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