Table Of ContentMotivational Interviewing
in Clinical Mental Health
Counseling
Motivational Interviewing in Clinical Mental Health Counseling is a
cutting-edge guide to empowering counselors with the philosophical
and actionable elements of motivational interviewing. This textbook,
appropriate for primary or supplementary use in counseling coursework,
is a practitioner and student-friendly text appropriate for readers across
all levels of familiarity with motivational interviewing. Chapters integrate
and present the newest conceptual and empirical literature, and the
relevant, up-to-date content in each chapter is accompanied by a detailed
case study and specific training exercises that will enhance counselors’
proficiency in core skills.
Motivational Interviewing in Clinical Mental Health Counseling
introduces new learners to the skills and philosophy of motivational
interviewing, enhances the skills of veterans familiar to the framework,
and is the perfect companion for students of motivational interviewing
across a variety of mental health counseling courses.
Todd F. Lewis, PhD, is a professor of counseling and counselor education
at North Dakota State University. He is a member of the Motivational
Interviewing Network of Trainers (MINT).
Edward Wahesh, PhD, is an associate professor in the Department of
Education and Counseling at Villanova University. He is a member of the
Motivational Interviewing Network of Trainers (MINT).
Motivational Interviewing
in Clinical Mental Health
Counseling
Todd F. Lewis and Edward Wahesh
C over image: From Getty
F irst published 2022
b y Routledge
6 05 Third Avenue, New York, NY 10158
a nd by Routledge
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
R outledge is an imprint of the Taylor & Francis Group, an informa business
© 2023 Todd F. Lewis and Edward Wahesh
T he right of Todd F. Lewis and Edward Wahesh to be identified as
authors of this work has been asserted in accordance with sections
77 and 78 of the Copyright, Designs and Patents Act 1988.
A ll rights reserved. No part of this book may be reprinted or
reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
T rademark notice: Product or corporate names may be trademarks
or registered trademarks and are used only for identification and
explanation without intent to infringe.
L ibrary of Congress Cataloging-in-Publication Data
Names: Lewis, Todd F., author. | Wahesh, Edward, author.
Title: Motivational interviewing in clinical mental health counseling /
Todd F. Lewis, Edward Wahesh.
Description: New York, NY : Routledge, 2022. | Includes
bibliographical references and index.
Identifiers: LCCN 2022015438 (print) | LCCN 2022015439 (ebook) |
ISBN 9781138568266 (hardback) | ISBN 9781138568273
(paperback) | ISBN 9781351244596 (ebook)
Subjects: LCSH: Motivational interviewing. | Interviewing in mental
health. | Mental health counseling.
Classification: LCC BF637.I5 L45 2022 (print) | LCC BF637.I5
(ebook) | DDC 158.3/9—dc23/eng/20220524
LC record available at https://lccn.loc.gov/2022015438
LC ebook record available at https://lccn.loc.gov/2022015439
ISBN: 978-1-138-56826-6 (hbk)
ISBN: 978-1-138-56827-3 (pbk)
ISBN: 978-1-351-24459-6 (ebk)
DOI: 10.4324/9781351244596
Typeset in Sabon
by Apex CoVantage, LLC
Contents
List of Abbreviations viii
List of Figures and Tables ix
Preface x
Acknowledgments xiii
PART I
Foundations of Motivational Interviewing 1
1 Introduction to Motivational Interviewing: Philosophy
and Spirit 3
Introduction 3
What Is Motivational Interviewing? 3
The Spirit of Motivational Interviewing: The Recipe of
Good Practice 6
Philosophy, Principles, and Clinical Stance 10
Clinical Mental Health Counseling and Motivational
Interviewing 13
Summary 15
References 16
2 Skills and Technical Aspects of Motivational Interviewing 18
Introduction 18
Summary 34
References 35
3 Motivational Interviewing, Ambivalence, and Change Talk 36
Introduction 36
Case Study 49
Summary 52
References 52
vi Contents
4 Motivational Interviewing in Action: The Four Processes 56
Introduction 56
What Motivational Interviewing Looks Like in
Practice 56
Case Study 66
Summary 72
References 72
PART II
Applications of Motivational Interviewing in Clinical
Mental Health Settings 75
5 Common Presenting Problems in Clinical Mental Health
Settings and Motivational Interviewing 77
Introduction 77
Using Motivational Interviewing in Inpatient Mental
Health Care Settings 78
U sing Motivational Interviewing in Outpatient Mental
Health Care Settings 80
Using Motivational Interviewing with Common Mental
Health Problems 80
Case Study 89
Summary 91
References 92
6 Motivational Interviewing and Group Counseling 95
Introduction 95
Overview of Group Counseling Process 96
Incorporating Motivational Interviewing into Group
Counseling Practice 102
Empirical Support 107
Contraindications 109
Case Study 110
Summary 112
References 112
7 Client Conceptualization: Using Motivational Interviewing
Within the Clinical Evaluation Process 115
Introduction 115
Clinical Evaluation 115
Contents vii
M otivational Interviewing and the Evaluation
Process 120
A ssessment Feedback and Motivational
Interviewing 120
A ssessing Stages of Change and Motivation 124
S ummary 128
R eferences 130
8 Clinical Supervision from a Motivational Interviewing
Perspective 132
I ntroduction 132
C ase Study 148
S ummary 151
References 152
9 Multicultural Counseling and Motivational Interviewing
in the Clinical Mental Health Setting 154
I ntroduction 154
T he Diversity of Counseling Clientele 154
M ulticultural Counseling: The Fourth Force in
Professional Counseling 155
M otivational Interviewing as a Culturally Sensitive
Approach 157
S ummary 162
R eferences 164
PART III
Training and Professional Development in Motivational
Interviewing 167
10 Training and Professional Development in Motivational
Interviewing 169
Introduction 169
Summary 179
References 180
Index 183
Abbreviations
ASA Ask share ask
CATs Commitment, activation, taking steps
CMH Clinical mental health
CMHC Clinical mental health counseling
DARN Desire, ability, reasons, need
DSM Diagnostic and statistical manual
EARS Elaborate, affirm, reflect, summarize
EPE Elicit provide elicit
FRAMES Feedback, responsibility, advice, menu, empathy, self-efficacy
MI Motivational interviewing
OARS Open questions, affirmations, reflections, summary
PACE Partnership, acceptance, compassion, evocation
Figures and Tables
Figures
7.1 The Clinical Evaluation and Its Components 116
Tables
2.1 Examples of Affirmations Contrasted with Praise 21
3.1 Examples of Change Talk from Evoking a Client’s
Motivation to Engage in Treatment 42
4.1 Questions to Guide the Planning Process 66
7.1 Assessing Importance and Confidence to Understand
Motivation 126
9 .1 Multicultural Considerations Throughout the
Counseling Process 156
