Motivational Interviewing
What is Motivational Interviewing?
Motivational interviewing (MI) is a collaborative, person-centered counseling style aimed at eliciting and strengthening motivation to make positive change.
The Basic Idea
There are many reasons why people might want to make positive changes in their lives, but there are also many reasons why they might lack the motivation to do so. It could be overcoming substance abuse, adopting healthier eating, or breaking away from criminal behavior. But, putting external pressure on a person to make changes to their behavior, lifestyle, or attitudes is often ineffective; people need to have the motivation to change in order for change to occur.
In motivational interviewing, practitioners engage with clients in a practical way to help them find and enhance their own intrinsic motivation for change.2 This occurs in two stages: first, building motivation to change; and second, strengthening commitment to change.
The central idea of MI is somewhat paradoxical: For people to be able to change, they first need to feel accepted as they are.1 To put it plainly, feelings of acceptance boost self-esteem and help bolster the motivation to change.
One of the main goals of MI is to overcome ambivalence, the conflicted state where individuals are stuck between wanting to change and not wanting to change.3 For example, an individual with serious health problems as a result of heavy drug abuse may have genuine concerns about the impact of using on their health, but continue to take drugs despite advice from their doctor. In these cases, the perceived short-term benefits take precedence over the perceived long-term gains.
MI is based on a set of principles that emphasize the autonomy of the client and a collaborative therapeutic relationship in which the therapist is viewed as a facilitator rather than an expert or authority. This is known as the “spirit” of motivational interviewing and has four components:
Collaboration: The practitioner and client work together as partners. The practitioner respects the client’s expertise in their own life and avoids an authoritative, confrontational, or prescriptive stance.
Evocation: Rather than imposing reasons for change from the outside, MI aims to draw out and cultivate the client’s own motivations and resources for change.
Acceptance: Practitioners demonstrate an accepting attitude toward clients by valuing the inherent worth of every individual, practicing empathy, respecting and reinforcing the client’ capacity for self-direction, and affirming the client’s strengths and efforts.
Compassion: Practitioners are conscious of their commitment to the well-being and best interests of the client—showing empathy and promoting judgment-free communication.
The 4 stages of motivational interviewing
MI is based on 4 distinct processes that provide a structured yet flexible framework for helping clients navigate the complexities of behavior change. These processes—engaging, focusing, evoking, and planning—are designed to enhance the effectiveness of MI by guiding the therapeutic conversation in a way that respects the client's autonomy and fosters intrinsic motivation.
These processes are not strictly linear; they often overlap and can be revisited as needed throughout the course of MI. The engagement process, for example, typically comes first as the therapist and patient develop a rapport, but is also present throughout the conversation. If engagement is lost at any point, the therapist will stop moving forward and go back to the engaging process to re-engage the patient.4
Engaging: This is the foundational step where the therapist establishes a trusting and respectful relationship with the client. Engaging involves active listening, empathy, and understanding the client’s perspective without judgment.
Focusing: Once engagement is established, the therapist and client work together to identify and clarify the specific behaviors, issues, or changes that the client wants to address. This involves setting an agenda and agreeing on the direction for the conversation.
Evoking: In this process, the therapist helps the client explore their motivations, desires, and reasons for change. This involves eliciting the client’s own arguments for change and addressing their ambivalence.
Planning: After the client has expressed a clear motivation to change, the therapist assists in developing a concrete and actionable plan for making the change. This includes setting goals, discussing potential strategies, and identifying resources and support systems.
People are the undisputed experts on themselves. No one has been with them longer, or knows them better than they do themselves. In MI, the helper is a companion who typically does less than half of the talking.
William R. Miller, co-author of Motivational Interviewing: Helping People Change
About the Author
Dr. Lauren Braithwaite
Dr. Lauren Braithwaite is a Social and Behaviour Change Design and Partnerships consultant working in the international development sector. Lauren has worked with education programmes in Afghanistan, Australia, Mexico, and Rwanda, and from 2017–2019 she was Artistic Director of the Afghan Women’s Orchestra. Lauren earned her PhD in Education and MSc in Musicology from the University of Oxford, and her BA in Music from the University of Cambridge. When she’s not putting pen to paper, Lauren enjoys running marathons and spending time with her two dogs.
