Examining How Motivational Interviewing May Foster College Student Development

158 Journal of College Counseling ■ July 2013 ■ Volume 16

© 2013 by the American Counseling Association. All rights reserved.

Received 09/23/10Revised 03/17/11

Accepted 08/02/11DOI: 10.1002/j.2161-1882.2013.00034.x

Examining How Motivational Interviewing May Foster College Student Development

Melanie M. Iarussi

Professional counselors practicing in higher education settings aspire to meet the developmental needs of college students in addition to addressing their mental health and substance use concerns. Motivational interviewing (MI) is an evidence-based counseling approach that focuses on enhancing motivation and com-mitment to change. This article describes how professional counselors working in higher education settings might apply MI to foster college student development while helping students make positive behavior changes.

Keywords: motivational interviewing, college student development; college counseling

Motivational interviewing (MI) is a person-centered, directive counseling approach that focuses on resolving client ambivalence and enhanc-ing motivation for change (W. R. Miller & Rollnick, 2002). MI has

expanded in its use and applications (Arkowitz & Miller, 2008) since it was developed by William Miller (1983) in the field of addiction counseling. MI was first described in detail in Motivational Interviewing: Preparing People to Change Addictive Behavior, authored by William Miller and Stephen Rollnick (1991). In 2002, W. R. Miller and Rollnick published the second edition of Motivational Interviewing: Preparing People for Change that broadened the application of MI from the treatment of addictions to change in general.

MI has been the subject of many controlled clinical trials, especially in the treatment of substance use disorders, and has been found to be efficacious in assisting people to change a number of problem behaviors (e.g., gambling, diet and exercise; Lundahl, Kunz, Brownell, Tollefson, & Burke, 2010). Research demonstrating the positive effects of MI has led to adaptations of MI being included in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-Based Programs and Practices (NREPP; www.nrepp.samhsa.gov). Because MI is a style of counseling or a method of communication, it has been found to have broad applications. Some texts have applied MI to work in mental health (Arkowitz, Westra, Miller, & Rollnick, 2008), health care (Rollnick, Miller, & Butler, 2008), and probation and corrections (Walters, Clark, Gingerich, & Meltzer, 2007).

MI has been used with college student populations, especially in the area of alcohol abuse (e.g., Branscum & Sharma, 2010; LaChance, Ewing, Bryan, & Hutchison, 2009; Walters, Vader, Harris, Field, & Jouriles, 2009). The

Melanie M. Iarussi, Office of Counseling Services, Old Dominion University. Melanie M. Iarussi is now at the Depart-ment of Special Education, Rehabilitation and Counseling, Auburn University. Correspondence concerning this article should be addressed to Melanie M. Iarussi, Department of Special Education, Rehabilitation and Counseling, Auburn University, 2084 Haley Center, Auburn, AL 36849 (e-mail: [email protected]).

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Brief Alcohol Screening and Intervention for College Students (BASICS) was developed as a college-based program that uses MI to provide assessment feedback about students’ alcohol use behaviors (Dimeff, Baer, Kivlahan, & Marlatt, 1999). BASICS has been the subject of several clinical trials (e.g., Baer, Kivlahan, Blume, McKnight, & Marlatt, 2001; Borsari & Carey, 2000) and is included in SAMHSA’s NREPP. In addition to BASICS being con-sidered an evidence-based program, a meta-analysis (Carey, Scott-Sheldon, Carey, & DeMartini, 2007) examined the efficacy of college student drinking interventions and found that interventions that included MI components produced greater effects in reducing alcohol-related problems compared with interventions that did not use MI components (B = 0.21, p < .01).

Few MI investigations in college settings have expanded beyond the issue of alcohol use. For example, Daugherty (2008) examined MI and academic success; Mandel-Parrino (2009) and Mulligan (2008) studied MI and smoking cessation. However, within the context of college alcohol abuse, Scholl and Schmitt (2009) discussed MI’s congruence with two theories of development: self-determination theory (Ryan & Deci, 2000) and the seven-vector model (Chickering & Reisser, 1993). Scholl and Schmitt recommended integrating an appropriate developmental model when using MI to address alcohol abuse in college students.

Just as W. R. Miller and Rollnick (1991, 2002, respectively) expanded their focus from changing addictive behaviors to change in general from the first edition of the MI text to the second, in this article, I present a similar con-cept—an expansion of the use of MI with the college student population that goes beyond alcohol-related problems to general change. I also suggest here that, when used for its intended purpose—guiding clients to making positive changes—MI may also foster students’ development in a college environment.

