Motivational Interviewing with Problem Drinkers

TLDR

Motivational interviewing is grounded in social‑psychological principles such as attribution, cognitive dissonance, and self‑efficacy, emphasizing an interpersonal process of internal responsibility over labeling. The authors propose a schematic diagram and a six‑step sequence to implement motivational interviewing. The approach uses empathic techniques from Carl Rogers, social‑psychological motivation principles, and objective assessment feedback to channel cognitive dissonance toward behavior change while avoiding low self‑esteem, low self‑efficacy, and denial.

Abstract

Motivational interviewing is an approach based upon principles of experimental social psychology, applying processes such as attribution, cognitive dissonance, and self-efficacy. Motivation is conceptualized not as a personality trait but as an interpersonal process. The model deemphasizes labeling and places heavy emphasis on individual responsibility and internal attribution of change. Cognitive dissonance is created by contrasting the ongoing problem behavior with salient awareness of the behavior's negative consequences. Empathic processes from the methods of Carl Rogers, social psychological principles of motivation, and objective assessment feedback are employed to channel this dissonance toward a behavior change solution, avoiding the “short circuits” of low self-esteem, low self-efficacy, and denial. This motivational process is understood within a larger developmental model of change in which contemplation and determination are important early steps which can be influenced by therapist interventions. A schematic diagram of the motivational process and a six-step sequence for implementing motivational interviewing are suggested.