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Applications of Motivational Interviewing
Motivierende Gesprächsführung. Ein Konzept zur Beratung von Menschen mit Suchtproblemen
Since the initial publication of this classic text, motivational interviewing (MI) has been used by countless clinicians in diverse settings. Theory and methods have evolved apace, reflecting new knowledge on the process of behavior change, a growing body of outcome research, and the development of new applications within and beyond the addictions field. Including 25 nearly all-new chapters, this revised and expanded second edition now brings MI practitioners and trainees fully up to date. William R. Miller and Stephen Rollnick explain how to work through ambivalence to facilitate change, present detailed guidelines for using their approach with a variety of clinical populations, and reflect on the process of learning MI. Chapters contributed by other leading experts then address such special topics as MI and the stages-of-change model; using the approach with groups, couples, and adolescents; and applications to general medical care, health promotion, and criminal justice settings.
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First published August 9, 1991
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About the author
William R. Miller
113 books61 followersWilliam Richard Miller is an American clinical psychologist, an emeritus distinguished professor of psychology and psychiatry at the University of New Mexico in Albuquerque. Miller and Stephen Rollnick are the co-founders of motivational interviewing.
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Displaying 1 - 30 of 187 reviews
December 25, 2013
I read an earlier addition of this manual when I was in school working towards my MA. I thought it was brilliant back then. But I had no idea how effective this stuff would be in practice. I'm currently doing my (MFT) internships and just beginning to implement this stuff, and WOW, it really works.
The first time I experienced a client drop dramatic, sudden, emphatic change talk in a session my jaw just about hit the floor. I was with a client who was on the verge of becoming homeless, but could not seem to take action due to depression and overwhelm. We explored the ambivalence, non-judgmentally, for just a few minutes, and suddenly she startled as if she were jerking awake from a deep sleep and said " oh my god, I have to go find a place to live". We scribbled out a quick list and she bolted for the door to go get some urgent and important stuff done. The next day she came into my office with the proud news that she got the apartment.
Listening with empathy and reflecting in a forward direction can transform an otherwise superficial or circular conversation into an insight and action provoking depth charge. KABOOM!
As an addendum I'm including the following progress update to the above mentioned clients status. She did in fact find and move in to the apartment. But as it turns out its is a meth house, and she has subsequently become hopelessly relapsed in her meth addiction (I was treating her opiate addiction at the time of writing, her meth addiction was in remission). One step forward three steps back I guess.
This of course does not at all reflect poorly on MI, but it does remind us that long term adaptive behavioral change takes sustained long term effort and commitment.
The first time I experienced a client drop dramatic, sudden, emphatic change talk in a session my jaw just about hit the floor. I was with a client who was on the verge of becoming homeless, but could not seem to take action due to depression and overwhelm. We explored the ambivalence, non-judgmentally, for just a few minutes, and suddenly she startled as if she were jerking awake from a deep sleep and said " oh my god, I have to go find a place to live". We scribbled out a quick list and she bolted for the door to go get some urgent and important stuff done. The next day she came into my office with the proud news that she got the apartment.
Listening with empathy and reflecting in a forward direction can transform an otherwise superficial or circular conversation into an insight and action provoking depth charge. KABOOM!
As an addendum I'm including the following progress update to the above mentioned clients status. She did in fact find and move in to the apartment. But as it turns out its is a meth house, and she has subsequently become hopelessly relapsed in her meth addiction (I was treating her opiate addiction at the time of writing, her meth addiction was in remission). One step forward three steps back I guess.
This of course does not at all reflect poorly on MI, but it does remind us that long term adaptive behavioral change takes sustained long term effort and commitment.
January 9, 2014
This is the most logical and effective approach I've learned for evoking change in people. I've seen it work in practice. It's pretty amazing. It would be a very good thing if this were required reading and training for everyone working in counseling, social work, medicine, criminal justice and teen mentoring as well as many other applications.
