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Motivational Interviewing Goes to War

We know that motivational interviewing is used effectively for addictions, psychological problems, health related behavior change, medication adherence, life coaching, and other “clinical” issues. But what about it’s use in the military setting? A recent article by James Cowan, Nengyalai Amalyar and Mohammad Mustafa argues for the use of MI in the area of combat advising.

If United States forces are ever to leave Afghanistan, “standing up a professional Afghan National Security Force (ANSF) is central” to this effort, according to the authors. Doing so requires a partnership between advisors and Afghan military personnel.

Advisors assigned to Afghanistan are told anecdotally that establishing an effective partnership depends on such elements as; developing rapport and respect, building trust, sharpening skills of persuasion, exercising patience, effecting empowerment, etc. but they are not given direct training in effective, proven ways to do these things. The authors argue that MI is consistent with these goals and should be provided to advisors as part of their training. To support their argument, they relate their own experiences and observations of delivering and receiving combat advising.

Combat advising is completely consistent with the spirit and principles of MI, according to the authors. They state, for example, that “the advisor’s role is to work alongside their ANSF counterpart as an equal partner as opposed to “an uneven power relationship” where the combat advisor is the expert and ANSF personnel are passive recipients of instruction and direction. Guiding an ANSF partner toward a specific course of action depends on evoking an understanding of the individual’s own thoughts (attitudes, knowledge, beliefs and values) about and good reasons for invoking the action. Honoring the autonomy of host-nation forces recognizes that they know best if, how and when a new action should be adopted in consideration of their own individual attributes and surrounding culture, norms and physical conditions. It also recognizes that ANSF are equal partners with, and not subservient to, U.S. military forces.”

The problem, of course is the “righting reflex.” This is the tendency of counselors (or in this case, advisors) to “fix” a problem or provide a solution, usually usually by providing unsolicited advice or information. The righting reflex, as we know in MI, leads to resistance. The authors state, “This is especially true among U.S. military personnel who are trained and rewarded for their take charge spirit, can-do attitude, and problem solving skills and are also doctrinally directed to seize the offensive and aggressively defeat the enemy.”

The authors argue that more progress could be made in establishing a professional Afghan National Security Force if advisors could “seek to understand their advisees’ own concerns, beliefs, reasons, values and motivations relevant to this aspiration.”

The article is an interesting and surprising use of motivational interviewing that, nevertheless, makes perfect sense. The original article can be downloaded at: http://smallwarsjournal.com/blog/2011/01/motivational-interviewing/

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