imaginative Relaxed Understanding
Anchored Determined Ingenious Reliable Unique
Assertive Die-hard Intelligent Resourceful Unstoppable
Assured Diligent Knowledgeable Responsible Vigorous
Attentive Doer Loving Sensible Visionary
Bold Eager Mature Skillful Whole
Brave Earnest Open Solid Willing
Bright Effective Optimistic Spiritual Winning
Capable Energetic Orderly Stable Wise
Careful Experienced Organized Steady Worthy
Cheerful Faithful Patient Straight Zealous
Clever Fearless Perceptive Strong Zestful

From Combined Behavioral Intervention Manual (Vol. 1) by William R. Miller (2004). In the public
domain. Reprinted in Motivational Interviewing, Fourth Edition: Helping People Change and Grow
(Guilford Press, 2023). This box may be reproduced and adapted without further permission (www.
guilford.com/miller2-materials).

80
 B OX 9.1. A Values Card Sort
William R. Miller, Janet C’de Baca, Daniel B. Matthews, and Paula L. Wilbourne

These values are usually printed onto individual cards that people can
sort into three to five piles. We have five header cards that read: “Most
Important,” “Very Important,” “Important,” “Somewhat Important,” and
“Not Important.” It is wise to provide a few empty cards so people can
add values of their own. These items are in the public domain and may be
copied, adapted, or used without further permission. A downloadable ver-
sion sized for printable business cards is available at www.guilford.com/
miller2-materials.
Sample instructions for sorting the cards:

These cards each contain words describing values that are important
to some people. Sort them into these five different piles depending on
how important each one is to you. Some may not be important to you
at all, and you would put those in the “Not Important” pile. Others that
are just “Somewhat Important” go into this second pile. Those that are
“Important” go here in the middle, and this fourth pile is for those that
are “Very Important.” Finally, this pile is only for those values that are
the “Most Important” to you. Go ahead and sort them now into these
different piles based on how important each one is to you. When you’re
done, if there are any other values that are important to you that are not
mentioned on these cards, you can use these blank cards to add them.
Any questions?

The starting order of the cards does not matter—simply shuffle them before
beginning (except for blank cards). It is also possible to use fewer than five
piles for sorting, such as “Not Important,” “Important,” and “Most Impor-
tant.”
A possible next step is to have the person pick out the 5 or 10 values
that are most important and rank-order them from 1 (most important) to 5 or
10. There may already be this many cards or more in the “Most Important”
pile, or it may be necessary to add some from the “Very Important” pile.
Alternatively, it is possible to skip the first (sorting) step and just have peo-
ple pick out and rank-order the 10 that seem most important. This could be
done just from the list below, but having the values on cards allows people
to move them around visually when sorting and rank-ordering.

1. ACCEPTANCE to be accepted as I am
2. ACCURACY to be correct in my opinions and beliefs
3. ACHIEVEMENT to have important accomplishments
4. ADVENTURE to have new and exciting experiences

81
 B OX 9.1 (cont.)
5. ART to appreciate or express myself in art
6. ATTRACTIVENESS to be physically attractive
7. AUTHORITY to be in charge of others
8. AUTONOMY to be self-determined and independent
9. BEAUTY to appreciate beauty around me
10. BELONGING to have a sense of belonging, being part of
11. CARING to take care of others
12. CHALLENGE to take on difficult tasks and problems
13. COMFORT to have a pleasant and comfortable life
14. COMMITMENT to make enduring, meaningful commitments
15. COMPASSION to feel and act on concern for others
16. COMPLEXITY to embrace the intricacies of life
17. COMPROMISE to be willing to give and take in reaching
agreements
18. CONTRIBUTION to make a lasting contribution in the world
19. COOPERATION to work collaboratively with others
20. COURAGE to be brave and strong in the face of adversity
21. COURTESY to be considerate and polite toward others
22. CREATIVITY to create new things or ideas
23. CURIOSITY to seek out, experience, and learn new things
24. DEPENDABILITY to be reliable and trustworthy
25. DILIGENCE to be thorough and conscientious in whatever
I do
26. DUTY to carry out my duties and obligations
27. ECOLOGY to live in harmony with the environment
28. EXCITEMENT to have a life full of thrills and stimulation
29. FAITHFULNESS to be loyal and true in relationships
30. FAME to be known and recognized
31. FAMILY to have a happy, loving family
32. FITNESS to be physically fit and strong
33. FLEXIBILITY to adjust to new circumstances easily
34. FORGIVENESS to be forgiving of others
35. FREEDOM to be free from undue restrictions and
limitations
36. FRIENDSHIP to have close, supportive friends
37. FUN to play and have fun
(cont.)

