Reexamining confrontation and motivational interviewing

Motivational interviewing (MI) was largely conceived as an alternative to "confrontational" approaches used in drug and alcohol treatment. Thus, MI emphasized building an empathic, collaborative alliance with clients rather than arguing or attacking in an attempt to "break down denial." An unintended consequence of this contrast with confrontation was a frequent application of MI that overemphasized client-centered aspects and deemphasized directive MI interventions that are equally important. This paper provides an alternative definition of confrontation that focuses on potential harm the client may experience as a result of their substance use. Research supporting this type of confrontation is reviewed and it is suggested that confrontation is integral to the directive interventions of MI. Suggestions for using confrontation to facilitate MI are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)