Recent Advances in Motivational Interviewing With Couples

"Motivational interviewing (MI) was developed as an approach to engaging individual clients in conversations about behavior change (Miller & Rollnick, 2023). The application of MI with couples-main or primary sexual- romantic relationship partners-initially encountered challenges and produced mixed results (Apodaca et al., 2013; Magill et al., 2010; Monti et al., 2014). When relationship partners are not equally ready to change-or desire to achieve change in different ways-MI techniques that work with individuals often fail."

"Qualitative analyses of intervention session content have identified unique processes (Starks et al., 2018), specific skills (Starks, Doyle, et al., 2022), and conflict management strategies (Starks et al., 2020), addressing many of the previously identified practice challenges. A small but growing number of quantitative studies suggest that MI with couples has the potential to reduce drug use (Starks, Adebayo, et al., 2022; Starks et al., 2019) and sexual risk-taking (Starks, Adebayo, et al., 2022) in male couples."

Motivational interviewing (MI) originated to support individual behavior change but has encountered challenges when applied to couples because partners often differ in readiness and change goals. Research on MI with couples has expanded, particularly among male couples at elevated HIV risk. Intervention analyses have identified distinct couple-focused processes, specific practitioner skills, and conflict management strategies that address prior practice barriers. Early quantitative evidence indicates potential reductions in substance use and sexual risk behaviors among male couples. Providers delivering MI to couples should attend to each partner and the relationship, support communication, and consider MI when one or both partners engage in the behavior of concern.

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