Psychologists may use many different types of theoretical views when conducting therapy. Traditional views tend to be labeled psychoanalytic or psychodynamic. These schools of thought place the therapist in the expert role and the patient in the student role. To the contrary, postmodern psychological theories, such as motivational psychology, employ a more collaborative approach that focuses on meeting the patient where he is in terms of readiness for change.
Motivational interviewing is based on a theory in behavioral psychology relating to how a person knows when he is ready to truly accept and commit to changes in behavior. Developed by psychologists Stephen Rollnick and William Miller in the early 1980s, motivational interviewing has been used to help individuals battle various types of compulsive behaviors, including poor or compulsive eating habits. One of the goals of the theory is to figure out how to transform external motivation to internal motivation. Another key concept is that each person begins the process of change from a different point.
Levels of Readiness
At the heart of motivational psychology is the patient’s level of readiness. The first stage is precontemplation, where motivation is almost entirely external and the desire to change has come from others being worried about the problem. Next comes contemplation and preparation stages, where the individual begins to accept that his behaviors need to be changed and he starts to deal with ambivalence toward a new lifestyle. Finally, action and maintenance occur with modification of habits and environment while new behaviors begin take root.
The Use of Questions
In order to assess where the patient is in the stages of change, the therapist asks many questions throughout the first sessions of therapy. A popular question coined by a school of therapy called Solution Focused Therapy is the “miracle question,” which basically asks patients to imagine what their world would be like without their particular problem. Common wording for this question is, “If you woke up tomorrow, and a miracle happened so that you no longer had this problem, what would you (or your friends) see differently?” The individual’s response gives therapists information regarding willingness and readiness to change.
Motivational interviewing applies well to problems based in behavior difficulties such as overeating, substance abuse and smoking addiction because it directly discusses how to change behavior on a deep level. The first place to begin in setting goals for any change in behavior is to figure out the stage of change where a person is at the outset. In doing this, goals can be realistic and the chances for success will increase
“A History of Modern Psychology;” Thomas Hardy Leahey; 2001
“Transtheoretical Therapy: Toward a More Integrative Model of Change;” James Prochaska and Carlo Diclemente; 1982
“Counseling and Psychotherapy Theories in Context and Practice”; John Summers-Flanagan and Rita Sommers-Flanagan; 2004.