Motivational Interviewing (MI) isn’t some fancy tool just for therapists with clipboards and cardigans. Nope, it’s a secret weapon for anyone longing to spark some real change in their own life or those around them.
When I first dipped my toes into MI training, I found myself in a training with doctors, vets, nurses, dietitians…you name it. This just goes to show that it doesn’t matter what your 9-5 looks like, MI can help sprinkle some magic in your professional relations and hey, even give a little zing to your personal life.
So, buckle up pals, ’cause we’re about to dive into what Motivational Interviewing is all about. In this post, we’re going to explore the essence of Motivational Interviewing, demystify its core components, and show how it might be useful for therapists and non-therapists alike.
What is Motivational Interviewing?
Motivational Interviewing is a therapeutic style designed to help individuals overcome ambivalence about change. Contrary to modalities like Cognitive Behavioral Therapy or Somatic Experiencing, MI is non-confrontational and focuses on evoking the participant’s own motivation. It’s not solely a therapy; it’s a way of engaging someone in an open and empathetic dialogue and helping them in making decisions aligned with their values.
Initially developed by William R. Miller and Stephen Rollnick in the 1980s, MI was aimed at helping clients that were struggling with substance use disorders and feeling ambivalent about whether or not to quit their substance use. However, its application has broadened significantly over time, encompassing a variety of professional and personal situations.
The Spirit of Motivational Interviewing
“Spirit of MI” concept emphasizes partnership, acceptance, compassion, and evocation, steering away from the expert-patient dynamic towards a more equal relationship. To put simply: we’re accompanying someone on their decision-making journey rather than telling them what to do.
Four Principles of Motivational Interviewing
1. Engaging and Building Rapport
Establish a safe, supportive environment where individuals feel heard. Whether you’re a teacher or a manager, developing a level of trust is crucial.
2. Focusing
Identify and prioritize the key issues from the individual’s perspective. This process involves honing in on specific areas that might require change.
3. Evoking
Encourage the expression of the individual’s own reasons for change. This involves listening for “change talk vs. sustain talk,” which hints at the person’s motivation to alter their behavior.
4. Planning
Once the person is ready, collaboratively develop a detailed, actionable plan to guide them toward their goals.
Change Talk vs Sustain Talk in Motivational Interviewing
I think one of the most powerful lessons in MI is to be listening for how someone is talking about a possible change. For example, if someone is saying: “I should probably quit smoking,” you know that they have probably spent some time thinking about this decision, want to make that choice, and maybe just need some extra push towards it. We would call this “change talk.”
Another thing to listen to is “sustain talk”: this is when someone is talking about or using language that argues for keeping the status quo.
Examples of Sustain Talk
Sustain talk signals that perhaps the person isn’t ready for change quite yet. They might say things like:
- “I’ve tried ____ before and it didn’t work for me.”
- “I’m not sure I’m ready for that.”
- “Smoking helps me relax.”
- “Drinking is the main way I have fun.”
- “I don’t think my exercise habits need to change.”
- “I don’t think things are bad enough.”
Examples of Change Talk
Change talk shows us that this person is further along in the “stages of change.” They’re either thinking about making changes in their life or making plans to do it eventually.
- “I want to be healthier.”
- “I’ve thought about _____.”
- “I really wish I could feel less _____.”
- “I need to quit _____.”
- “I should probably ____ less.”
- “If I were home more, I would probably have a better relationship with my partner.”
- “It’s important to be to be a role model for my kids.”
- “I am trying to drink less this week.”
So where do you go from here? You elicit and explore that change talk, and OARS is a great acronym of tools to help you get started.
OARS: A Toolkit for Motivational Dialogue
The acronym OARS represents four core communication skills in Motivational Interviewing:
Using open-ended questions in MI
These types of questions move beyond simple “yes” or “no” answers. These questions encourage get people thinking and encourage them to share more.
