Motivational Interviewing

Motivational interviewing is an evidence-based counseling method used to help people become internally motivated to change behaviors that are keeping them from making positive life decisions. It is a practical, short-term, person-centered process in which the counselor recognizes individual strengths and brings them to the forefront whenever possible.

Source: Project E3

Goals of Motivational Interviewing Training

Understand the five principles of motivational interviewing
Recognize examples of motivational interviewing communication skills
Consider motivational interviewing as a support for decision-making

The Five Principles of Motivational Interviewing

Apply the five principles of motivational interviewing to support those working to resolve ambivalent feelings about changing and to spark their internal motivation to change:

Express empathy through reflective listening
Identify discrepancy between clients’ goals or values and their current behavior
Avoid argument and direct confrontation
Adjust to client resistance rather than opposing it directly
Support self-efficacy and optimism

Communication Skills

Motivational interviewing requires a collaborative, goal-oriented style of communication to strengthen someone’s personal motivation for change. Here are some strategies to keep in mind:

Asking open-ended, non-leading questions will help foster a meaningful, thought-provoking conversation.

Open-ended questions encourage more of a dialogue, as they cannot be answered with a simple “yes” or “no”
- Closed-ended question: “Are you worried about your interview?
- Open-ended question: “What worries you most about your interview?”

Non-leading questions prompt a genuine answer, rather than the answer they think you want to hear
- Leading: “You’d like to be a manager in five years, wouldn’t you?”
- Non-leading: “What job would you like to have in five years?”

Reflective listening makes people feel “heard” in a conversation and encourages more in-depth sharing. It also lets a counselor confirm their perceptions to avoid a breakdown in communication. There are three levels of reflective listening:

Repeating or rephrasing – Repeat what was said, staying close to the original statement
- Statement: “I’m here only because I haven’t been able to get a job on my own.”
- Repeating: “You’re here because you haven’t been able to get a job on your own.”

Paraphrasing – Restate what was said in your own words while keeping the intended meaning
- Statement: “I’m here only because I haven’t been able to get a job on my own.”
- Paraphrasing: “You came to see me because you’ve been looking and haven’t been able to get a job.”

Reflection of feeling – Use a feeling statement to reflect the feeling behind what was said
- Statement: “I’m here only because I haven’t been able to get a job on my own.”
- Reflection of feeling: “You’ve been looking for work and are worried you won’t get a job”.

Useful starters for reflective listening:
- “So you feel…”
- “It sounds like you…”
- “You’re wondering if…”

Summarizing lets a person know you heard and understood what they said. It also lets you present discrepancies, emphasize important points, and focus the conversation.

Statement: “I’d really like to get a job as a mechanic at Miller’s, but they’re on the other side of town and I don’t like taking the bus. And I’ve always thought I’d be good at welding.”

Summary: “It sounds like you’d like to work as a mechanic and you might be interested in welding. You don’t like the idea of taking the bus to work. Are there other ways you could get to work?”

Source: Introduction to Motivational Interviewing, SAMHSA-HRSA Center for Integrated Health Solutions

Strategies

Researchers recently explored how motivational interviewing can support decision-making in the vocational rehabilitation process. They provide three tips for vocational rehabilitation service providers: