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Why Just Telling People to Change Doesn’t Work

An introduction to motivational interviewing.

Key points

  • External pressure to change is, at best, temporarily effective, and at worst, counter to the change process.
  • Motivational interviewing is a communication style that invites individuals to voice their own reasons for making a change.
  • By eliciting change talk, motivational interviewing offers a new kind of communication in which individuals talk themselves into change.

Getting motivated to change

Think about something that you would like to change, or you know you should change, but you haven’t changed yet (Miller & Rollnick, 2013). This could be something related to your diet, exercise, sleeping patterns, social media use, communication with your partner, alcohol use, tobacco use, internet gaming, shopping/spending, vaping, use of leisure time, driving habits, work habits, etc.

You know that making a change would probably be good for you… but there are also several reasons why you don’t want to change (e.g., you know smoking is bad for your health, but you also like the way it makes you feel; you know exercising would help with your diabetes, but you have so many other things you to do; you know you shouldn’t criticize your spouse in public, but you like the attention you get from your friends when you do it). These are all examples of ambivalence or feeling two ways about something at the same time (Miller & Rollnick, 2013). Ambivalence is a common experience on the road to behavior change and something we are all familiar with.

Now, suppose someone approaches you and begins telling you all the reasons why you should make the change.

They read statistics about the issue, make convincing arguments about why the change is necessary, admonish you to make the change, question why you haven’t made the change sooner, offer a myriad of suggestions for how to change, provide their own personal advice on how you should go about it, and give you a wealth of information on the topic. They end by saying you really should make the change, and you'd better do it quickly!

So, how likely are you to change?

If you are like the average person, not very likely at all. In fact, paradoxically, all the external pressure to make the change may actually make you less likely to change (Miller & Rollnick, 2013).

Why external pressure doesn’t work

The odds are good that your lack of behavior change isn’t stemming from a shortage of information, statistics, or advice. Most people in a state of ambivalence already have plenty of information and know loads of facts about the issue. Moreover, another person’s reasons why an individual should make a change often aren’t very compelling.

External pressure is, at best, minimally motivating or motivating for only a short period of time. We know from our own experience that just telling someone to change rarely, if ever, leads to lasting behavior change—yet people do it all the time! We try to convince others to change, give them reasons to change, pressure them into changing, threaten them to change, or shame them for not changing. But even if our efforts are sincere, they may be leading people further away from making positive change.

Is there another option? Bill Miller and Stephen Rollnick would say yes.

Motivational Interviewing as an alternative

Miller and Rollnick (2013) are the originators of motivational interviewing (MI), a communication style that encourages people to resolve their ambivalence by voicing their own reasons for making a change. Rather than trying to compel or force someone to change, MI suggests a completely different posture in which individuals are given space to speak from the part of themselves that wants to change and the part of themselves that does not want to change (which is the definition of ambivalence). In this way, individuals can voice their own arguments for making a change and act out of their own motivation (Miller & Rollnick, 2013).

MI developed from the addictions field in the 1980s as an alternative to the traditional confrontational approaches to get individuals to stop using substances (Miller & Rollnick, 2013). Rather than just telling people to stop and “breaking through denial,” MI respects the autonomy of clients by acknowledging both sides of their ambivalence (reasons to stop using substances and reasons to keep using substances). As a style of communication, MI specifically elicits clients’ own reasons to make a change (in MI, this is called change talk) and reflects those reasons back to the client. Thus, in essence, clients are talking themselves into change (Miller & Rollnick, 2012; MINT, 2020).

Due to its efficacy in addiction treatment, MI has been applied to a variety of issues, such as medication compliance, gambling, physical activity adherence, diet, spiritual struggle, treatment compliance, offender counseling, career decision making, parenting, and more. Backed by empirical support, MI has revolutionized the way we think about change.

How does it work?

The heart of MI is to join with the ambivalent person and create opportunities for them to give their own reasons for making a change (you see, we are much more apt to listen to our own advice than the advice of others!). If a person is ambivalent about making a change, such as not incurring any more debt, they likely don’t need another person giving them reasons why they should make this change. Indeed, Miller and Rollnick (2013) wrote, “People who are ambivalent about change already have both arguments within them—those favoring change and those supporting the status quo” (p. 21). The authors argue that if an external person begins speaking for one side of the argument (e.g., arguing for a change), the individual likely will begin speaking for the other side (e.g., arguing against changing; Miller & Rollnick, 2013).