The purpose of this article is to examine how MI may be used in college counseling centers to help guide students toward making positive changes and simultaneously foster college student development. First, college student development is briefly introduced, followed by a synopsis of MI. A discussion about the fit of MI with college student development theory is then presented, beginning with the client–counselor relationship and extending to Chickering and Reisser’s (1993) seven-vector theory of development.

College Student Development

Student development is defined as “the ways that a student grows, progresses, or increases his or her developmental capabilities as a result of enrollment in an institution of higher education” (Rodgers, 1990, p. 27). Those who work in student affairs use student development theory to help identify and address the needs of students, to guide program and policy development, and to create a collegiate environment that fosters positive growth (Evans, Forney, Guido, Patton, & Renn, 2010). Theory provides university professionals with



a method to conceptualize and facilitate changes in students’ ways of thinking, feeling, and interpreting and interacting with the world (Chickering & Reisser, 1993). Similar to the notion that counselors must use a theoretical approach to guide their work with clients, Evans et al. (2010) stated, “Student affairs practice without a theoretical base is neither effective nor efficient” (p. 26).

Promoting student development is considered a primary objective of profes-sionals working in higher education settings. According to Chickering and Reisser (1993), “to be effective in educating the whole student, colleges must hire and reinforce staff members who understand what student development looks like and how to foster it” (p. 44). Professional counselors working in college counseling settings assume a unique role in that they must work to meet the mental health needs of their student clients, but they also share the focus and mission of the higher education institution and student affairs community. Because MI has demonstrated clinical effectiveness and may har-monize with the objectives of student affairs professionals to foster college students development, it can assist professional counselors working in the college environment meet students’ needs from the role of the mental health professional and as a member of the higher education community.

Motivational Interviewing

MI is defined as “a collaborative, person-centered form of guiding to elicit and strengthen motivation for change” (W. R. Miller & Rollnick, 2009, p. 137), and it consists of relational and technical components (W. R. Miller & Rose, 2009). Within the relational component, MI possesses a “spirit,” or an underlying foundation for the way in which counselors interact with clients. The MI spirit, and the four principles of MI, guide its practice and ground the approach in humanism. MI draws from Carl Rogers’s (1951, 1957) person-centered therapy, including the importance of the therapeutic alliance to help facilitate client change including three essential conditions: the counselor’s expression of empathy, of genuineness, and having unconditional positive regard for the client. The expression of empathy through reflective statements is emphasized in MI. MI differs from person-centered therapy, however, with its directive components that include exploring and resolving client ambivalence about change and enhancing client intrinsic motivation for change.

Relational Component

MI represents a counseling approach that is more than just a set of techniques that can be used with clients. MI is unique from other counseling approaches in that its spirit is essential to its practice (W. R. Miller & Rollnick, 2002). It is not considered a toolbox from which counselors may pull interventions, but rather a specific interpersonal style that creates an environment conducive to facilitating client change. The spirit of MI consists of three fundamental



components: (a) collaboration between client and counselor; (b) evocation of client knowledge, values, and perspectives; and (c) promotion of client autonomy. In an effort to explain or demonstrate the spirit of MI, its found-ers offered four guiding principles: (a) expressing empathy, (b) developing discrepancy, (c) rolling with resistance, and (d) supporting self-efficacy.

Expressing empathy is the first principle of MI and involves communicating acceptance and understanding of the client’s world. Rogers’s (1957) concept of unconditional positive regard is present in this concept and supported by W. R. Miller and Rollnick’s (2002) belief that overall acceptance of individuals and meeting them where they are in the change process will help facilitate change. Empathy is expressed by conveying an understanding of clients’ subjective worlds and their experiences related to change. MI emphasizes strategic use of reflective statements to express empathy in critical therapeutic moments (e.g., responding to client resistance or ambivalence) and to assist clients’ movement toward change.

MI diverges from person-centered counseling in its directive nature, whereby counselors seek to enhance client motivation for positive change. By assist-ing clients in developing discrepancies, the second principle of MI, counselors may guide clients to recognize the implications of their problem behaviors by examining the congruency between clients’ personal values and goals and their current behaviors. For example, consider a female student who is con-templating changing majors from the one her father had directed her toward to another major that is in her area of interest. In developing discrepancy, the counselor might encourage the student to explore her values and inter-ests surrounding her education and future career and how pursuing the field chosen by a parent might be incongruent with her values and goals. As the student verbalizes her personal and professional values and goals, the counselor then may guide the student to consider the discrepancies that are revealed between her current major and her own values and goals. As discrepancies are presented, it is the student rather than the counselor who argues for change and motivates herself to change. As opposed to “installing” motivation in clients, counselors practicing with the MI spirit elicit clients’ own intrinsic motivations for change by exploring their goals and values and developing discrepancies (W. R. Miller & Rollnick, 2002).