82
 B OX 9.1 (cont.)
38. GENEROSITY to give what I have to others
39. GENUINENESS to act in a manner that is true to who I am
40. GOD’S WILL to seek and obey the will of God
41. GRATITUDE to be thankful and appreciative
42. GROWTH to keep changing and growing
43. HEALTH to be physically well and healthy
44. HONESTY to be honest and truthful
45. HOPE to maintain a positive and optimistic outlook
46. HUMILITY to be modest and unassuming
47. HUMOR to see the humorous side of myself and the
world
48. IMAGINATION to have dreams and see possibilities
49. INDEPENDENCE to be free from depending on others
50. INDUSTRY to work hard and well at my life tasks
51. INNER PEACE to experience personal peace
52. INTEGRITY to live my daily life in a way that is consistent
with my values
53. INTELLIGENCE to keep my mind sharp and active
54. INTIMACY to share my innermost experiences with
others
55. JUSTICE to promote fair and equal treatment for all
56. KNOWLEDGE to learn and contribute valuable knowledge
57. LEADERSHIP to inspire and guide others
58. LEISURE to take time to relax and enjoy
59. LOVED to be loved by those close to me
60. LOVING to give love to others
61. MASTERY to be competent in my everyday activities
62. MINDFULNESS to live conscious and mindful of the present
moment
63. MODERATION to avoid excesses and find a middle ground
64. MONOGAMY to have one close, loving relationship
65. MUSIC to enjoy or express myself in music
66. NONCONFORMITY to question and challenge authority and
norms
67. NOVELTY to have a life full of change and variety
68. NURTURANCE to encourage and support others
69. OPENNESS to be open to new experiences, ideas, and
options

83
 B OX 9.1 (cont.)
70. ORDER to have a life that is well-ordered and
organized
71. PASSION to have deep feelings about ideas,
activities, or people
72. PATRIOTISM to love, serve, and protect my country
73. PLEASURE to feel good
74. POPULARITY to be well liked by many people
75. POWER to have control over others
76. PRACTICALITY to focus on what is practical, prudent, and
sensible
77. PROTECT to protect and keep safe those I love
78. PROVIDE to provide for and take care of my family
79. PURPOSE to have meaning and direction in my life
80. RATIONALITY to be guided by reason, logic, and evidence
81. REALISM to see and act realistically and practically
82. RESPONSIBILITY to make and carry out responsible
decisions
83. RISK to take risks and chances
84. ROMANCE to have intense, exciting love in my life
85. SAFETY to be safe and secure
86. SELF-ACCEPTANCE to accept myself as I am
87. SELF-CONTROL to be disciplined in my own actions
88. SELF-ESTEEM to feel good about myself
89. SELF-KNOWLEDGE to have a deep and honest understanding
of myself
90. SERVICE to be helpful and of service to others
91. SEXUALITY to have an active and satisfying sex life
92. SIMPLICITY to live life simply, with minimal needs
93. SOLITUDE to have time and space where I can be
apart from others
94. SPIRITUALITY to grow and mature spiritually
95. STABILITY to have a life that stays fairly consistent
96. TOLERANCE to accept and respect those who differ
from me
97. TRADITION to follow respected patterns of the past
98. VIRTUE to live a morally pure and excellent life
99. WEALTH to have plenty of money
100. WORLD PEACE to work to promote peace in the world

84
1 2
Advantages of change Advantages of no change

3 4
Disadvantages of change Disadvantages of no change

F
IGURE 9.1. A decisional balance.