Rather than falling into the predictable volley of “yes, but…” statements, MI encourages a specific communication style that invites individuals to voice their own reasons for making a change. Specifically, MI relies on evocation, or the act of drawing out an individual’s own arguments for change (which is in stark contrast to imparting reasons to change upon them). Importantly, MI is not a way of coercing or tricking someone into a new behavior (like a salesperson trying to make a deal); instead, “it is about eliciting the person’s own inherent arguments for change” (Miller & Rollnick, 2009, p. 131).

For example, go back to the thing you first identified when you began reading this blog… the thing that you would like to change or think you maybe should change but haven’t changed yet. Now, take a moment to answer the following questions:

  • What would be the benefits of making the change?
  • How significant is making this change to you?
  • What would you like to be different from how things are now?
  • If you don’t make the change, what might happen?
  • What are the most important reasons why you would make the change? (All questions are adapted from Miller & Rollnick, 2013, p. 11, 172.)

These types of questions, in which individuals are invited to consider their own reasons for making a change, are MI-congruent (rather than telling a person why and how they should change). Oftentimes, a person’s most compelling reasons for making a change are linked to their personal values and goals—something that others might not know or might not fully know.

Consider this example:

Helper: “I hear that you really like the way drinking makes you feel. It calms you down when you are anxious in social settings. I am curious, are there any reasons why you would want to change how you drink?” (MI-congruent question is asked.)

Helpee: “Well, even though it calms me down at parties, sometimes I say or do things that I am embarrassed about later. When I am drinking, I don’t have as much control, and I would never want to hurt my family’s reputation.” (Helpee responds by giving her own reason for the change.)

When individuals voice their own reasons for change, it often is very motivating, compelling, and personally meaningful. Indeed, when discrepancies exist between our goals/values and our behaviors, we often are motivated to make a change. By identifying and exploring our goals and values, it is easy to see which behaviors are incongruent. For example, consider a man who values being a good father yet overworks to the point that he has few interactions with his children during the week. As he reflects on this discrepancy, he is motivated to change.

The components of MI

MI is a unique way to engage in conversations about change. It bypasses the defensiveness that comes with blaming, shaming, informing, pressuring, and threatening. Instead, it is built upon partnership (it is collaborative), acceptance (respect for the individual’s autonomy), compassion (motivated by the welfare of the individual), and evocation (the act of drawing out the individual’s own reasons for change rather than imparting reasons upon them; Miller & Rollnick, 2013; MINT, 2020). In this spirit, individuals who use MI engage in four processes: engaging (forming a connection), focusing (identifying a specific direction for the conversation), evoking (inviting the individual to identify their own reasons for making a change), and planning (determining a course of action; Miller & Rollnick, 2013; MINT, 2020).

MI invites helpers to take a different posture when working with people who are ambivalent about a behavior change—one that relies on an individual voicing their own reasons for change and motivating themselves into action. Indeed, Miller and Rollnick (2013) wrote, “If you as a helper are arguing for change and your client is arguing against it, you’ve got it exactly backward” (p. 9). Those who use MI often reflect both sides of an individual's ambivalence—the side that wants to change and the side that does not want to change. When both sides are recognized, the individual is free to explore their own motivation for change without feeling compelled to defend the “no-change” side of their ambivalence (Miller & Rollnick, 2013). Consider this example of a double-sided reflection (reflecting both sides of ambivalence):

Helpee: “I know I need to cut back on my time at the casino. I am wasting too much money that should be going toward renovations on the house. But when I’m sitting at the slots, all my problems just seem to disappear.”

Helper: “Part of you likes how gambling provides an escape from your troubles, and you also recognize that you are losing money that is needed elsewhere.”

By using these types of statements, helpers reflect both sides of an individual's ambivalence and invite them to consider their own motivation for making a change. Oftentimes, hearing one’s own reasons for change reflected back can be very compelling.

It takes time and intentionality to learn MI. As a dynamic communication style, there are many methods for encouraging change talk (individual’s own reasons for change) and ways to respond effectively to sustain talk (individual’s reasons for not changing; Miller & Rollnick, 2013). Rather than a surprise, both change talk and sustain talk are anticipated among those who are ambivalent about change—indeed, they are viewed as part of the change process. MI provides guidelines for how to engage in conversations that invite individuals to voice their own reasons for change and build upon their own motivation.

Interested readers are encouraged to consult the references below.

References

Miller W. R., & Rollnick, S. (2009). Ten things motivational interviewing is now. Behavioural and Cognitive Psychotherapy, 37, 129-140. https://doi.org/10.1017/S1352465809005128

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New Guilford Press.

Motivational Interviewing Network of Trainers (2020). Understanding motivational interviewing. https://motivationalinterviewing.org/understanding-motivational-intervi…

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