Rolling with resistance is the third principle of MI. As opposed to confronting and arguing with clients about change, MI counselors normalize ambivalence about change and “come alongside” clients when they express resistance to change. This idea of siding with clients is based on the assumption that taking one side of an argument will likely lead the other person to defend the op-posite side. In MI, counselors refrain from arguing for change to circumvent opportunities for clients to arguing against change. By coming alongside or joining clients in their resistance to change (i.e., conveying an understand-ing of clients’ perspective), counselors diminish the need for resistance and present an opportunity for clients to assume the argument for change (W. R. Miller & Rollnick, 2002).



According to MI, ambivalence about change is considered a natural aspect of the change process and something to be expected and explored rather than opposed (W. R. Miller & Rollnick, 2002). Arkowitz (2002) considered client resistance to be a source of information for counselors. He suggested that resistance may be purposeful for clients, and the reasons for its presence should be respected and explored to understand what is preventing the client from pursuing change. Arkowitz further noted that resistance may emerge intrapersonally (i.e., the client experiences a conflict within himself or herself) or interpersonally (e.g., the counselor’s behavior may evoke resistance within the therapeutic relationship). In practicing MI, counselors must recognize their role in eliciting interpersonal resistance and alter their behavior to miti-gate such resistance.

The fourth and final principle of MI is supporting self-efficacy. This includes emphasizing clients’ past successes with change and expressing to clients the counselor’s belief that the client is capable of change. This principle emphasizes the importance of the counselor’s and client’s beliefs that change is possible and that the counselor’s role is to assist the client with the process of change only if invited by the client (W. R. Miller & Rollnick, 2002).

Technical Component

The technical component of MI comprises its directive nature, which coun-selors use to guide clients toward making positive changes (W. R. Miller & Rose, 2009). Research has demonstrated a positive relationship between cli-ent speech that speaks in favor of change and subsequent behavior changes (Amrhein, Miller, Yahne, Palmer, & Fulcher, 2003; Moyers, Martin, Houck, Christopher, & Tonigan, 2009). Therefore, MI counselors use specific skills to enhance clients’ intrinsic motivations for change by eliciting, reinforcing, and strengthening client change talk—or client language that speaks to their desires, abilities, reasons, and need for change (W. R. Miller & Rollnick, 2004). MI counselors work to consolidate and strengthen client language in favor of change based on the clients’ own beliefs, values, and goals, and then assist them in developing a plan for initiating positive changes.

Using MI to Foster College Student Development

Sanford (1967), an early theorist of college student development, offered a distinction between development and change in that development is positive whereas change may describe a positive or negative movement. MI is a coun-seling approach designed to help facilitate clients’ movement toward positive change. Therefore, MI may be used to facilitate college student development, in order to help students move toward positive changes by assisting them in resolving their ambivalence about change and enhancing intrinsic motivation for change.



MI seeks to enhance students’ motivations and guide them toward changing specific problem behaviors (W. R. Miller & Rollnick, 2002, 2009), whereas college student development involves students’ mastery of developmental tasks, achieving self-direction, and gaining independence (T. K. Miller & Prince, 1976). Components of MI (e.g., promoting client autonomy, supporting self-efficacy) that are integral to the approach appear to be consistent with fostering student development. For example, MI’s emphasis on the expression of empathy and evocation of clients’ perspective, values, and goals coincides with college student development theory’s promotion of student validation to encourage growth and development. According to Rendon (1994), in higher education, student validation is considered “an enabling, confirming and sup-portive process initiated by in- and out-of-class agents that foster academic and interpersonal development” (p. 46). Validation of students is considered a process rather than an end goal in collegiate environments because the “more students get validated, the richer the academic and interpersonal experience” (Rendon, 1994, p. 46). MI’s emphasis on the expression of empathy—or ex-pressing an understanding of the student’s circumstances and perspectives—as an essential component of the counseling process corresponds with student development theory’s emphasis on validation of the student experience.

In addition to the style of MI coinciding with efforts to foster student development, students may need to make specific changes in their lifestyles or behaviors (e.g., diminishing substance abuse) to master specific develop-mental tasks and enhance overall growth and development. Therefore, by using MI for its intended purpose—to assist individuals in changing specific behaviors—counselors may simultaneously be able to work toward altering specific problem behaviors and promote student development.

