Working the Difference: Science, Spirit, and the Spread of Motivational Interviewing

Motivational interviewing (MI) is a professional practice, behavioral therapy, and self-professed conversation style that encourages clients to talk themselves into change. E. Summerson Carr's book Working the Difference explores how cultural forms, and particularly forms of expertise, emerge and spread, offering a compelling analysis of American preoccupations at MI's core.

Format: Paperback / softback
Length: 304 pages
Publication date: 28 November 2023
Publisher: The University of Chicago Press

Motivational interviewing (MI) is a multifaceted approach that encompasses professional practice, behavioral therapy, and a conversational style aimed at facilitating clients' self-directed change. Initially conceived for the treatment of alcohol addiction, MI has rapidly expanded its reach into diverse fields such as corrections, medicine, and sanitation. In his book "Working the Difference," E. Summerson Carr delves into the training and dissemination of MI, exploring how cultural forms, particularly forms of expertise, emerge and spread. The result is a profound analysis of the central themes at the heart of MI, encompassing democratic autonomy, freedom of speech, Protestant ethics, and American pragmatism.

MI is rooted in the belief that individuals possess the internal motivation and resources to change. It employs a non-confrontational and collaborative approach, fostering a supportive environment where clients can explore and address their underlying issues. The core principles of MI include expressing empathy, rolling with resistance, and reinforcing positive behaviors.

One of the key insights of MI is its recognition of the importance of client autonomy. The therapist aims to empower clients by respecting their choices and allowing them to take ownership of their change process. This approach contrasts with traditional methods that often rely on imposing external solutions or imposing authority.

MI has been widely adopted in various settings, including addiction treatment centers, mental health clinics, schools, and workplaces. Its effectiveness has been demonstrated in numerous studies, highlighting its ability to improve outcomes, such as substance abuse recovery, mental health symptoms, and behavior change.

In addition to its therapeutic applications, MI has broader implications for understanding cultural forms and expertise. Carr's book explores how MI has been influenced by different cultural contexts, such as American individualism, Protestantism, and pragmatism. It also examines how MI has been adapted and modified to meet the specific needs of different populations, such as adolescents, incarcerated individuals, and healthcare professionals.

One of the most significant contributions of MI is its emphasis on the importance of the therapeutic relationship. The therapist's role is not merely to provide information or advice but to actively engage with clients and build a rapport based on trust, respect, and empathy. This relationship-building aspect is crucial in promoting client motivation and engagement, particularly in challenging or complex situations.

MI has also been criticized for its potential limitations and challenges. Some argue that it may be ineffective in certain situations, such as when clients are resistant to change or have complex mental health issues. Additionally, the emphasis on client autonomy can sometimes lead to a neglect of the therapist's expertise and guidance.

Despite these criticisms, MI remains a widely used and influential approach to promoting change and addressing complex social problems. Its emphasis on client-centeredness, collaboration, and empowerment has resonated with practitioners and researchers across various fields. As MI continues to evolve and adapt to new contexts, it remains an important tool for promoting positive change and advancing social well-being.

In conclusion, motivational interviewing (MI) is a powerful approach to promoting change and addressing complex social problems. Its roots in behavioral therapy and its emphasis on client autonomy have made it a widely adopted practice in various fields. Through its exploration of how cultural forms emerge and spread, MI provides valuable insights into the dynamics of human behavior and the factors that shape cultural change. As MI continues to evolve and adapt to new contexts, it remains an important tool for promoting positive change and advancing social well-being.

Dimension: 229 x 152 x 18 (mm)
ISBN-13: 9780226827629