January 15, 2021
Several friends recommended William R. Miller and Stephen Rollnick’s Motivational Interviewing as a reliable and longstanding practice that would be useful for an aspiring counselor to explore. The book is a terrific resource for professionals and laypeople interested in the language of change and dynamics of personal development.
Miller and Rollnick originally invented motivational interviewing (MI) in the 1980s as a talk therapy treatment for alcohol addiction. They have continued to evolve its theory and practice over the last several decades; MI is now used in a variety of contexts and has been fruitfully integrated with other therapeutic methods. The approach borrows the conceptual foundations of Rogerian client-centered therapy, but also departs from it by being considerably more goal-oriented. The explicit purpose of MI is to help clients change their lives in ways that will minimize harm and promote growth and flourishing:
"Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion." (29)
In MI, the counselor’s prime directive is to draw out a client’s intrinsic motivations for change, rather than confronting them with extrinsic motivations or taking an authoritative tone:
"Telling someone that 'You can’t,' and more generally trying to constrain someone’s choices typically evokes psychological reactance, the desire to reassert one’s freedom. On the other hand, directly acknowledging a person’s freedom of choice typically diminishes defensiveness and can facilitate change. This involves letting go of the idea and burden that you have to (or can) make people change. It is, in essence, relinquishing a power that you never had in the first place." (19)
Motivational Interviewing is a process-oriented text that provides many concrete examples of how Miller and Rollnick’s theories succeed or fail in practice, as well as discussions of MI’s efficacy as demonstrated by academic research. The authors also have a talent for metaphor, often invoking creative references to music, dance, travel, and the natural world. The book strikes an excellent balance between instructional information and values-driven reflections on the art of therapeutic consultation.
Miller and Rollnick break down the method of MI into four stages: engaging, focusing, evoking, and planning. Their simplest articulation is as follows:
"Engaging is about 'Shall we travel together?'
Focusing asks 'Where to?'
Evoking is about 'Whether?' and 'Why?'
Planning is about 'How?' and 'When?'" (271)
The four stages occur in sequence as the client makes their way toward change, but Miller and Rollnick point out that any stage can be revisited as needed.
Engaging is the stage of MI that most closely resembles client-centered therapy. It is all about listening well, creating a safe and acceptant space for the client, and demonstrating empathic attention to the client’s perspective and needs. Miller and Rollnick’s descriptions and examples of “reflective listening” are especially helpful, making it easy to see why their method is so effective when utilized properly. “Processes for engaging do differ across cultures,” they write, “but listening lies at the heart of nearly all of them” (349).
Once a solid rapport has been established, the consultation enters the focusing stage. This is where counselor and client collaboratively explore goals for change and agree on an intended outcome or set of outcomes. Miller and Rollnick recommend that counselors adopt a “guiding” style––a compromise between “following” (allowing the client to dictate the direction of the conversation) and “directing” (taking the reins in order to produce the counselor’s desired outcome):
"Midway between directing and following sits a guiding style. Guiding promotes a collaborative search for direction, a meeting of expertise in which the focus of treatment is negotiated. The client’s agenda is important, and any limitations inherent in the context are taken into account. The clinician’s expertise is also a possible source of goals. The focusing process of MI commonly starts in this middle ground between directing and following, where the focus, momentum, and content are mutually forged." (99)
After focusing comes evoking, which is arguably the most crucial and challenging of the four stages. Evoking is the process by which a counselor seeks to elicit and strengthen the client’s personal reasons for change. This is done through delving into the client’s ambivalence––their reasons for and against making the change or changes identified during the focusing stage. Careful attention is paid to “change talk” and “sustain talk”:
"Sustain talk and change talk are conceptually opposite––the person’s arguments against and for change––and they predict different outcomes. A predominance of sustain talk or an equal mix of change and sustain talk is associated with maintenance of the status quo, whereas a predominance of change talk predicts subsequent behavior change." (165)
Affirming and encouraging change talk is the main mechanism by which MI practitioners help clients articulate and commit to their intrinsic motivations for change. “Evoking is a co-creative process through which the person’s potential for change is released,” Miller and Rollnick tell us. “The motivation for change is emerging even as you speak together.” (182) Here we see another strong connection to Carl Rogers’s theory of personal growth, which prizes client autonomy and asserts that meaningful and lasting change typically stems from behavioral adaptations that are self-chosen rather than imposed from the outside.
