Can Motivational Interviewing be Truly Integrated with Person-centered Counselling?

Abstract

T his article examines whether Motivational Interviewing (MI) can be truly integrated with Carl Rogers' person-centered approach (PCA) to counselling. While the 'spirit' of MI has much in common with PCA, it is argued that the theory and practice of MI indicates several fundamental differences with PCA that distinguishes the ways that each perspective may contribute to rehabilitation counselling. These differences are discussed in relation to the unique aspects of their underlying assumptions, how they define clients' problems, and how they articulate the role of counsellor and successful outcome. Recent metaanalyses have indicated the beneficial aspects of both approaches. Empirical evidence for the efficacy of both MI and PCA is strong across a diverse range of client groups and health care settings. However, the highly variable effectiveness of both MI and PCA suggests that further process-outcome research is needed. Implications for rehabilitation counsellors are discussed. Keywords: Motivational interviewing, person-centered counsellingMotivational Interviewing (MI) has been defined by Miller and Rollnick (2002, 2009, 2012 as an evolution of Carl Rogers' Person-Centered Approach (PCA) to counselling. However, they argue that MI departs from PCA by being consciously goaloriented, by being intentionally directive and by selectively reinforcing the client's change talk. Despite these differences, commentators have often alluded to the debt that MI owes PCA (e.g., Britt, Blampied & Hudson, 2003;Csillik, 2013;Mason, 2009;Wagner & McMahon, 2004). Recent commentaries have also aligned the traditional rehabilitation counselling theme of self-determination with both MI (Page & Tchernitskaia, 2014;Wagner & McMahon, 2004) and PCA (Crisp, 2011).It is easy to conflate the "spirit" of MI (Miller & Rollnick, 2002, pp.34-5) with PCA since both approaches value collaboration, both aim to elicit the client's own intrinsic motivation for change, and they privilege the client's autonomy. They share a disdain for confrontation, a preference for drawing on the client's own resources rather than imparting knowledge, and avoid taking an authoritarian stance. But, can Address for correspondence: PO Box 1172, Croydon, VIC. 3136, Australia, E-mail: ross.crispsy@gmail.com While Miller and Rollnick (2002, 2009, 2012 acknowledge Rogers' (1961) emphasis on reflective listening, MI and PCA tend to diverge in several ways, not least in their notions of empathic understanding and reflective listening. In this article, I will contend that PCA is not easily integrated with MI because MI diverges significantly from PCA in both its non-directive and directive aspects. In Table 1, MI is summarised and compared with PCA in terms of theory, practice and evidence-based research. The issues listed in Table 1 serve as the framework for the discussion that follows. The aim of this article is to clarify the differences between MI and PCA and the implications for the practice of rehabilitation counselling.

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“…A key strategy of person-centred practice is construction of a trust-based 'therapeutic' relationship between the person and the service provider that facilitates the person's openness to challenges and the anticipation of their needs and thus, helps to adjust assistance accordingly, resulting in positive service outcomes (Crisp, 2015;Hamovitch et al, 2018;Parr, 2016).…”