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What is motivational interviewing?
Motivational Interviewing (MI; Miller 1996) is a psychological intervention which is rooted in
the client-centred counselling method of Carl Rogers (Rogers 1959) and gives great importance to both understanding a
patient’s internal frame of mind and exhibiting unconditional positive regard (Miller & Rose
The key elements of MI are partnership, acceptance, compassion, and evocation (Miller &
MI involves a flexible and strategic application of some core communication and
counselling skills (Miller &
Rollnick 2012)comprising: open questions, affirmation, reflective listening, summarizing,
informing and advising with patient’s permission.
MI seems to be more effective in people
at pre-contemplation and contemplation stages of change (Miller & Rose
According to the Transtheoretical Model, people move through a series of stages
in the process of changing behaviour from being unwilling (pre-contemplation
stage), to considering a change (contemplation stage), and to make a change
(action stage) (Prochaska &
DiClemente 1986). Laplante-Levesque et
al. (2014)assessed the stages of change in patients who failed a hearing screening test.
38% were in contemplation stage and 9% were in pre-contemplation stage, hence
not everyone with hearing impairment was ready to use hearing aids (HAs). This
could be a contributing factor to non-regular use. Therefore, combining MI with
audiology care might improve non-regular use (Aazh 2016a; Aazh
There are over 200 randomised controlled
trials (RCTs) on the effect of MI on a wide array of problems. Several
systematic reviews and meta-analyses support efficacy of MI on adherence to
long-term treatments and promoting behaviour change in management of alcohol
abuse, addiction, weight loss, diabetes, physical activity, and smoking
cessation (Rubak et al. 2005;
Lai et al. 2010).
Aazh, H. (2016a).
Feasibility of conducting a randomised controlled trial to evaluate the effect of motivational interviewing on
hearing-aid use Int J Audiol, 55, 149-156.
Aazh, H. (2016b). Patients' experience of motivational interviewing
for hearing aid use: A qualitative study embedded within a pilot randomised
controlled trial. J Phonet and Audiol,
Lai, D. T., Cahill, K., Qin, Y., et al. (2010). Motivational
interviewing for smoking cessation. Cochrane
Database Syst Rev, CD006936.
Laplante-Levesque, A., Brannstrom, K. J., Ingo, E., et al. (2014).
Stages of Change in Adults Who Have Failed an Online Hearing Screening. Ear Hear, 36, 92-101.
Miller, W. R. (1996). Motivational interviewing: research, practice,
and puzzles. Addict Behav, 21, 835-42.
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford
Miller, W. R., & Rose, G. S. (2009). Toward a theory of
motivational interviewing. Am Psychol,
Prochaska, J. O., & DiClemente, C. C. (1986). Towards a
comprehensive model of change. In W. Miller & N. Heather (Eds.), Treating Addictive Behaviours Processes of
Change (pp. 3-27). New York: Plenum Press.
Rogers, C. R. (1959). A theory of therapy, personality, and
interpersonal relationships 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 context (pp.
184-256). New York: McGraw-Hill.
Rubak, S., Sandbaek, A., Lauritzen, T., et al. (2005). Motivational
interviewing: a systematic review and meta-analysis. Br J Gen Pract, 55,