Motivational Interviewing

Motivational Interviewing (MI) was developed by William Miller and Stephen Rollnick in the early 1980s, originally in the context of alcohol treatment. It is a collaborative, person-centered approach to facilitating change that is built on a fundamental respect for the individual's autonomy and ambivalence. MI does not try to convince, coerce, or pressure people into changing. Instead, it creates a space in which people can explore their own mixed feelings about change, articulate their own reasons for changing, and build their own intrinsic motivation to do so.

The Spirit of MI

• Partnership: therapy as collaboration, not prescription
• Acceptance: unconditional positive regard, affirming the person's autonomy
• Compassion: genuinely working in the client's interest
• Evocation: drawing out the client's own wisdom and motivation rather than installing it from outside

Ambivalence Is Normal

One of MI's most important insights is that ambivalence — simultaneously wanting to change and not wanting to change — is completely normal and not a sign of resistance or failure. People struggling with substance use, for example, typically have very good reasons to keep using (the substance meets real needs) and also very good reasons to stop or cut back. MI respects both sides of this ambivalence and helps the person explore it without judgment, trusting that when the conditions are right, the person's own motivation will emerge.

MI at NEST

Motivational Interviewing informs the work of several NEST clinicians, particularly in the context of substance use, harm reduction, and any situation where a person is navigating significant ambivalence about change. The MI spirit — collaborative, non-judgmental, respectful of autonomy — is also consistent with the broader therapeutic stance at NEST. We believe that lasting change comes from within, and that the therapist's role is to create the conditions in which that internal process can unfold.