Motivational interviewing is a non-confrontational way of raising difficult topics with people, especially where the topic is associated with an unhealthy behaviour that needs changing. The technique can be used by health professionals or individuals wishing to help friends and family members. It does not have to be seen as interviewing, but more so a form of communication.
There are two key aspects of speech important within motivational interviewing, which can be used to guide efforts to help people change:
Change Talk – which can be detected via verbal signals indicative of desire and commitment to change
Resistance Talk – which is an oppositional reaction to behaviour change discussions
Motivational interviewing is a technique that requires the use of several core communication skills, tools, and strategies (Table 1).
Table 1: Motivational Interviewing Skills
Key Communication Skills
Tools and Strategies
Role with resistance
Resist the righting reflex
Understand the patient’s dilemma
Listen to the patient
Empower the patient
Asking skilful open ended questions
Making well timed affirmations
Making frequent the skilful reflective listening statements
Using summaries to communicate understanding
Setting the scene
Agreeing on the agenda Exploring a typical day
Assessing confidence Exploring two possible futures Looking back and looking forward
Agreeing to a plan
The autonomy of the person with the behaviour that requires changing is increased by the underlying belief that they are the expert in their own lives. In other words, people are better persuaded by their own reasons for changing behaviour than by those of others. This is why motivational interviewing helps people move towards a desire to change rather than trying to push it upon them.
Autonomy in decision-making is an important component of motivational interviewing and crucial for the maintenance of new, healthier behaviours.
Many health behaviour change interventions fail because they immediately target behaviour rather than the underlying attitudes that drive behaviour.
Motivational interviewing also helps identify the level of support someone might need to change:
If someone is motivated to change, then they may merely require information and a support system.
If they are not motivated to change, the use of motivational interviewing might either instantly change their attitude or raise questions productive to future change.
The individual who walks away with no commitment to change need not be perceived as a failed attempt. By establishing their readiness to change and their motivation to change, you have identified the most appropriate course of action. Sometimes the best course of action is to accept the individuals resolve to continue with behaviours that are negative or unhealthy, in the knowledge that you have at the very least provided them with an opportunity to commit to change.