The Therapeutic Relationship

Arnett’s (2000) theory of emerging adulthood is characterized by identity exploration. Within this developmental theory, college students would likely benefit from a counseling environment that encourages identity exploration and uses Rogers’s (1957) therapeutic constructs of unconditional positive regard, genuineness, and empathy. Counseling approaches that use a directive style (i.e., students are told what changes they need to make and how to go about doing so) may evoke argumentation or resistance if students feel that the environment conflicts with their developmental need to explore their own identities and possible directions.

When working with college students in emerging adulthood, the coun-selor must set him- or herself apart from other adults who may interact with these students from a place of authority. MI offers a guiding approach that diminishes the opportunity for arguments and resistance to arise by avoiding authoritarian stances and instead using counselor skills such as rolling with resistance and promoting client autonomy (W. R. Miller & Rollnick, 2002). By approaching the therapeutic relationship collaboratively and promoting



client autonomy, counselors may facilitate unique and helpful relationships with students. The counselor is an adult, specifically an adult who is associ-ated with the university, yet he or she is not directing the student in what to do or providing unsolicited advice. In this counseling relationship, the counselor refrains from warning, confronting, pushing advice, and overtly directing the client to change and instead serves as a guide in assisting the client to accomplish his or her goals.

MI counselors are advised to refrain from using the “righting reflex” (W. R. Miller & Rollnick, 2002, p. 20) or the tendency to fix clients’ problems by attempting to “install” solutions as may be the case when students inter-act with their parents or professors. Instead, MI counselors affirm clients by reflecting their sentiments and evoking clients’ perspectives and ideas about change to guide them toward change in a collaborative manner. With MI, if advice or information is given by the counselor, it is only provided after the client has requested it or has given the counselor permission to give it. By collaborating with clients, the counselor not only practices with the spirit of MI but also is distinguishing him- or herself from other adults—teachers, parents, advisors—whose customary methods may be to use their righting reflexes to direct students on how to behave.

The focus in MI is on evocation, in that the counselor aims to elicit clients’ thoughts and perspectives related to their circumstances; it is recommended that the client speaks more than the counselor during a counseling session. To pursue this objective, MI counselors must be skilled in evoking clients’ speech, including their thoughts, beliefs, goals, values, and experiences. Coun-selor skills such as open-ended questions, reflective statements, statements of affirmation, summarizations, and focusing on clients’ language that speaks for change are used to facilitate evocation (W. R. Miller & Rollnick, 2002).

Integrating MI With the Seven-Vector Theory

Although many theories of human development may be applied to the col-lege student population, in the remainder of this article I focus on how MI, and specific components of MI, fit with the seven-vector theory described by Chickering and Reisser (1993). Chickering and Reisser’s seven vectors provide a comprehensive theory of psychosocial development for college students (Evans et al., 2010). Arthur Chickering first described his theory in the book Education and Identity, published in 1969. Chickering then collaborated with Linda Reisser to revise and update his work, resulting in the second edition published in 1993. Each vector of Chickering’s theory is considered to be a path toward individuation, yet he noted that the path is not always linear but may instead resemble a spiral or steps on which individuals progress at varying rates. The seven vectors are as follows: developing competence, managing emotions, moving through autonomy toward interdependence, developing mature interpersonal relationships, establishing identity, developing purpose, and developing integrity.



Developing Competence

Developing competence, Chickering and Reisser’s (1993) first vector, consists of three areas: intellectual competence, physical competence, and interper-sonal competence. Intellectual competence includes knowledge acquisition as well as critical thinking and reasoning skills. Physical competence involves attending to physical wellness and engaging in artistic or athletic activities. Interpersonal competence involves skills used in effective communication and leadership and being able to work well with others.

Coinciding with Chickering and Reisser’s (1993) first vector, MI incorporates a “competence worldview” when working with clients, which advocates that clients “have self-knowledge, attitudes, and capabilities that can effect change” (Corbett, 2009, p. 4). This belief contrasts with more traditional approaches of psychology that hold a deficit worldview, in which clients are perceived as having deficits in competence, and it is the role of the clinician to teach clients what they need to repair the deficit in accordance with the clinician’s expert perspective. MI counselors, however, subscribe to the competence worldview and seek to evoke and emphasize competencies clients already hold and build on their presented strengths. The competence worldview MI uses may work to foster the development of competencies as Chickering and Reisser described by giving clients the opportunity to formulate their own thoughts and ideas and to verbalize them, as well as to have their existing knowledge and efforts to expand their knowledge be affirmed and validated.

