stephenrollnick

Like-minded is one way of describing colleagues involved in these two areas.  That's the origin of this forum space: a small group of us decided to open up an exchange that anyone can take part in.

What can self-determination theory and motivational interviewing offer each other?

How compatible are they?

Can MI practitioners, researchers, trainers and theorists learn from the work of colleagues in the SDT field, and vice versa?

Feel free to raise questions and express your views.  The rules are simple!

Try to write simply and clearly, bearing in mind an audience who might not be specialists in these fields. Respectfulness goes without saying!

Bon voyage,

Steve

Steve,

I love the image of a diamond with its facets. In the most brilliant cuts there are hundreds of facets. They are different but each one makes a contribution to the brilliance of the diamond. That is the way I think about MI and SDT. I would also add SOC and Relapse Prevention into the mix. Each one catches the light differently and contributes something unique.

There are obvious areas of convergence between SDT and MI. In SDT the focus on relatedness and autonomy is a clear overlay. There are also differences. SDT pays more attention to competence than does MI. SDT is concered with the satisfaction of basic needs as motivational energizers whereas MI is more of a motivational technology.

I teach SDT when I teach MI because I see them each contriobuting something unique. I think that SDT explains to some extent why MI works. I was fascinated to see in the presentation at San Diego that Bill had mapped out SOC against MI.

However, I don't see this as a convergence of theory as much as contributions from different facets of motivational theory. It doesn't matter to me that SDT and SOC both claim to be meta-theories. I think a grounding in each of these approaches is helpful to both the practitioner and the researcher.

Vaughn Keller

Grateful for this forum!  Curious about many things, one is to learn more about SDT, one is that I read in the latest Runners World magazine (where Deci is quoted about motivation around running possibly starting as extrinsic and becoming intrinsic) that we can think of athletes having three principle drives, for competence, relatedness and/or autonomy, that we have each of these drives to greater or lesser extents and that boosting our intrinsic motivation may be a matter of aligning with which one is the highest for us personally.  So, I'm wondering what SDT thinks about this way of conceptualizing intrinsic motivation.  Are these three categories (competence, relatedness, autonomy) useful ways of thinking about it?

Thanks in advance.

Hi

I'm excited about opening up this exchange of thoughts. I think there are several points of convergence between MI & SDT but there are also some differences with potentially important therapeutic implications. At this moment, a group of scholars is trying to get a special issue published on MI & SDT as a follow-up of a sattelite meeting in Sintra in 2009 organized by Pedro Teixeira & Antonio Palmeira. The special issue is likely to come out in 2011 in the International Journal of Behavioral Nutrition and Physical Activity. A couple of years, two independent groups of researchers wrote a theoretical paper on the convergence of SDT & MI. Those papers may offer some thoughts for discussion on this forum.

Markland, D., Ryan, R. M., Tobin, V. J., & Rollnick, S. (2005). Motivational interviewing and self-determination theory. Journal of Social and Clinical Psychology, 24, 811-831.

Vansteenkiste, M., & Sheldon, K. M. (2006). There is nothing more pratical than a good theory: Integrating motivational interviewing and self-determination theory. British Journal of Clinical Psychology, 45, 63-82.

Maarten

Can I make a suggestion: when you contribute, say in a few words what your principle focus has been; e.g. MI, SDM, clinician, researcher, and so on.

One step we'll take soon is to ask Ken Resnicow for a list of questions he posed in an email some weeks ago. be good to have a focus?

Regard

Steve

OK, SDT colleagues, here's a really ignorant question:

Is there a form of counseling or intervention that you have developed from SDT?

Interesting secondary questions include what does it look like, have you devised a measure of competence and do you have audiotapes of sessions?   I then get to wonder how different thes sessions might be from an MI session....

Regards, Steve

Steve,

Thanks for the forum, and for this discussion. I had seen a journal article where you were a contributor suggesting that SDT might be a theoretical framework for MI. Let me say that I don't have a great grasp of SDT, and consider myself a student (still learning) about motivational interviewing.

I've recently read Daniel Pink's Drive, which is centered around motivation, and specifically the value of intrinsic motivation. This seems where the likely intersection between MI and SDT exists, and in my mind offers the greatest potential. In a recent post on another forum, there is mention of a study about integrated CBT and MI. One of the findings is that MI influences readiness to change 12 months later, but that it seems to be diminished somewhat at 24 months. Perhaps an increase in intrinsic motivation is a key ingredient for sustaining this impact.

