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Abstract
Motivational Interviewing (MI) is an empirically-supported approach for helping people change, but more research on its active ingredients and mechanisms of change is needed. One explanation, the conflict resolution hypothesis, states that it is MI’s specific focus on exploring and resolving ambivalence – the simultaneous presence of both wanting and not wanting to change – that accounts for change. However, given that recognizing and appropriately responding to ambivalence is a central tenet of MI theory and practice, there has been little research on the conceptualization of ambivalence. In this study, 70 certified Motivational Interviewing Network of Trainers members responded to an online survey regarding: 1) the definition of ambivalence, 2) whether ambivalence was cognitive, emotional, or both, and 3) concepts that are often confused with, but are different from, ambivalence. Qualitative analysis of their responses revealed six related themes: 1) Coexistence of Opposites/Pros versus Cons Dynamic, 2) Emotions/Cognitions, 3) Behavioral Inertia, 4) Context of Ambivalence, 5) Factors Affecting Ambivalence, and 6) Cognitive versus Emotional Controversy. The second theme, Emotions/Cognitions, was further comprised of five subthemes: Conflict/Competition, Mixed Feeling or Thinking, Decision-making/Indecision, Desire, and Fear/Anxiety. The majority of respondents described ambivalence as both cognitive and emotional; the remainder supported either a primarily cognitive or emotional definition. Constructs that were commonly identified as being related to but distinct from ambivalence were resistance, denial, discrepancy, lack of motivation, and precontemplation/contemplation. These results highlight the apparent multifaceted nature of ambivalence. Ideally these findings also will be useful in the subsequent development of measures to assess ambivalence.
Acknowledgements
The authors wish to thank the members of the MINT community for their time and Dr. Theresa Moyers for her help with participant recruitment, study design, and generous support of this research. The authors also wish to thank Dr. Sarahmona Przybyla for her consultation regarding qualitative methods.
Disclosure statement
The authors have no conflicts of interest to report.
Funding
This research was supported by the National Institute on Alcohol Abuse and Alcoholism, 10.13039/100000027 [T32-AA007583,T32-AA018108]. The views expressed are those of the authors and do not necessarily represent the views of the NIAAA.