Managing Emotions

Chickering and Reisser’s (1993) second vector, managing emotions, encom-passes recognition and acceptance of emotions as well as the ability to control and express emotion. Accepting and addressing negative emotions has been presented as one of the top issues of college campus mental health (Eells & Van Brunt, 2011). Students may avoid experiencing negative emotions and develop unhealthy behavioral or emotional responses (e.g., anger outbursts, substance abuse, depression) as a result. MI counselors use reflective state-ments, which often include a reflection of client emotion, to empathize with clients and to validate their emotions. They may also use reflections to explore clients’ ambivalence about experiencing and addressing negative emotions. Through counselors’ empathic reflections of clients’ emotions, clients will likely experience a heightened awareness of their emotions, and MI may be used to give clients an opportunity to explore and resolve their ambivalence pertaining to accepting and addressing negative emotions. If the client resolves his or her ambivalence in favor of making this change, the client and coun-selor may then examine behaviors that may be helpful to manage emotions in a healthy, effective way.

Also consistent with Chickering and Reisser’s (1993) second vector, MI may be used to facilitate change in client behaviors related to emotional expression and control. For example, consider a female student who experi-



ences anger control issues and who is facing disciplinary action for fighting. This student is ambivalent about changing her aggressive behaviors: She does not want to change her behavior out of fear of being perceived as weak by others, but she believes there is a need to change because she faces the possibility of being dismissed from the university on assault charges. MI is a strategy that can validate the client’s perspective and ambivalence about change through the expression of empathy. The counselor may use MI to develop discrepancies between the client’s current aggressive behaviors and her goal of graduating from college. By developing discrepancies between the client’s current behaviors and her goal, the counselor may help raise awareness of the client’s problem, and the client’s motivations for changing her behaviors to manage anger in a way that will allow her to accomplish her goal of graduation may increase. If the client chooses to change her behaviors, MI may then be used to elicit from the client ways in which she had successfully managed her anger in the past and to develop a plan that includes healthy anger management behaviors.

With regard to making changes in general, emotions are often intertwined in ambivalence about change or feeling torn in two directions at once (Wagner & Ingersoll, 2008). The nonjudgmental, collaborative environment created by the MI counselor presents the client with an opportunity to explore and discuss ambivalence about change and the emotions behind it that may have been otherwise unacknowledged. For example, consider a student who, on one hand, would like to leave her boyfriend because of his repeated acts of infidelity and the hurt this has caused her but, on the other hand, is not sure she wants to leave the relationship because she fears being alone. Both emotions—hurt and fear—exist simultaneously, pulling the student in two directions at once. The use of MI to guide the client in resolving ambivalence may serve as a type of “emotional emancipation” (Wagner & Ingersoll, 2008, p. 191). In working with clients to address and accept emotions, then collab-oratively creating a plan for behavioral change that fits with clients’ values and goals, the MI counselor is also working in the direction of fostering overall emotional growth and development.

Developing Autonomy

MI places an emphasis on promoting client autonomy. This element of MI appears to be consistent with fostering college student development as it co-incides with Chickering and Reisser’s (1993) third vector of moving through autonomy toward interdependence. According to Chickering and Reisser, on this developmental path, students gain independence from others, including developing their own sense of direction and problem-solving skills, but they acknowledge that they are interconnected with others and recognize recip-rocated influences in interdependent relationships.

To demonstrate how MI may be useful in fostering development, consider a 20-year-old male student who is delayed in his development of moving



through autonomy toward interdependence when he presents to a college counseling center. This student returns to his parents’ home every weekend and relies on them for general decision making, meeting his financial needs, and keeping him on track in his academics by tracking his assignments and exams for him. By engaging in such behaviors and relationship with his par-ents, this student appears to be delaying his development of self-direction, problem-solving skills, and overall sense of independence. The student feels conflicted about depending on his parents in these areas, and he is attending counseling for help gaining autonomy although he is concerned about upsetting homeostasis in the family. The counselor may use MI to explore and resolve the student’s ambivalence about gaining autonomy by using essential aspects of MI, such as eliciting the student’s own thoughts, ideas, values, and goals; promoting autonomy; supporting self-efficacy; and emphasizing his personal choice and control in counseling sessions in a manner that is congruent with the developmental task itself. Should the client resolve his ambivalence in favor of making changes, the counselor may then use MI to collaboratively guide this student toward action to help him progress on the developmental vector of autonomy and interdependence.