Intrinsic motivation, at least according to Pink and others, addresses mastery, autonomy, and purpose. MI would seem to intersect well with the first two through self efficacy and choice, but not sure about the match with purpose/relatedness - connecting someone to a sense of belonging (I'm certain this is way too simplistic). I would think that a focus on helping someone develop intrinsic motivation would be key in seeing readiness to change extend long term.  How might this be accomplished with MI or some other therapuetic approach? I don't have an answer, just wanting to learn from thosse who might have ideas about this.

This strikes me as a particularly interesting conversation at a time when intrinsic motivation does not seem to remain in the definition for MI in the upcoming revision, which I understand is a work in progress.

Greg Sumpter

Dear Greg,

thanks so much for coming into the discussion. I hesitated to reply because I want others to join in and dont want this exchange to revolve around me!

Nevertheless, maybe I can restrict myself to clarifying aspect of MI......

Definition(s) of MI. You express a concern that ...." intrinsic motivation does not seem to remain in the definition for MI in the upcoming revision, which I understand is a work in progress".  Bill Miller and I are busy reconstructing a framework for MI, shifting around the pieces of a puzzle about what we imagine MI is or could be. Its always been this way for us, relying on the clinical insights of ourselves and others. Definitions are tricky. You cant include everything in a definition. In any case, they are merely pointers to what's inside MI, not the last word on the subject. Yet intrinsic motivation is at the heart of MI for sure. Definitions? We will probably use three!  A lay person's definition, a pragmatic practitioner's one, and a technical one.  Our current lay definition (& and this is only a provisional one, not for citing in publications yet etc etc) is: Motivational interviewing is a collaborative conversation to strengthen a person’s own motivation for and commitment to change

Are you happy?

Having noted this, only a brief scan of SDT leads me to realise that my understanding of he dynamics of intrinsic motivation is very limited. That's why I am so keen to learn from the SDT field. Please help anyone, with a pragmatic practitioners guide to intrinsic motivation from an SDT perspective!

Then we might move on to autonomy.  Enhancing this feels fundamental to MI, whether its in the definition(s) or not. Again there will be nuances about autonomy that the SDT field can help us all with.

Finally, let me say that I have been reviewing recently theories of behaviour change and their relevance for health psychology with a group of colleagues. I'm disappointed about how little attention is pad to SDT in the literature. Its seems to be that so many social cognitive and value expectancy models ignore relatedness and autonomy. I'm shocked. There's also an assumption that change is linear in many models, which goes against what I know to be a circuclar, dynamic and process, filled with what I have called irrational coherence, which takes me back to the concept of ambivalence as a core construct......... that's for another discussion.....

Long may we champion the role of client values and needs in understanding and promoting change that makes sense to them.

Kind regards, Steve

Hi,

I have read a little and am interested in SDT (particularly related to sport and exercise settings) and whilst I agree with the reams of literature suggesting that intrinsic motivation is an extremely desirable quality (I will have to read more on MI!), I also wonder how can I enhance someone else's intrinsic motivation? If I were to 'interfere' then surely I would by definition be influencing the individuals' extrinsic motivation, which again according to the literature can undermine intrinsic motivation? Is this a dilemma or am I just stuck in the maze of my limited understanding?

Almost (but not quite!) answering/reflecting on the above, the process of internalisation may use this extrinsic motivational influence and over time assimilate it into the indivduals thinking. Under the right circumstances this could move towards a more integrated motivational approach which itself may enhance intrinsic motivation... but should it just be left to 'chance'?

Is this where MI comes in?

Apologies if I have moved off task!
thanks for listening
Julia

Wonderful Julia. I loved the simplicity of your question. let's see how others feel about this.  I also feel a little ignorant of the nuances of intinsic motivation. Steve

Here are some questions, several which I've circulated previously and many of  you have commented on. I thought it might be good to post them here in the official forum. If those who answered previously would post their responses that would provide a nice archive of the discussion....I have tweaked a few of them, which might tweak a few of you...he he....

So happy to see this rolling

Ken R from Ann Arbor (12 degrees F today)

FROM MI TO SDT
How does SDT conceptualize RESISTANCE and REACTANCE, and what would the SDT practitioner do to mitigate them clinically?

How does SDT conceptualize AMBIVALENCE, and what would the SDT practitioners do to mitigate?

• Are they above manifestations of AMOTIVATION or CONTROLLED motivation?  Can a client be autonomously motivated and still ambivalent or resistant?v
• Given the SDT continuum, can a person be at multiple positions along that continuum simultaneously?

