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Toward systematic integration between self-determination theory and motivational interviewing as examples of top-down and bottom-up intervention development: autonomy or volition as a fundamental theoretical principle

Maarten Vansteenkiste1*, Geoffrey C Williams2 and Ken Resnicow3

Author Affiliations

1 Department of Psychology, Ghent University, Ghent, Belgium

2 Departments of Medicine and of Clinical and Social Psychology, University of Rochester, Rochester, USA

3 School of Public Health, University of Michigan, Michigan, USA

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International Journal of Behavioral Nutrition and Physical Activity 2012, 9:23  doi:10.1186/1479-5868-9-23

Published: 2 March 2012


Clinical interventions can be developed through two distinct pathways. In the first, which we call top-down, a well-articulated theory drives the development of the intervention, whereas in the case of a bottom-up approach, clinical experience, more so than a dedicated theoretical perspective, drives the intervention. Using this dialectic, this paper discusses Self-Determination Theory (SDT) [1,2] and Motivational Interviewing (MI) [3] as prototypical examples of a top-down and bottom-up approaches, respectively. We sketch the different starting points, foci and developmental processes of SDT and MI, but equally note the complementary character and the potential for systematic integration between both approaches. Nevertheless, for a deeper integration to take place, we contend that MI researchers might want to embrace autonomy as a fundamental basic process underlying therapeutic change and we discuss the advantages of doing so.