Within the concepts of autonomy and self-efficacy, MI counselors will em-phasize the client’s personal choice and control related to change, including that change is the client’s responsibility and no one can force the client to change or make the change for the client, and assert that the client is capable of change. The example that follows demonstrates how a counselor might emphasize the personal choice and control of a male student who is using the drug ecstasy several times per month and cannabis daily and who has experienced anxiety since childhood and an onset of depression within the past year. The student had attended counseling briefly while in high school but described himself as uncooperative because it was initiated by his parents. When the student presents to the college counseling center, he is ambivalent about pursuing appropriate treatment.

Client: Over winter break, I told my parents I am not doing well in school, but they didn’t do anything about it. My parents don’t think my problems are real.

Counselor: Your parents didn’t push you to get help, and you hoped that they would.

Client: They didn’t do anything. They don’t take me seriously.Counselor: I’m wondering what would happen if you were to pursue

treatment on your own and make the changes we’ve talked about, if you might be sending the message that you are taking these issues seriously.

Client: (silent, becomes tearful) Yeah, it would. Counselor: Regardless of what your parents think, it seems as though

only you can decide what you need to do to make things better for yourself.



In the example, the counselor guided the client to consider taking action to address the client’s concerns, without a directive from his parents. The coun-selor emphasized the client’s personal choice and control over his decision to pursue and engage in appropriate treatment for his concerns and supported his self-efficacy in being able to do so, therefore assisting his development in becoming an autonomous adult.

Cultural factors will likely influence how students develop a sense of inter-dependence with others and should be taken into consideration. For example, African American and Asian American clients may hold cultural values wherein the collective group (e.g., family, community) is considered to be of higher priority rather than the individual (Parham & Brown, 2003; Sandhu, Leung, & Tang, 2003). In these cultures, the welfare of the group is often placed ahead of the welfare of individuals. Gaining an understanding of students’ worldviews, including cultural contexts and values, is essential for college counselors to effec-tively guide students to develop a sense of autonomy and interdependence with others. MI encourages this understanding by placing emphasis on empathizing with clients and eliciting clients’ beliefs and perspectives, and then when the client is ready for change, collaboratively developing a plan for change.

Developing Interpersonal Relationships

Chickering and Reisser (1993) addressed development in the area of inter-personal relationships within the first vector, developing competence, and more fully in the fourth vector, developing mature interpersonal relationships. The first vector places an emphasis on interpersonal competence as one of its three foci. This competence includes skills in communication, leadership, and working with others. The fourth vector refers to one’s capacity for healthy, enduring relationships with both romantic partners and friends and includes tasks of tolerance and appreciation for interpersonal differences.

As college students begin to explore mature relationships—romantic rela-tionships, friendships, and family relationships—they may experience problem behaviors and ambivalence about changing these behaviors. For example, stu-dents may experience ambivalence about opening up to and trusting others or about exiting or altering a relationship that has become unhealthy (i.e., intimate partner violence, overbearing parents). MI is an approach that emphasizes the exploration and resolution of ambivalence. Students may benefit from explor-ing and resolving their ambivalence about their behavior in relationships and then working collaboratively with a counselor to move toward a goal that is a healthy choice for them (e.g., opening up incrementally to work toward trusting a partner; establishing and maintaining boundaries with parents).

The decisional balance is an activity commonly used in MI (although it is not unique to MI) to explore both sides of client ambivalence and to en-hance intrinsic motivation for change. In MI, the decisional balance is used to elicit clients’ perceptions of the costs and benefits of change and of the status quo or nonchange. When using a decisional balance, it is important



for the counselor to attend to client change talk and work to reinforce and strengthen language that speaks in favor of healthy changes so that the cli-ent does not remain stuck in his or her ambivalence (W. R. Miller, 2008). Examples of when this activity may be useful are with clients who have developed harmful patterns of interacting with others (e.g., staying in an abusive relationship, behaving aggressively toward others), who are socially withdrawn, or who have an enmeshed family relationship in which they are struggling with individuation.

