Tinnitus & Hyperacusis Therapy Masterclass

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Specialist course for management of tinnitus and hyperacusis in children and adults


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 2009). The key elements of MI are partnership, acceptance, compassion, and evocation (Miller & Rollnick 2012). 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 2009). 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 2016b).

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, 2, 1-13.

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 Press. 

Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. Am Psychol, 64, 527-37.

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, 305-12.