The planning stage is precisely what it sounds like. “Planning is the clutch that engages the engine of change talk,” where client and counselor work out the details of how to transform the client’s desires for change into reality (30). Miller and Rollnick provide many useful examples and resources for how this can be accomplished, all the while staying true to their ethos of supporting the client as they discover what works best for them.
Although MI certainly seems like a great system, there are a couple apparent limitations I’d like to highlight. The first is simply that much of MI won’t apply to clients who aren’t seeking change or don’t need to change their behavior in any profound way. The second is that, by locating the potential and responsibility for change primarily within the client, MI runs the risk of downplaying or ignoring structural factors that may render change difficult or even impossible. To their credit, Miller and Rollnick are aware of this issue and mention it several times in the book. It’s important to remember that, due to external circumstances completely beyond their control, some people seeking counseling may not have the power to transform their lives in the way MI suggests. This isn’t really a criticism, but rather an acknowledgment that MI is just one of many effective tools we can use to meet humanity’s variety of mental health needs.
This review was originally published on my blog, words&dirt.
Miller and Rollnick originally invented motivational interviewing (MI) in the 1980s as a talk therapy treatment for alcohol addiction. They have continued to evolve its theory and practice over the last several decades; MI is now used in a variety of contexts and has been fruitfully integrated with other therapeutic methods. The approach borrows the conceptual foundations of Rogerian client-centered therapy, but also departs from it by being considerably more goal-oriented. The explicit purpose of MI is to help clients change their lives in ways that will minimize harm and promote growth and flourishing:
"Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion." (29)
In MI, the counselor’s prime directive is to draw out a client’s intrinsic motivations for change, rather than confronting them with extrinsic motivations or taking an authoritative tone:
"Telling someone that 'You can’t,' and more generally trying to constrain someone’s choices typically evokes psychological reactance, the desire to reassert one’s freedom. On the other hand, directly acknowledging a person’s freedom of choice typically diminishes defensiveness and can facilitate change. This involves letting go of the idea and burden that you have to (or can) make people change. It is, in essence, relinquishing a power that you never had in the first place." (19)
Motivational Interviewing is a process-oriented text that provides many concrete examples of how Miller and Rollnick’s theories succeed or fail in practice, as well as discussions of MI’s efficacy as demonstrated by academic research. The authors also have a talent for metaphor, often invoking creative references to music, dance, travel, and the natural world. The book strikes an excellent balance between instructional information and values-driven reflections on the art of therapeutic consultation.
Miller and Rollnick break down the method of MI into four stages: engaging, focusing, evoking, and planning. Their simplest articulation is as follows:
"Engaging is about 'Shall we travel together?'
Focusing asks 'Where to?'
Evoking is about 'Whether?' and 'Why?'
Planning is about 'How?' and 'When?'" (271)
The four stages occur in sequence as the client makes their way toward change, but Miller and Rollnick point out that any stage can be revisited as needed.
Engaging is the stage of MI that most closely resembles client-centered therapy. It is all about listening well, creating a safe and acceptant space for the client, and demonstrating empathic attention to the client’s perspective and needs. Miller and Rollnick’s descriptions and examples of “reflective listening” are especially helpful, making it easy to see why their method is so effective when utilized properly. “Processes for engaging do differ across cultures,” they write, “but listening lies at the heart of nearly all of them” (349).