To illustrate the use of decisional balance to facilitate positive changes and foster development, consider a female student who comes to the col-lege counseling center and reports feeling depressed. This student notes a decline in her academic performance and marks “loneliness” as her greatest concern on her intake forms. During the intake interview, the counselor learns that because of painful social experiences in which the student was repeatedly ridiculed by peers in middle school and high school, she came to college socially withdrawn. The counselor also learns that the student keeps to herself in her own (single) room when not attending class or studying in the library, and she avoids social interaction with other students out of fear of being rejected. In this situation, the problematic behaviors (i.e., staying in her room, avoiding interaction with peers) contributing to her primary concern of loneliness appear to be purposeful because they protect the client from experiencing additional pain inflicted by others. With this client, the MI counselor’s use of empathy, unconditional positive regard, and rolling with resistance (W. R. Miller & Rollnick, 2002) could create a therapeutic relationship in which to explore such a sensitive behavior change. Through discussions with the counselor, the student may become aware that her mistrust of others is causing her to avoid social interactions, and the change she may become ambivalent about is working toward incrementally trusting others. After a safe therapeutic environment is established, the counselor may introduce a decisional balance to guide the client in exploring both sides of her ambivalence related to changing her behaviors to decrease her feelings of loneliness. The decisional balance example presented in Table 1 lists the benefits and costs of altering the client’s behaviors to gradually trust others

Table 1

example of a Decisional balance

benefitHave closer

relationshipsFeel less lonelyOvercome pastBe able to talk to and

express myself to others

Improve life overall

Cost

Change: Work Toward Trusting Othersbenefit Cost

Stay the Same: Remain Untrusting of Others

Open self up to be hurt

Will not feel vulnerable

Will not have to work to change

Never feel close to anyone

Will continue to be lonely



who have demonstrated trustworthiness and the benefits and costs of the client’s current behaviors (as elicited from the client).

Using MI and the decisional balance, the counselor can elicit the client’s own ideas about the costs and benefits of change as well as acknowledge the purpose-fulness of the client’s current behavior, thus creating an opportunity to explore both sides of her ambivalence about change. As the client discloses her thoughts, the counselor can focus on the client’s speech and use reflective statements and open-ended questions to reinforce and strengthen client language that describes her desires, needs, reasons for, and commitment to change to enhance her moti-vation to make positive changes to reduce her primary concern of loneliness. For example, the counselor might ask the client, “What do you think will happen if you do not change?” to which the client might respond, “Nothing will change. I will still be lonely.” The counselor may then reflect the client’s reason for change back to her by stating, “If you do not initiate a change at some point, you believe you will continue to be unhappy.” In this example, by deciding to make changes related to social behaviors, the client may not only reduce her experiences of loneliness and depression but also progress developmentally by working toward developing mature interpersonal relationships.

Establishing Identity

This fifth vector of Chickering and Reisser’s (1993) theory, establishing identity, involves acknowledgment and comfort in physical appearance, gender, sexual orientation, a defined self-concept including roles and lifestyle, social and cultural heritage, a secure sense of self, self-acceptance and self-esteem, and personal stability and integration. The MI approach fits well with the notion that young adulthood is distinct for identity exploration (Arnett, 2000) in that evocation of clients’ thoughts, perspectives, values, and goals is a salient component of MI. As clients are encouraged to verbalize specific aspects of themselves that may otherwise be under- or unacknowledged, they are es-sentially describing who they are and their identity. By promoting clients’ explorations of themselves in an ongoing fashion throughout counseling, the use of MI may foster further development and comfort within this identity.

The following example presents an exchange between a counselor and a female student who is experiencing financial stress because she recently lost her job. In this example, the counselor uses MI to gain an understanding of what is important to the student (e.g., her values) and then guides the student to evaluate her behaviors in light of the stated values.

Client: I have been avoiding my friends because I don’t have the extra money to spend going out to eat or shopping as we usually do. I’m not a materialistic person, but I just don’t want them to pity me.

Counselor: And you believe that they would pity you.Client: No, I know they’d understand, but I don’t know. It’s just hard.Counselor: It’s a difficult situation.Client: Yeah.



Counselor: Well, money is one thing, but as you’ve said, you’re not a materialistic person. What are some other things in life that are im-portant to you if not materials?

Client: Hmmm . . . I don’t know. My family and my friends for sure. Counselor: What about them make them important to you?Client: That we’re close and are there for each other.Counselor: And your financial problems are affecting that.Client: Yeah, it seems dumb but I guess I just didn’t want them to see

me in a bad situation.Counselor: Yet, you know that they would be supportive of you, if they

knew and if you continued to spend time with them.Client: Yeah, I do.Counselor: What might you do differently if you acted consistently with

your value of your friendships and family relationships?

