Common conflict and effective counselor responses in Motivational Interviews with couples

What is it about?

One of the biggest obstacles to conducting a Motivational Interview with a couple is how counselors should respond in situations where partners feel differently about whether or how change should happen. If partners respond to these disagreements about change in ways that amplify or sustain conflict, then partners may discourage one another from making progress towards their goals. In contrast, if partners are able to avoid conflict and instead productively discuss their perspectives and priorities, then it is more likely that consensus goals -- shared by both partners -- will emerge. In this qualitative analysis of intervention sessions conducted with male couples discussing substance use and HIV risk reduction, we identified 3 common sources of conflict. 1) Partners conflated the presentation of thoughts and feelings. Statements such as "I feel like you don't care" are often experienced as accusations rather than productive disclosures. 2) Vague or indirect communication sometimes initiated conflict as partners became frustrated with each other's failure to understand messages conveyed and respond in desired ways. 3) Partners sometimes made inaccurate assumptions about each others intentions, leading them to respond "as if" their partner intended to make them feel hurt or angry when in fact that was not true. Counselors were most successful at diminishing these forms of conflict by providing partners the opportunity to clarify and correct assumptions about their intentions, accurately reflecting partners' expressions of thoughts and feelings, reflecting common ground, affirming or highlighting strengths in relationship functioning, and initiating conversations about relationship repair (or how the couple could rebuild and move on after a conflict).

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Photo by Lareised Leneseur on Unsplash

Photo by Lareised Leneseur on Unsplash

Why is it important?

Finding ways for counselors to respond effectively in situations where partners feel differently about change has been one of the most stubborn obstacles to the use of Motivational Interviewing (MI) with couples. This paper draws on real counseling session examples to identify the most common forms of conflict counselors encountered in session and the skills they used to respond effectively in those situations. It represents a substantial step forward in the development of counselor skills and strategies that address challenges to the implementation of MI with couples.