Motivational Interviewing Skills and Techniques
Motivational Interviewing is an empathic, gentle, and skillful style of counseling that helps practitioners have productive conversations with individuals with co-occurring and other disorders. Essential characteristics of motivational interviewing include:
- Expressing empathy through reflective listening.
- Noting discrepancies between current and desired behavior.
- Avoiding argumentation and rolling with resistance.
- Encourage the consumer's belief that he or she has the ability to change.
- Communicating respect for and acceptance of people and their feelings.
- Establishing a nonjudgmental, collaborative relationship.
- Being a supportive and knowledgeable consultant.
- Complimenting rather than denigrating.
- Listening rather than telling.
- Gently persuading, with the understanding that change is up to the person.
- Providing support throughout the process of recovery.
This approach is different from pressuring a person through threats of negative health consequences, shame, or guilt. The core communications skills of motivational interviewing-asking, informing, listening-are well suited to helping people talk about, commit to, and undertake health behavior change. Empathy, hope, and respect provide the foundation for what is possible in recovery from co-occurring disorders.
It is a crucial, collaborative conversation and joint decision-making process between the practitioner and person receiving treatment. Ultimately, only the individual can make behavior and lifestyle changes to improve his or her health.
Motivational interviewing techniques include:
- Asking open-ended questions
- Using affirmations
- Forming reflective statements
- Providing a summaries
These core techniques are referred to as OARS .
Ask open-ended questions
Below are some examples of how you can ask open-ended questions.
- Invite individuals with co-occurring disorders to tell their story in their own words without leading them in a specific direction.
- Elicit what is important to the individual.
- Establish rapport, gather information, and increase understanding.
- Demonstrate genuine interest and respect.
- Help the person go deeper and provoke thought. The practitioner's goal is to encourage thinking that envisions a different future.
- Affirm a person's autonomy and self-direction.
- Provide opportunity to hear oneself speak.
- Asking sounds like:
- "How are things going?"
- "What is most important to you right now?"
- "Hmm... Interesting... Tell me more..."
- "How did you manage that in the past?"
- "How would you like things to be different?"
- "What will you lose/gain if you give up XXX?"
- "What do you want to do next?"
- "How can I help you with that?"
Providers can empower individuals by using language that affirms their strengths. Examples of Affirmations include:
- "I'm really glad you brought that up."
- "I think what you are doing is really difficult. I'm really proud to be working with you on this."
- "So many people avoid seeking help. It says a lot about you that you are willing to take this step."
- "What have you noticed about yourself in the past few months since you started coming here?" This question is designed to prompt the consumer to self-affirm.
Form Reflective Statements
Practitioners can show individuals that they are listening and understand issues from their perspective by using reflective statements. The use of reflective statements also allow individuals to hear their own words and resolve ambivalance. Depending on the individual's stage of change, practitioners may use different types of reflective statement.
Summaries can be used for multiple purposes. For example, summaries can be used to:
- Highlight important aspects of the discussion
- Shift the direction of conversations that become "stuck"
- Highlight both sides of an individual's ambivalence about change
- Communicate interest and understanding of an individual's perspective
Resources and Links
This website contains many resources on motivational interviewing.
Written for practitioners, this concise book presents powerful tools to enhance communication with people and guide them in making choices to improve their health. Engaging dialogues and vignettes bring to life the core skills of motivational interviewing and illustrate how to incorporate this evidence-based approach into any health care setting.