Instead of asking something like, “Do you want to quit smoking?” (which just gets you a yes or no), you could ask, “What’s been on your mind about quitting smoking?” This kind of question encourages someone to think and talk about their feelings, motivations, and goals. It’s amazing how much insight you can gain just by asking the right kind of question.
Using Affirmations in MI
Affirmations are little gems of encouragement. They’re about pointing out someone’s strengths or acknowledging their progress or efforts, and they can go a long way in boosting confidence. As Dr. Polley says, “Part of the process of making change is a person has to believe in their ability to do things.”
Examples of an affirmations is: “You’ve been honest about your struggles, and that kind of self-awareness is an important step forward.”
Using Reflections in MI
Reflective listening involves mirroring back what you’ve heard. It’s about letting them know you’re really listening and that you understand where they’re coming from. For instance, if someone says, “I want to exercise more, but I just don’t have time,” you might respond with, “Sounds like you’re feeling torn—you care about your health, but your schedule feels overwhelming.” This helps people feel heard and often gets them to dig a little deeper into their own
Using Summaries in MI
Summaries are a way to pull everything together and show someone the bigger picture. They helps consolidate what’s been discussed, reinforcing the change talk, and letting the person see their own words reflected back. Dr. Polley describes it like picking a bouquet of flowers:
“Think of a summary as though you’re walking through a wildflower garden and you’re going to build a bouquet. You walk through and keep your eye out for flowers that you think are pretty, for the colors that you like, for the vibe of the bouquet that you’re trying to go for. You don’t just, like, grab up all the flowers and then hand them to the person, right?
You’re careful, you’re deliberate about what you’re choosing. And then you’re creating this beautiful bouquet to give back to the person… The idea being that you’re emphasizing change talk in your summary.”
Example: You might say, “So, there are a lot of things you like about smoking marijuana. You’re having more issues with focusing and you’re wondering if your ADHD medication is interacting with the marijuana or if your ADHD is getting worse, and you’ve recognized it negatively impacts your relationship with your mom.”
Dr. Polley also highlights that it’s key to put the “sustain talk” at the beginning of the summary and end with the “change talk.” People naturally respond to what was said last, so it either evokes more change talk or helps explore the ambivalence.
Motivational Interviewing Basics Video and Examples:
Applying Motivational Interviewing in the “Real World”
For the non-therapist, MI can be an empowering way to guide discussions about personal growth. Here are a few ways MI principles might be integrated into everyday roles:
Managers
Engaging employees in career planning, talking about goals and barriers.
Parents
Using MI to guide teens through difficult decisions, offering them a safe space to express doubts and explore solutions.
Educators
Applying MI to support students in setting priorities and building confidence in their academic pursuits.
Dieticians
Using MI to help patients make dietary or nutritional changes.
Doctors
Discussing decisions healthcare changes like smoking cessation or addressing chronic issues.
Nurses
Supporting patients in exploring their health goals and fostering motivation for positive behavior changes, like for medication adherence or lifestyle improvements.
Motivational Interviewing allows anyone to help others navigate challenges with empathy and collaboration. By focusing on listening, understanding, and guiding rather than just telling someone what to do, MI empowers others make positive changes in their lives.
PS. Motivational interviewing is also a helpful tool for your marriage or in-law relationships too. 😉
Anyone Can Do Motivational Interviewing
Motivational Interviewing may appear complicated at first glance, but its core principles are actually simple and useful. By focusing on partnership, active listening, and the OARS tools, MI creates an effective framework for change (while not taking away the person’s autonomy) Whether in the workplace, at school, or at home with your kids, employing motivational interviewing techniques can lead to more productive interactions. If you haven’t listened to the full podcast episode on MI, I recommend you start there, but then check out MI role play videos on YouTube—I find those to be a helpful way to see it in action and to learn more.
Are you struggling with some big life changes or decisions? Find a therapist at Ellie that specializes in Motivational Interviewing.