The Spirit of MI
The basic assumptions of MI differ from traditional or typical dietetic or medical counseling, and this is what is meant by the term spirit. Rather than “the practitioner is the expert and the patient will be taught” approach, MI assumes a “dual expertise” between patient and practitioner.6 MI assumes that the client and practitioner are experts in the counseling relationship, which is collaborative in nature, and that carefully listening to the patient is essential. The clinician may be the expert in what patients ought to do, but the patients have the expertise in what is important to them and what is possible in the context of their lives. MI assumes that patients have all the answers they need, and our job is to assist in the evocation of this information. The traditional health behavior counseling approach is installation therapy in that we assume patients have a deficit of information, and if we transmit it properly, they will have it and be willing and able to use the information.


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