Once a solid rapport has been established, the consultation enters the focusing stage. This is where counselor and client collaboratively explore goals for change and agree on an intended outcome or set of outcomes. Miller and Rollnick recommend that counselors adopt a “guiding” style––a compromise between “following” (allowing the client to dictate the direction of the conversation) and “directing” (taking the reins in order to produce the counselor’s desired outcome):
"Midway between directing and following sits a guiding style. Guiding promotes a collaborative search for direction, a meeting of expertise in which the focus of treatment is negotiated. The client’s agenda is important, and any limitations inherent in the context are taken into account. The clinician’s expertise is also a possible source of goals. The focusing process of MI commonly starts in this middle ground between directing and following, where the focus, momentum, and content are mutually forged." (99)
After focusing comes evoking, which is arguably the most crucial and challenging of the four stages. Evoking is the process by which a counselor seeks to elicit and strengthen the client’s personal reasons for change. This is done through delving into the client’s ambivalence––their reasons for and against making the change or changes identified during the focusing stage. Careful attention is paid to “change talk” and “sustain talk”:
"Sustain talk and change talk are conceptually opposite––the person’s arguments against and for change––and they predict different outcomes. A predominance of sustain talk or an equal mix of change and sustain talk is associated with maintenance of the status quo, whereas a predominance of change talk predicts subsequent behavior change." (165)
Affirming and encouraging change talk is the main mechanism by which MI practitioners help clients articulate and commit to their intrinsic motivations for change. “Evoking is a co-creative process through which the person’s potential for change is released,” Miller and Rollnick tell us. “The motivation for change is emerging even as you speak together.” (182) Here we see another strong connection to Carl Rogers’s theory of personal growth, which prizes client autonomy and asserts that meaningful and lasting change typically stems from behavioral adaptations that are self-chosen rather than imposed from the outside.
The planning stage is precisely what it sounds like. “Planning is the clutch that engages the engine of change talk,” where client and counselor work out the details of how to transform the client’s desires for change into reality (30). Miller and Rollnick provide many useful examples and resources for how this can be accomplished, all the while staying true to their ethos of supporting the client as they discover what works best for them.
Although MI certainly seems like a great system, there are a couple apparent limitations I’d like to highlight. The first is simply that much of MI won’t apply to clients who aren’t seeking change or don’t need to change their behavior in any profound way. The second is that, by locating the potential and responsibility for change primarily within the client, MI runs the risk of downplaying or ignoring structural factors that may render change difficult or even impossible. To their credit, Miller and Rollnick are aware of this issue and mention it several times in the book. It’s important to remember that, due to external circumstances completely beyond their control, some people seeking counseling may not have the power to transform their lives in the way MI suggests. This isn’t really a criticism, but rather an acknowledgment that MI is just one of many effective tools we can use to meet humanity’s variety of mental health needs.
This review was originally published on my blog, words&dirt.
January 12, 2026
My journey with this book started with the second edition, but this fourth edition is the first that I have finally finished completely. Psychotherapy does not make sense without MI.
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April 21, 2025I am embarrassed about how long it took me to read this book (grad school is tough, man...). However, I LOVED it and highly recommend it to any therapist who is starting their psychotherapy training. The four basic Motivational Interviewing skills that the authors talk about: engaging, focusing, evoking, and planning are highly applicable to any type of psychotherapy you practice with your clients.
June 15, 2025
Den bästa boken om psykoterapi jag har läst. Ingen nonsens, full av praxis. Utstrålar en varm och empatisk syn på terapeutiska samtal vars utgångspunkt är att hjälpa personen hitta sin egna motivation (som vi alla har!) till förändring i livet.
July 26, 2018
Read for work. Written with clinicians in mind but has a lot of useful advice for people who want to become better listeners in all types of settings. Has some really tangible advice on how to divorce yourself from the impulse of offering people unsolicited advice, and instead working with others to find what they want and how they can get to that goal on their own. Also found it super useful for personal goal setting, and thinking about how I work towards my goals and react to failure. I'm not much of a reader of "self-help" style books but really did like this one!
