Splitting Hairs or Parsing Concepts, Fuzzy Thinking or Fuzzy Categories: Where Does Motivational Interviewing End and Client-centered Therapy Begin?

Abstract

An increasingly robust debate is emerging about the role of equanimity, equipoise and equality of concepts in defining what constitutes motivational interviewing (MI) versus client-centered therapy. At the heart of this debate is whether a MI practitioner may remain neutral about a goal and still be practicing MI. After that point of agreement, the debate becomes increasingly complex and defuse. However, MI has never included in its definition that the clinician identifies a specific behavioral goal. Nor is this articulated in any of the principles. Instead, it seems to be an ad hoc explanation of what does and does not constitute MI practice in an effort to establish the boundaries of MI. It is clear that a lack of data and only a nascent theory of how MI works contribute to this problem, but it may also be issues of fuzzy thinking and fuzzy categories. An exploration of these areas suggests it is possible that a practitioner could be practicing MI and not have a specific behavioral goal, other than assisting the client in resolving ambivalence.