Another example of how MI can be used to create behavior change and encourage identity development can be demonstrated through the use of a structured activity, the Personal Values Card Sort (W. R. Miller, C’de Baca, Matthews, & Wilbourne, 2001). This activity is used in MI to facilitate clients’ evocation about their personal values and to develop discrepancies between clients’ values and their current behavior that may be inconsistent with such values (Walters, Ogle, & Martin, 2002). In this activity, clients are presented with up to 50 rectangular cards with each naming a specific value and two blank cards. Clients are invited to create their own value card on the blank cards if a value they hold is not described on one of the preprinted cards. Clients are then asked to sort the cards in three categories: very important to me, important to me, and not very important to me. Counselors then ask clients to elaborate on the values they sorted as very important to them and discuss the values’ importance and meaning in their life.

The Personal Values Card Sort and other discussions focusing on client evocation of values and goals present students with an opportunity to explore themselves as distinct beings from their outside influences (e.g., parents, teachers, friends), to compare and contrast differences as they perceive them between their own values and those of others close to them, and to reflect on what is important to their individual self. With the MI counselor’s practice of unconditional positive regard and acceptance, clients can explore their identity in a safe, nurturing environment and work toward their own acceptance of self. In addition to fostering identity establishment, such activities can also guide clients toward making positive changes by examining discrepancies between behaviors/lifestyles and values/goals and considering the possible changes to enhance congruency.

Developing Purpose and Developing Integrity

Evocation and discussion of client values and goals may also foster student development on Chickering and Reisser’s (1993) final two vectors, developing a purpose and developing integrity. The sixth vector, developing purpose, re-



quires the individual to develop clear vocational goals and make commitments to interests, activities, and relationships that the individual finds meaningful. As demonstrated in the earlier examples, MI can be used to elicit, explore, and clarify students’ values and goals related to career, relationships, and general lifestyle and to guide students toward engaging in behaviors that will enable them to achieve their goals. Therefore, by using MI, counselors will foster students’ progression in this vector.

The seventh and final vector, developing integrity, includes humanizing and personalizing values and developing congruence. MI emphasizes client evoca-tion and focuses on personal values. A main principle of MI is to develop and resolve discrepancies between incongruent behaviors and values. By using MI to examine and integrate students’ values and behaviors, counselors will help students progress in this last vector.

Conclusion

MI consists of specific components, including its spirit and principles that coincide with what might be seen as natural efforts to encourage college student development. In addition to fostering development in general, MI can be useful in guiding students to make specific changes that may improve their quality of life. Overall, MI appears to have potential to guide students to make positive changes while simultaneously promoting college student development. Examples provided in this article, however, are based on my own clinical experiences, and outcome research is needed to investigate the effectiveness of MI in fostering college student development. It may also be beneficial to examine how MI may fit with alternative theories of development.

Given that MI may be a sufficient fit for use with college student development theory, its applications may extend beyond college counseling centers into other areas of student affairs (e.g., judicial services, student health services, student advising services) to comprehensively foster college student develop-ment in the broader university environment. Similar to how MI’s applications transcended into general health care and medicine in communities, MI has begun to be applied to college health settings, with seemingly positive results. Although outcome research is needed in this area, Rash (2008) interviewed college health practitioners who were trained to offer students a brief MI intervention with regard to their alcohol use behaviors. Rash found that college health practitioners who used MI believed the approach was more effective than directive approaches in facilitating student behavior change and that MI provided for a more satisfying interaction for the practitioners and the students. Rash also found that the college health practitioners she interviewed unanimously believed that the MI approach could benefit the college health environment.

Learning MI is neither simple nor easy, thus training in MI presents a note-worthy issue (W. R. Miller & Mount, 2001; W. R. Miller & Rollnick, 2009). For university counselors and possibly other student affairs professionals (e.g.,



health practitioners, judicial personnel) to effectively implement MI into their style of interaction with students, sufficient training would need to occur. MI is typically learned through professional workshops, and recent research sug-gests that in order to develop and retain MI proficiency, trainees would need to receive coaching or feedback on their practice from an MI expert (W. R. Miller, Yahne, Moyers, Martinez, & Pirritano, 2004). Therefore, an issue of practice integrity may arise when professionals working in higher education complete a brief MI training and believe they are using MI but they may not be proficient in MI. Investing in the training required to adopt MI, however, may result in greater student benefits. A meta-analysis by Lundahl et al. (2010) of MI interventions in the counseling profession suggested that adopting MI is likely to lead to greater positive effects with clients overall and possibly in less time when compared with other treatments (e.g., 12-step programs, cognitive behavior therapy).

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Examining How Motivational Interviewing May Foster College Student Development