Thursday, April 21, 2011

Comparison of Motivational Interviewing with Acceptance and Commitment Therapy: A Conceptual and Clinical Review

Motivation Interviewing (MI) is not an a mindfulness and acceptance-based treatment; however, it is consistent with many of same principles and can be used in conjunction with a number of treatments. MI is a type therapy in which the primary aim is increasing motivation for change. It was originally developed for addiction but has since been adapted for all sorts of things, including health-related behaviors. Rooted in Carl Roger's person-centered approach, MI is not a stand alone therapy in itself, but a way to prepare someone for change. The therapist accepts the client where she is while helping to guide the individual towards talking about change.

Dr. Jonathan Bricker--who also piloted the telephone smoking cessation study I posted about last year--co-authored a recent article exploring the conceptual similarities and differences between MI and Acceptance and Commitment Therapy (ACT). The article highlights three ways in which both approaches overlap:

1. Both seek to increase commitment to changing behavior.

2. Both draw upon values to enhance commitment. In particular, MI and ACT therapists strive to help people contact long-term goals and life directions to increase the motivation for behavior change.

3. Both look at processes of language to help facilitate change. In MI, there's an emphasis on helping people engage in "change talk" (e.g., openly verbalizing what they want to do). By contrast, ACT seeks to undermine verbal self-rules (e.g., unhelpful ideas that keep people stuck) and help people make commitments towards valued goals and directions.

The article does a nice job summarizing both treatments. According to the Acknowledgments section, the authors received feedback on the manuscript from Drs. Bill Miller and Steve Hayes, core originators of MI and ACT, respectively. There's no new data, but the article provides a balanced view of MI and ACT and offers suggestions for how they may complement one another. Even if you've never heard of MI, the article provides a concise introduction.

The article hasn't been officially published yet but is available online. To download a copy click on the full citation below:

Bricker, J., & Tollison, S. (in press). Comparison of Motivational Interviewing with Acceptance and Commitment Therapy: A Conceptual and Clinical Review. Behavioural and Cognitive Psychotherapy.

If you'd like to read further about MI, I encourage you to check out the core MI book:

Miller, W.R., & Rollnick, S. (2002). Motivational Interview, Second Edition: Preparing People for Change. New York: Guilford Press.

For a book with chapters on an ACT approach to substance use, check out:

Hayes, S.C., & Strosahl, K. (Eds.) (2004). A Practical Guide to Acceptance and Commitment Therapy. New York: Springer.

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