Motivational interviewing techniques

Motivational interviewing techniques

Motivational interviewing (MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change.) is a counselling style that helps people resolve ambivalence and find their own motivation for change. It is one of the most evidence-based behaviour-change methods we have, and SPLWsSPLW— Social Prescribing Link WorkerA role that supports people to access community-based services, groups and activities to meet practical, social and emotional needs that affect their health and wellbeing. Used internationally; equivalents in some countries include 'link worker', 'community connector' or 'health navigator'. are explicitly expected to apply it.

It is not a script. It is a way of being in conversation.

The four processes

MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change. as taught is built around four processes that loop, not a linear interview:

1. Engaging — building the relational foundation.
2. Focusing — together, agreeing what we will work on.
3. Evoking — drawing out the person's own reasons for change (this is the heart of MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change.).
4. Planning — co-producing the next step, only when the person is ready.

The OARS skills

Day-to-day, MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change. is delivered through four skills, often shorthanded as OARSOARSThe four core skills of motivational interviewing: Open questions, Affirmations, Reflective listening, Summaries.:

• Open questions — the kind that produce stories, not yes/no
• Affirmations — genuine recognition of effort, strength and small wins
• Reflective listening — saying back what you heard, sometimes in slightly different words
• Summaries — pulling together what you have heard so far

If you do nothing else from MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change., get good at OARSOARSThe four core skills of motivational interviewing: Open questions, Affirmations, Reflective listening, Summaries..

Change talk vs sustain talk

MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change. listens carefully for two types of speech:

• Change talk — the person voicing reasons for change. "I'm sick of feeling like this." "I used to enjoy walking." "My grandkids want me at their birthday."
• Sustain talk — reasons against change. "I don't have the energy." "I've tried before and it didn't work." "What's the point."

The skill is to reflect change talk back (so the person hears their own motivation), and to roll with sustain talk (acknowledge it without arguing — argument hardens it).

What MI is not

• It is not "manipulation". It is profoundly respectful: the person decides if and when to change.
• It is not asking lots of leading questions until they say what you wanted.
• It is not the same as coaching. It overlaps but has its own evidence base.

Practical micro-skills

• Lead with affirmations: "It took something to come in today."
• When the person says something ambivalent, reflect both sides: "On one hand the medication helps with the pain, on the other you don't like how it makes you feel."
• Close with a summary that emphasises change talk the person said.

Going further

The Personalised Care Institute and many ICS training hubs run MIMI— Motivational InterviewingA counselling style that helps people resolve ambivalence and find their own motivation for change. training. Ask your supervisor about local options.

Linked competencies

• Promotes and supports behaviour change through coaching and motivational interviewing techniques (Domain 2).