Motivational Interviewing in Social Work: An Evidence-Based Communication Approach

March is Social Work Month, a time to celebrate the social work profession and the immeasurable contributions social workers make to our society. Social workers are one of the largest groups of mental health care providers in the country, helping individuals and families overcome challenges so they can live to their fullest potential. Especially at a time of pandemic, racial unrest, economic uncertainty, and political divisiveness, social workers help the nation heal through the power of communication. And one of the most powerful communication methods they draw from is motivational interviewing.

Here’s a brief overview of what motivational interviewing is, the importance of motivational interviewing in social work, and how current and future social workers can gain valuable practice using motivational interviewing skills.

What is motivational interviewing?

Motivational interviewing (MI) is a communication technique originally developed by psychologists and educators Miller and Rollnick with the goal of helping people make behavior changes. Below is their most recent definition of motivational interviewing found in their book, Motivational Interviewing: Helping people to change (3rd edition):

“MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.” – Miller and Rollnick (2013)

The four processes Miller and Rollnick outline in motivational interviewing include engaging, focusing, evoking, and planning. The approach uses skills and techniques to foster a partnership with clients, with elements including:

• Collaboration
• Promotion of autonomy
• Listening
• Respect
• Curiosity
• Compassion
• Affirmation

Motivational interviewing skills are especially useful when working with people who are resistant to change, uncertain or doubtful about an issue, or struggle with low confidence. By helping these individuals discover their own intrinsic motivation to change, therapists, social workers, and other health professionals can help make a lasting impact in their clients’ lives.

The value of using motivational interviewing in social work

Motivational interviewing in social work is powerful because of the profession’s practice in behavioral health.

Social workers provide a wide spectrum of services to diverse populations and are focused on the overall wellbeing and health of their clients, with behavioral health being key. For every 10 people who visit a doctor, seven are there for reasons related to behavioral health. These prevalent issues can include:

• Depression
• Anxiety
• Diabetes management
• Weight loss
• Smoking
• Alcohol and other drug use problems

The social work practice in behavioral health involves the assessment, diagnosis, treatment, and prevention of mental illness, substance use, and other addictions.

Social workers are unique in that they not only help clients identify how they feel about situations, they also help create action plans for responding to them. Social work is complex and multi-faceted. Motivational interviewing is a powerful skill for social workers to master because it fits into the various roles they take on, particularly related to addiction.

Motivational Interviewing and SBIRT

An approach known as SBIRT — Screening, Brief Intervention, and Referral to Treatment — has gained popularity in recent years as an effective, evidence-based public health approach to the delivery of early intervention and treatment to these individuals, and uses motivational interviewing skills to increase awareness and motivate behavioral change.

SBIRT been bolstered by initiatives and formal recommendations from the National Institutes of Health (NIH), Substance Abuse and Mental Health Services Administration (SAMHSA), Health Resources and Services Administration (HRSA), Agency for Healthcare Research and Quality (AHRQ), and several national and international public health agencies.

NORC at the University of Chicago, in collaboration with the Council on Social Work Education (CSWE), created a curricular resource on SBIRT. In this valuable resource for social work educators, motivational interviewing in social work is the sixth competency outlined.

“Through SBIRT, and consistent with the spirit of MI, social workers foster conversations that are centered on the strengths, priorities, and self-identified concerns of the individuals with whom they work. Social workers are mindful of the heavily contextualized nature of SBIRT practice and understand how individuals are affected by and affect families, other influential groups, organizations, and communities.” – NORC at the University of Chicago, Curricular Resource on Screening, Brief Intervention, and Referral to Treatment (SBIRT), P. 16

Because social workers understand the importance and influence of external factors and contexts, they are uniquely positioned to effectively use motivational interviewing and SBIRT to effectively engage with their clients.

Learn and practice motivational interviewing techniques

Schools of social work are embracing technology to train their students. Using simulation technology to give students practice using motivational interviewing in social work can help give them valuable practice before they work with clients in-person or during telehealth sessions.

“It can be really scary for our students to walk out there and greet clients for the first time and remember all the things that we taught them about – confidentiality, how to engage, how to establish rapport, all of that,” says Dr. Noell Rowan, a professor and associate director at the University of North Carolina Wilmington (UNCW) School of Social Work. “The Kognito simulations can help students to feel more confident when they reach an actual client or client system or family or organization.”

Kognito’s behavioral health simulations use evidence-based role-play simulations to help equip social work professionals and students of social work with skills and knowledge to address clients’ behavioral health.

Two simulations are particularly impactful in social work:

SBI With Adolescents helps health professionals build and assess their skills in conducting substance use Screening & Brief Intervention (SBI) with adolescent patients and providing referrals to treatment when appropriate.

SBI Skills Assessment helps health professionals assess their skills in conducting substance use Screening & Brief Intervention (SBI) using evidence-based intervention and motivational interviewing techniques.

Motivational interviewing in social work is powerful, but takes practice to master. Through virtual simulation, learners can gain meaningful practice in a safe environment.

Learn more about Kognito’s behavioral health simulations and request a demo at kognito.com.