The “Big Picture:” Motivational Interviewing and Social Justice

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September 4, 2015 by Nicholas Spence

social-justiceA large focus of the motivational interviewing literature is on the science and empirical evidence on the use of motivational interviewing across a variety of contexts. Don’t get me wrong, I enjoy keeping abreast of these developments in the field, but I also believe it is important to look at the “big picture,” including the purpose of this endeavor called motivational interviewing.

I came across a personal piece by world-renowned expert Dr. William Miller, called Motivational Interviewing and Social Justice, in Motivational Interviewing: Training, Research, Implementation, Practice.

Given my own passion for social justice issues, I was immediately drawn to words in the first part of the article, “…I believe that [motivational interviewing] is a small part of something much larger…” What was Dr. Miller referring to? Social justice.

In laying out his argument, he discusses the history of motivational interviewing and its disproportionate use “…among some of the most despised, rejected and marginalized members of society: people with alcoholism, drug and addiction, psychoses, HIV and AIDS, the homeless, sex workers, and criminal offenders—those for whom human treatment is most unexpected, most welcome, and most impactful.” In Dr. Miller’s opinion, this is no coincidence and evidence of the relationship between social justice and motivational interviewing.

Next, Dr. Miller’s reflections include an amalgamation of ideas from great minds, including CS Lewis, Carl Rogers, the Dalai Lama, and Martin Luther King. The essence of the article is simply that beyond the increasing curriculum requirements of clinical programs and increasing evidence base to utilize motivational interviewing in practice, motivational interviewing has largely grown so quickly and widely because “it is as though we knew it by heart.” What he means by this is that there is a distinct relationship between motivational interviewing and six core humane values that we all share, which are also distinctly aligned with social justice: compassion, respect, fairness, human potential, prizing of differences, and collaboration.

Some people may disagree with the underlying assumptions of the true nature of human beings and their values (a worthy debate for another forum), but the reflections by Dr. Miller are very useful in forcing researchers and clinicians to think about how the basic tenets and practice of motivational interviewing fit into the bigger picture of social justice.

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