The document discusses the differences and relationships between motivational interviewing (MI) and client-centered therapy. It explores how definitions of MI have evolved over time from a set of concepts and precepts to a more directive method for enhancing motivation. The document also examines debates around key terms like "equipoise" and whether a binary or fuzzy logic is more appropriate for understanding MI. Clarifying definitions is important for research on evidence-based practices and ensuring interventions are implemented with fidelity.

1. Splitting hairs or parsing concepts, fuzzy thinking or fuzzy categories: where does MI end and client-centered therapy begin? David B. Rosengren, Ph.D. Director, Research & Evaluation Services Prevention Research institute ICMI – 2 Stockholm, SE June 7, 2010

2. How did we get here? MI grew from empirical observations and.. Self observations by W.R. Miller A set of concepts & precepts followed Data, revision, data, revision & a beginning theory MI extended beyond addictive behaviors Along the way, interest exploded

3. Where do the tent pegs go?

4. Definitions Current MI is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. Evolving MI is a person-centered, guiding method of communication to elicit and strengthen motivation for change. Person-centered therapy/approach Three conditions: genuineness, acceptance & unconditional positive regard Assists the person in moving towards self-actualization

5. The Trouble With Definitions A creationist can embarrass an evolutionist by asking for a definition of species. Walter Lang As a rule we disbelieve all the facts and theories for which we have no use. Gustave Flaubert

6. And then there was equipoise…

7. Back to the Trouble with Definitions Definition of Equipoise Equality of distribution in weight, relationship or emotional forces Synonyms Calmness, balance, equilibrium, poise, composure, equanimity, etc... Dr. Dunn’s conclusions – it refers to two states Counselor demeanor/inner state Counselor behavior Dr. Miller’s response “… never…thought of equipoise in relation to general demeanor.” “… exists in relationship to a specific behavior.”

8. So, equipoise… about what?

9. Fuzzy thinking or Fuzzy categories?

10. Boolean Logic vs. Fuzzy Logic… Or why I didn’t become a computer scientist… Boolean Logic Typically is a binary logic system It takes into account two possible states: 0 and 1. Fuzzy Logic Fuzzy logic is a form of multi-valued logic Derived from fuzzy set theory Deals with approximate rather than precise reasoning Values between 0 and 1 Huh? Examples

11. What in the world does this have to do with MI? It seemed like a good idea at the time Maybe we’ve been using the wrong logic Do we need a new metaphor? Four concepts: Engaging Guiding Evoking Planning

12. Remind me… why does this matter? Clinicians? It probably doesn’t Research on EBPs We need to define what it is When it is done well Implementation Done with fidelity Systems to implement, coach and assess It will help Allan sleep at night