Cognitive dissonance. 2: A theoretical grounding of motivational interviewing

PURPOSE: The aim of this article is to demonstrate the utility of the concept of cognitive dissonance in clinical psychology by showing how it may underlie an existing intervention. The technique of motivational interviewing (MI) is taken as an example of an area where the literature on cognitive dissonance can find such an application. The further aim of this exercise is to utilize insights from cognitive dissonance to suggest possible modifications to the intervention as it currently stands. METHODS: A mapping is undertaken of principles of cognitive dissonance as found in Draycott & Dabbs (1998) onto the description of nature, principles and techniques of MI as set out by Miller & Rollnick (1991). Following this, areas where insights from cognitive dissonance are ignored or underutilized are drawn out and used to suggest modifications to MI. RESULTS: The nature, principles and techniques of MI are, without exception, found to relate to one or more of the principles of cognitive dissonance. Criticisms and amendments to the technique of MI can be offered with the aim of making this mapping of cognitive dissonance more exact. Several practical suggestions can be made and a more structured approach offered. CONCLUSIONS: The concept of cognitive dissonance can clearly be seen to be of use in understanding the mechanism of action of MI. It can further be of use in guiding modifications to this existing intervention. This concept, and others available through the experimental psychological literature, can be of use in all branches of clinical psychology.