Motivational Interviewing

If you’re looking for an effective, collaborative treatment plan that will inspire healthy behavior change, consider motivational interviewing. This evidence-based talk therapy helps individuals explore their feelings while working toward a goal.

What is motivational interviewing?

Motivational interviewing (MI) is a collaborative counseling style designed to inspire personal motivation for behavior change. First developed by psychologists William Miller and Stephen Rollnick in the 1980s, it’s since been regarded as an effective way to help address substance use disorders, smoking cessation, medication adherence, and to instill overall healthier habits.

MI uses structured interviews to help people identify their negative feelings and thoughts and to create healthier habits. With this approach, the therapist listens and offers guidance, while empowering the client to connect with their reasons, motivation, and capacity for change. A key component of the process is “change talk” which is when a person explains why and how they might change. 

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“It’s a way of having a conversation about change that is the opposite of telling people what’s wrong with them and what to do. It's more about inviting them to tell you about their own reasons for change, their own motivations for change, and their own ideas about how to do it,” Miller explained on a podcast last year

“Put simply, this involves coming alongside the person and helping them to say why and how they might change for themselves,” wrote Rollnick on his website.

Benefits of motivational interviewing

Motivational interviewing is a versatile tool that can be used in a variety of settings—ranging from schools to jails to health care facilities—to help people achieve their goals. It’s especially helpful for those who are initially resistant or ambivalent to making lifestyle changes to improve their mental or physical health.

Some of the leading benefits of MI include:

  • Offering people a space to discuss and process their problems or concerns
  • Building a person’s trust and confidence in themselves
  • Allowing people the opportunity to take responsibility for their actions
  • Motivating individuals to create positive behavioral change
  • Helping people imagine a future without substance use or certain mental health struggles
  • Reducing the likelihood of relapse 
  • Autonomy instead of authority
Woman participating in motivational interviewing with therapist online
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How does motivational interviewing work? 

Motivational interviewing relies on structured interviews to help people unpack their feelings and thoughts to create healthier habits. Below are the four leading motivational interviewing skills that are designed to inspire behavior change.

Open-ended questions

During a motivational interviewing session, a therapist typically asks open-ended questions to encourage a thoughtful discussion. While closed questions usually elicit limited responses, open-ended questions are better for engaging in conversation and reflection. Instead of a simple “yes” or “no,” there is an opportunity to more deeply discuss your feelings and experiences. 

Examples of open-ended questions that a therapist might ask include: 

  • How can I help you with ___?
  • What was your experience with ___?
  • How would you like things to be different?
  • What is your fondest memory from your childhood?
  • What gets you out of bed each morning?
  • What treatments have you tried in the past, and what did you like or not like about them?

Affirmations

Affirmations are personalized statements that can be used to change a person’s mindset. Sometimes it is difficult to recognize our power to create positive change in our lives, so affirmations offer people a chance to gain that understanding.

During motivational interviewing, therapists use positive affirmations to help a person identify their strengths, motivations, and reasons for wanting to change. To be an effective part of therapy, affirmations must be genuine so it’s helpful to base the statements on specific behaviors and acknowledge small successes.

Examples of affirmations from a therapist include: 

  • It took a lot of awareness and self-control to navigate that situation.
  • I appreciate you taking the time out of your day to attend our appointment. I know it isn’t easy to take the first step.

Reflective listening

Another technique that therapists use during motivational interviewing is active listening. Also known as reflective listening, the therapist’s role is to listen while you guide the conversation based on your thoughts and feelings. 

Below are a few examples of how your therapist might practice active listening:

  • Repeating your thoughts to confirm they understand
  • Paraphrasing your thoughts and feelings
  • Using feeling statements to express empathy

Summaries 

Summaries are the last of the motivational interviewing techniques. These are other tools therapists use during motivational interviewing to recap your thoughts and feelings. They help highlight important aspects of the conversation and are a natural way to redirect the conversation if you feel like you’re hitting a wall. The summary allows you to revisit any topics you're still working through, and ensures that you're ready to continue the conversation next session.

What can motivational interviewing treat?

Motivational interviewing was originally created as a tool to help people living with substance use disorders. Today, it’s still considered by many to be an evidenced-based, best-practice approach in SUD treatment and just as effective as other treatments for addictive behaviors related to alcohol, tobacco, and marijuana.

Other use cases for motivational interviewing are to help people adopt healthier lifestyle habits—such as diet, exercise, and medication adherence. Some mental health professionals even use motivational interviewing to help people leave unhealthy relationships or to support those experiencing homelessness. Therapists also use motivational interviewing to supplement cognitive behavioral therapy (CBT) for anxiety, depression, and trauma, but it’s considered to be a less effective treatment for those conditions on its own. 

Motivational interviewing’s success also largely depends on a person’s mindset. For example, it might not work as well for those who are already highly motivated to make a behavior change or for those who are adamant that they don’t have a problem requiring change.

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Is motivational interviewing right for you?

If you’re interested in engaging in motivational interviewing, it’s important to find a therapist who understands "the spirit of motivational interviewing." The theory suggests that each person holds the power to create their change and that motivation comes from within.

To that end, you want to connect with a therapist who understands the spirit of motivational interviewing. These guiding principles of motivational interviewing include:

  • Partnership. Motivational interviewing is a collaborative process that is conducted both for and with a person. To have the most effective partnership, the therapist should show genuine empathy and interest in what you have to say. 
  • Acceptance. Your therapist doesn't have to agree with everything you say, but they must show respect and empathy for your point of view.
  • Compassion. Deciding to change takes courage and sometimes even vulnerability. Your therapist should show compassion while listening to your goals and guiding your next steps.
  • Evocation. This practice is client-focused meaning the therapist should elicit your intrinsic motivation, values, and strength to help you reach your goals.

Therapist and man practicing motivational interviewing

Choosing motivational interviewing with Charlie Health

Interested in working with a MI practitioner to help create healthy change in your life? Charlie Health’s team of compassionate mental health professionals is here to listen to your needs, answer your questions, and match you with an appropriate treatment plan. Learn more today.

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