Four Key Steps in Motivational Interviewing Techniques

Four Steps of Motivational Counselling

Motivational Interviewing (MI) is a unique coaching or counseling style that helps clients explore and resolve ambivalence to elicit behavior change. Co-created by William Miller and Stephen Rollnick, MI is defined as "a directive, client-centered counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence."

At the heart of MI lies the process of evoking, where the practitioner draws out "change talk" from the care recipient about the focus. This is achieved through open questions, targeted reflections, and providing summaries. Evoking in MI is a process that increases motivation toward change.

The book "Motivational Interviewing: Helping People Change" by Miller and Rollnick defines four essential processes of MI. These are engagement, focusing, evoking, and planning. Engagement in MI is about building trust, autonomy, acceptance, and using OARS (open questions, affirmations, reflections, and summaries).

Focusing in MI is about agreeing on the end goal of treatment with the client. The client's expertise about what's best for them needs to be honored in this process. In some settings, goals may be predetermined, but in others, they need to be negotiated between the practitioner and the client.

Planning is the process in which attending to possible barriers to success could be appropriate, but talking about barriers earlier in the processes could be counterproductive. The most important part of planning in MI is remembering that you don't need to have all of the answers, and trusting your client's expertise on their own life.

It's crucial to keep in mind other concepts for successful MI conversations. These include checking your righting reflex, being aware of moving between processes, using more reflections than questions, letting go of the "assessment mindset", and keeping the spirits of MI in mind (partnership or collaboration, compassion, evocation, and acceptance).

MI doesn't work when the overall goal of the conversation isn't clear, defined, and agreed upon between both parties. In the MI process of planning, the practitioner can ask key questions such as "What do you think you'll do next?" or "How will you know if you've been successful in your plan?"

To learn more about MI strategies, look for opportunities to train with a member of the Motivational Interviewing Network of Trainers (MINT). By understanding and applying MI, practitioners can help clients explore their ambivalence and make positive changes in their lives.