What to Focus on in Motivational Interviewing
As a long-time trainer and coach, I frequently hear learners say, “I just need to study it more,” or “I don’t know what to focus on.” Since Motivational Interviewing (MI) is a complex language, those statements ring true. So what should you focus on to stay true to the spirit and practice of MI?
Bill Miller and Stephen Rollnick gave us some clear guidance in the latest edition of their book. In MI, there is a conversation about change in which you are:
- Using empathetic listening to understand the person’s perspective and engage in a collaborative relationship.
- Maintaining a clear focus with one or more change goals.
- Actively evoking the person’s own motivation for change.
Planning may or may not follow, but it tends to flow naturally from evoking.
Start with Empathetic Listening
If you can tap into your client’s “bubble”—their worldview—and articulate it out loud, they will feel understood. Feeling understood makes people more open to a conversation about change. If you can reflect hope beneath the bleak words they are expressing, even better.
Establish a Clear Focus
Having a clear focus saves time and provides a roadmap for the conversation. This may be as simple as asking:
- “What brought you in today?”
- “What would you like to get out of our time together?”
These questions help both of you understand what the conversation is about.
Listen for Change Talk
Listening for change talk and reflecting it back is the heart of MI. This might be as simple as asking:
“When you were able to make this change in the past, what helped?”
Then listen intently to the answer and reflect it back. Recalling past successes activates the brain, and hearing those strengths reflected back creates a powerful double impact—and is much more effective than giving advice.
When this happens, people often begin talking about change naturally because change talk tends to emerge as a result of evoking. If not, you might ask:
- “What do you think your next step is?”
- “What would you like to happen next?”
Keep It Simple
That’s it.
Focus on three things:
- Empathetic listening
- Having a clear focus
- Evoking the person’s own motivation for change
Those three elements are the heart and soul of Motivational Interviewing.