85
 Glossary

Glossary of Motivational
Interviewing Concepts

Ability language—a form of preparatory change talk that reflects perceived per-
sonal capability of making a change; typical words include can, could, and
able.

Acceptance—one of four central components of the underlying spirit of MI by

which the interviewer communicates nonjudgmental understanding of people
as they are.

Accurate empathy—the skill of perceiving and reflecting back a person’s meaning

so that both understand more clearly.

Activation language—a form of mobilizing change talk that expresses a dispo-

sition toward action but falls short of commitment; typical words include
ready, willing, and consider.

Agenda mapping—selecting from a menu of possibilities the topic(s) to be dis-

cussed in a consultation.

Ambivalence—the simultaneous presence of competing motivations for and

against change.

From Motivational Interviewing, Fourth Edition: Helping People Change and Grow by
William R. Miller and Stephen Rollnick. Copyright © 2023 The Guilford Press. Permission
to photocopy this material, or to download and print enlarged versions (www.guilford.com/
miller2-materials), is granted to purchasers of this book for personal use or use with clients;
see copyright page for details.

86
 Glossary

Amplified reflection—a response in which the interviewer reflects back the per-
son’s content with greater intensity than the person had expressed; one form
of response to sustain talk or discord.

Analogy—a form of reflection that offers a metaphor or simile.

Apology—a way of responding to discord by taking partial responsibility.

Ask–offer–ask (AOA)—an information exchange process that begins and ends

with exploring the person’s own experience to frame whatever information
is being provided.

Autonomy support—an interviewer response that acknowledges and honors the

person’s freedom of choice and self- determination.

Beginner’s mind—entering an interaction with curiosity and openness, knowing

that you don’t know.

Bubble sheet—a paper sheet with circles containing a variety of options such as
possible topics for conversation.

CATs—an acronym for three subtypes of mobilizing change talk: commitment,

activation, and taking steps.

Change talk—any speech that favors movement toward a particular change goal.

Client– treatment matching—the attempt to discover which kinds of clients benefit

differentially from certain types of treatment.

Closed question—a question that limits the range of answers, such as asking for
yes/no, a short answer, or specific information.

Coming alongside—a response to persistent sustain talk or discord in which the

interviewer adopts and reflects the person’s perspective.

Commitment language—a form of mobilizing change talk that conveys intention

or agreement to carry out change; common verbs include will, do, am going
to.

Compassion—one of four central components of the underlying spirit of MI; a

benevolent intention toward the person’s well-being.

Complex affirmation—an appreciative statement that highlights or infers an

enduring positive attribute.

Complex reflection—an interviewer reflection that adds additional or different

meaning beyond what the person has already said; a guess as to what the
person may have meant.

87
 Glossary

Computer-automated coding—using artificial intelligence to identify specific

counselor or client responses.

Confidence language—change talk that implies or bespeaks ability to change.

Confidence ruler—a scale (typically 0–10) that rates level of confidence in one’s
ability to make a particular change.

Confront response—an MI-inconsistent response such as warning, disagreeing,

or arguing.

Continuing the paragraph—a method of reflective listening in which the coun-

selor offers what might be the next (as yet unspoken) sentence in the person’s
paragraph.

Contraindication—a situation or characteristic that makes a particular approach

ill advised.

Cultivating change talk—responding in a manner that increases the depth,

strength, or momentum of a person’s language in favor of change.

DARN—an acronym for four subtypes of preparatory change talk: desire, ability,
reason, and need.

Decisional balance—the relative strength of positive and negative motivations

toward change; an intervention that equally explores the pros and cons of a
change or plan.

Deliberate practice—intentional time and effort devoted to strengthening skills

outside normal performance.

Desire language—a form of change talk that reflects a preference for change; typi-
cal verbs include want, wish, and like.

Developing ambivalence—cultivating perceived discrepancy between the status

quo and a client’s important goals and values.

Directing—a natural communication style that involves telling, leading, providing

advice, informing, or instructing.

