Is MI Therapy?
A question came up today around the interviewer not wanting to appear as a ‘therapist.’
Fleet Maull’s response: Great question. While the use of MI by correctional counselors, probation and parole officers, etc. is not intended to be “therapy,” I think we certainly want the communication to be therapeutic in the best sense in that it supports the client in moving toward positive change. It might be more useful to think of it as “coaching.” In using MI with our clients, our questions and reflections (ideally a ratio of at least 3 reflections, if not more, to one question) are designed to create a therapeutic alliance that will make it safe for the client to begin addressing their challenges more and more directly and honestly with more and more focus on change, the future, and what the steps are toward positive change and a new future. By asking change and future oriented questions and then doing lots of reflections and affirmations we “coach” and/or facilitate the client in discovering their own motivation and strategies for change. Keeping the communication off the “Drama Triangle” and in an adult to adult context will also help avoid some of the problems we might associate with therapy and emphasize an adult to adult coaching context. Nonetheless, establishing what is often called a therapeutic alliance or a relationship of trust and willingness to work together toward positive goals seems essential to producing any of the desired outcomes with clients. Working with presence and mindfulness will also help support an adult-to-adult environment of trust and change orientation.