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Building Core Skills

When To Practice Motivational Interviewing

Motivational Interviewing Practice

Motivational Interviewing skills can be divided into two primary categories, as illustrated in the illustration below. There are skills that rise out of decisional guidelines which serve to inform how an interviewer structures the conversation. These guidelines are often referred to as:

  • the variables that establish the “spirit” of MI conversations, or the “environment” in which MI conversations take place
  • the MI practices, or “behaviours” that are used to accomplish the necessary work of the four processes of an MI conversation

People who want to learn to activate motivation through the practice of MI will need to develop competency with the following kinds of skills:

The “OARS- I” skills, where:

  • “O” = Open ended questions (which evoke change talk)
  • “A” = Affirmations of client strengths, capacities, competencies, and other positive traits that help reinforce the client’s perception about their ability to make specific changes
  • “R” = Reflective Listening, strategically, to help clients hear important elements of their thinking that will help construct their own, intrinsic argument for pursuing a specific change
  • “S” – Summarizing important points that the client has made that help to reiterate what the client has said that might support a decision or plan to change
  • “I” = Information giving (sometimes including advice and suggestions) that will provide the client with knowledge that will support the process of change

Most people who participate in MI training already have many (or all) of the core skills that are used in MI work.

What is required from useful training is not the development of these foundational skills. Rather, effective MI training helps participants to become more strategic in the use of these skills in order to:

  • Differentially reflect the pro-change side of arguments about the change target, without negating or invalidating the client’s reservations or concerns about change
  • Design questions for which clients need to hear their own answers (related to their potential desire, ability, reason, need, and eventual commitment related to the change target)
  • Side-step “sustain talk” (client language that reinforces an argument to “leave things as is” and avoid the pursuit of the change focus)
  • Identify client strengths and positive traits that could be utilized within the change process that is under discussion, and to “surface” the client’s awareness of these strengths
  • Provide required information, advice, and suggestions in a way that client’s will see as a useful resource and not as an attempt to persuade, manipulate, or coerce
  • Avoid the temptation to use the MI conversation as a “trick” that will help the client to do what the MI providers thinks they ought to do!

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