Directional—favoring movement toward a particular change.

Directional question—a strategic question the natural answer to which is change

talk.

Directional reflection—a strategic reflection focused on change talk.

Discord—interpersonal behavior that reflects dissonance in the working

88
 Glossary

relationship; sustain talk does not in itself constitute discord; examples

include arguing, interrupting, discounting, or ignoring.

Double-sided reflection—an interviewer reflection that includes both sustain talk

and change talk, usually with the conjunction and.

Embedded change talk—change talk that is expressed in combination with sustain

talk.

Empathy—the extent to which an interviewer communicates accurate understand-

ing of the person’s perspectives and experience; most commonly manifested
as reflection.

Empowerment—helping people realize and utilize their own strengths and abili-
ties.

Engaging task—the first of four fundamental tasks in MI designed to establish a

mutually trusting and respectful helping relationship.

Envisioning—speech that reflects the person imagining having made a change.

Evidence-based treatment (EBT)—a therapeutic method for which there is suf-

ficient scientific evidence of efficacy according to specified criteria.

Evoking task—the third of four fundamental tasks of MI designed to elicit the

person’s own motivations for a particular change.

Experiencing—speaking about oneself in first-person, present-tense, emotionally

engaged language.

Expert trap—assuming and communicating that the counselor has the best answers
to the person’s problems.

Fidelity drift—decreased adherence to a treatment approach over time.

Fixing reflex—the natural desire of helpers to prevent harm and promote a per-
son’s welfare by trying to correct or repair perceived problems.

Focusing task—the second of four fundamental tasks of MI designed to identify

shared goals or direction for change.

Following—a natural communication style that involves listening to and following

along with the other’s experience without inserting one’s own material.

Genuineness—being your authentic and natural self.

Guiding—a natural communication style for helping others find their way, com-
bining some elements of both directing and following.

89
 Glossary

Implementation science—the study of how a particular product or service is

adopted and applied in practice.

Importance ruler—a scale (typically 0–10) to rate the importance of making a

particular change.

Interrater reliability—the extent of agreement between two observers in rating or

classifying responses.

Key question—a particular form of question offered following a summary of

change talk, which asks, in essence, “What’s next?”

Learning community—a group of practitioners engaged in deliberate practice

together to strengthen their skills.

Lending change talk—tentatively offering a reflection of change talk that a client

has not yet voiced directly but that seems to follow from what the client has
been saying.

Mediator—in research, a variable that explains the relationship between two other
variables.

MET—an acronym for motivational enhancement therapy.

Meta-analysis—a method for combining the results of separate studies to examine

size and trends in effect.

MINT—the Motivational Interviewing Network of Trainers, founded in 1997 and

incorporated in 2009 (https://motivationalinterviewing.org).

MIPC—the Motivational Interviewing Process Code.

Mirroring—seeking to accurately reflect what a person is saying and experiencing.

MISC—the Motivational Interviewing Skills Code; the original system for coding
client and interviewer utterances within MI.

MISTS—the Motivational Interviewing Supervision and Training Scale.

MITI—the Motivational Interviewing Treatment Integrity coding system, simpli-

fied from the MISC and focusing only on interviewer responses, to document
fidelity in MI delivery.

Mobilizing change talk—a subtype of change talk that expresses or implies action
to change; examples are commitment, activation, and taking steps.

Motivational enhancement therapy (MET)—a combination of MI with assess-

ment feedback, originally developed and tested in Project MATCH.

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Motivational interviewing—a particular way of talking with people about change

and growth to strengthen their own motivation and commitment

Need language—a form of preparatory change talk that expresses an imperative

for change without specifying a particular reason. Common verbs include
need, have to, got to, and must.

Neutrality—an interviewer’s intentional decision not to influence the direction of

choice or change.

Norm correction—an intervention offering information on what is actually aver-

age behavior based on reliable survey or other normative data.

OARS—an acronym for four basic person- centered communication skills: open
question, affirmation, reflection, and summary.