Why, from an SDT perspective, is reflective listening, particularly rolling with resistance and amplified negative, so darn effective?
Why, from an SDT perspective, is change talk so important in behavior change?

• How do you conceive change talk?  Why is the actual verbal expression important in buildng autonomous motivation?

Can autonomy be retained even when the practitioner is directive?

• What is the difference between autonomy support and volition?
• Given MI is now defined as GOAL ORIENTED, does that conflict with the concept of autonomy in SDT?

How does the MI clinician balance the three needs of competence, autonomy and relatedness, particularly when they may collide. Example, pt. with low efficacy asks the doc for highly directive advice about HOW to do something.  SDT seems to have shifted focus more on AUTONOMY than the other two needs. 

FROM SDT TO MI
How does (or should) MI incorporate the concept of ENERGY (used in SDT) as it relates to motivation and behavior change?  Is the change talk crescendo, shown to predict outcomes recently, really a shift in ENERGY and or HOPE?

Is AMOTIVATION too difficult to change even for MI?

Is building discrepancy through values clarification borrowing ENERGY from one domain and lending it to the behavior change at hand?

Does MI adequately account for/focus on, etc AUTONOMY support and VOLITION?  We obviously talk about it, but maybe we need more targeted training activities in this regard.

Is our goal orientation in any way inconsistent with AUTONOMY support and VOLITION?

What is the role of COMPETENCE and RELATEDNESS in MI? Perhaps the former has a discrete role (ii.e, the 0-10 ruler) while the later may be more subsumed within the therapuetic alliance.

Should MI distinguish between TYPES and therefore quality of change talk,  CONTROLLED vs. AUTONOMOUS (and do we need to care about the difference)?  We seem to focus on amount more than quality.

Should we devote more effort to SDT constructs in our coding systems such as MITI? Automony is already a global but less so competence.

I have been inspired by the mutual benefits of combining MI with SDT, and have read the two theoretical papers with great interest:
Markland, D., Ryan, R. M., Tobin, V. J., & Rollnick, S. (2005). Motivational interviewing and self-determination theory. Journal of Social and Clinical Psychology, 24, 811-831.

Vansteenkiste, M., & Sheldon, K. M. (2006). There is nothing more pratical than a good theory: Integrating motivational interviewing and self-determination theory. British Journal of Clinical Psychology, 45, 63-82.

There is an important question that seems unanswered by the papers as I can see it: The metatheoretical contradictions between a nondirective humanististic and organismic approach (SDT) and a more directive and behavioural approach (MI). It is possible that I may have misunderstood, but I think it is important also from a clinical point of view (I am a MD). I think that the danger of nondirective counselling may be liberal indifference or "soft manipulation", and the danger of directive counselling is authoritarian misuse of power and resistance. MI seems to address the last pitfall without withdrawal from the responsibility of directiveness in counselling. Has SDT changed its metatheoretical foundation? I hope someone might clarify this question for me? Is it an irrelevant and constructed disaggreement?
Eivind Meland, UoBergen

Wow Elvind! Great question.

This forum on MI & SDM is going through a quiet phase, and I am trying not to dominate it. Its for others to use and enjoy.

We might have some have motivational problems among many of the key people in MI & SDT who are not contributing to this forum as yet - they have the competence, they should feel nicely related and at home here, yet their autonomy is expressed elsewhere! That’s just a joke. People are clearly busy, and its also possible that so many questions have been raised in this thread that its hard to know where to begin. I certainly feel that.

To receive a specific question like yours is therefore really helpful:

SDT: I’d like to hear from SDT folk about whether your characterization of SDT is one they are happy with: “a nondirective humanistic and organismic approach (SDT)”.

MI: You characterize MI as “a more directive and behavioral approach”. I think you will find a range of views here within the MI field. Few would characterize MI as simply as a “behavioural approach”. My personal view is that there is an inevitable convergence between the practitioner’s aspirations for change and those of the client. Hence my efforts to describe good practice in change conversations as being based on a guiding style (see MI in Health Care book), in which there is a frank and open effort to clarify and agree on the focus for change. From the outset, Miller & I described motivational interviewing as “client-centred and directive” (see Rollnick & Miller, 1995).

My suspicion is that when it comes to practice, MI & SDT are overwhelmingly compatible. The former is a method with ongoing efforts to explain it, the latter is a theory with ongoing effort to apply it. Hence this forum space for anyone to contribute to. Barriers between therapy forms in the psychology world have left a legacy of competition and bitterness that we should avoid at all costs. Open debate in a generous spirit – let’s go!

Kind regards to you Elvind, Steve