Open question—a question that offers the person broad latitude in how to respond;
compare with closed question.

Overstating—a reflection that adds intensity to the content or emotion that was
expressed; see also amplified refection.

Partnership—one of four central components of the underlying spirit of MI by

which the interviewer functions as a partner or companion, collaborating
with the person’s own expertise.

Pendulum approach—a strategy for eliciting change talk in which the interviewer
first reflects perceived good things about the status quo in order to then query
the less good things.

Permission—obtaining assent before providing advice or information.

Person-centered—an approach introduced by psychologist Carl Rogers in which

people explore their own experience within a supportive, empathic, and
accepting relationship; also called client- centered.

Persuasion response—attempts to change a person’s opinions, attitudes, or behav-

ior using methods such as logic, compelling arguments, self-disclosure, or
facts.

Persuasion trap—communication that attempts to convince.

Planning task—the fourth fundamental process of MI designed to identify a path

to accomplish a particular change.

Preparatory change talk—a subtype of change talk that expresses motivations for
change without stating or implying specific intent or commitment to do it;
examples are desire, ability, reason, and need.

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Psychological reactance—the natural human tendency to assert one’s freedom

when it appears to be threatened.

Quality assurance—measuring the fidelity of services provided.

Rapid engaging—an initial period of exclusive listening without investigative ques-

tions, problem solving, or interruptions.

Real play—a skill-practice method in which the person being interviewed is relat-
ing their own experience.

Reason language—a form of preparatory change talk that describes a specific if–
then motive for change.

Reflection—an interviewer statement intended to mirror the meaning (explicit or

implicit) of what a person has said; see also simple reflection and complex
reflection.

Reframing—an interviewer statement that invites the person to consider a different

interpretation of what has been said.

Role play—a skill-practice method in which the “client” being interviewed is por-
trayed by an actor.

Seeking collaboration—an interviewer response that communicates sharing power

or acknowledging the person’s expertise.

Self-affirmation—statements that recognize a person’s own positive efforts or

attributes.

Self-disclosure—sharing something of oneself that is true when there is good rea-

son to expect that it will be helpful to the person.

Self-regulation—the ability to develop a plan of one’s own and to implement

behavior in order to carry it out.

Shared decision making—a process whereby people are offered the best available
evidence about options and are supported to choose how to proceed.

Shifting attention—a way of responding to discord by redirecting attention and

discussion to a less contentious topic or perspective.

Simple affirmation—an appreciative statement that recognizes a specific positive

action, statement, effort, or intention.

Simple reflection—a reflection that contains little or no additional content beyond

what the person has already said.

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Softening sustain talk—responding to sustain talk or discord in a manner that

diminishes its depth, strength, or momentum.

Spirit of MI—the underlying set of mind and heart within which MI is practiced,
including partnership, acceptance, compassion, and empowerment.

Stages of change—within the transtheoretical model of change, a sequence of steps

through which people pass in the change process: precontemplation, contem-
plation, preparation, action, and maintenance.

Status quo—the current state of affairs without change.

Summary—a reflection that draws together content from two or more prior state-
ments.

Supportive significant other—a person who supports a client’s movement toward

change.

Sustain talk—any speech that favors status quo rather than movement toward
change.

Systematic review—an ordered summary of research findings on a particular topic.

Taking-steps language—a form of mobilizing change talk that describes an action

or step already taken toward change.

Time trap—resorting to hurried or unhelpful communications in response to felt

time pressure.

TNT—an acronym for the Training of New Trainers of MI; begun in 1993 and
now organized by MINT.

Understating—a reflection that diminishes or understates the intensity of the con-

tent or emotion expressed by a client.

Value– behavior discrepancies—conflicts between a person’s actions and their core

goals or standards that provide meaning and direction in life.

Vertical ambivalence—the simultaneous presence of competing motivations for

and against change, with the person consciously aware of one motivation but
unaware of an opposing motive.

Wandering trap—listening with insufficient attention to directional movement.

Working alliance—the quality of the collaborative relationship between client and

counselor, which tends to predict retention and outcome.

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