January 3, 2018
One of my textbooks this semester. I thought it was a decent read, however I felt as if the concepts were very straight forward. This book was presented as a groundbreaking theory of sorts but I got the feel that MI is simply an explanation of current concepts counselors face. It was valuable for learning a few new skills though!
August 31, 2025
This is *the* MI guidebook, written by the masters. This edition has moved with the research and is even more person-centred than the last. It’s written in an incredibly engaging and straightforward way that equips you to start practising immediately. It also describes ways to improve and refine MI practice. An absolute must have for any therapist, coach, teacher, or leader.
June 2, 2019
ספר מעולה, קריא וברור, מאורגן היטב בנושא של גישה מוטיבציונית כגישה טיפולית.
ממליצה מאוד לכל עמיתי הפסיכולוגים. מומלץ גם לרופאים, אחיות, עובדים סוציאלים וכל אנשי הטיפול באשר הם.
ממליצה מאוד לכל עמיתי הפסיכולוגים. מומלץ גם לרופאים, אחיות, עובדים סוציאלים וכל אנשי הטיפול באשר הם.
November 2, 2025
Rating textbooks is weirrrrrrd. I never would’ve read this if it weren’t for an assignment, because when I first heard the concept of MI I went ‘nah mate’, and I have to say it was pretty effective at making me check my biases and assumptions. It’s a really well written, accessible introduction to the practice that makes it make a lot of sense, so I’d absolutely recommend it as a starting point for the topic. As for MI itself, I can see some aspects I like, and I also have reservations and critiques, but that’s the case for me with pretty much every theory/modality because I’m contrary. We’ll see if and how it integrates into my practice with time I guess, but for now, the book is absolutely doing its job at getting me through this essay so it can have four stars. 😂
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September 30, 2024Nu är jag färdig. Den är utläst. Slut! Skönt. Hade jag kunnat gjort något bättre med tiden? Förmodligen, framförallt all ineffektiv tid som lagts på att tänka att jag borde läsa ut den, men nu är det gjort. Sånt här behöver väl övas på, inte bara läsas om. Tycker ändå de 18 första kapitlena gav matnyttig info och jag gillar MI som metod och koncept. Hade velat omsätta det bara – för att det ska stanna kvar. Det försöker jag ju dock så gott det går i egna samtal med patienter. En del saker hade kunnat kortas ner. Tycker även vissa översättningar fungerar sådär. Nya upplagan är förmodligen bättre. Hej och hå
July 3, 2025
the OGs of motivation interviewing. great introduction to this practice. humble reminder that theory isn't enough. applying what we read, is the final test. nevertheless, this will be a timeless toolkit. glad I make a habit of writing my own index(thanks pmac)
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December 13, 2024Fantastic
March 29, 2021
Read for work!!
April 25, 2024
I forgot to mark this as finished last week. but this was a really helpful book for my motivational interviewing class. I liked that it was not a boring school text but rather it had scenarios and example in the book, it kept it interesting!
February 2, 2026
*scroll to the middle for a bonus!*
THE textbook on Motivational Interviewing.
The 3rd edition is comprehensive and may be a bit overwhelming if you are not looking for an academic treatment. If you want something that is more concise, get the 4th edition.
The Table of Contents gives a good idea of how much material is covered:
PART I. WHAT IS MOTIVATIONAL INTERVIEWING?
CHAPTER 1. Conversations about Change
CHAPTER 2. The Spirit of Motivational Interviewing
CHAPTER 3. The Method of Motivational Interviewing
PART II. ENGAGING: The Relational Foundation
CHAPTER 4. Engagement and Disengagement
CHAPTER 5. Listening: Understanding the Person’s Dilemma
CHAPTER 6. Core Interviewing Skills: OARS
CHAPTER 7. Exploring Values and Goals
PART III. FOCUSING: The Strategic Direction
CHAPTER 8. Why Focus?
CHAPTER 9. Finding the Horizon
CHAPTER 10. When Goals Differ
CHAPTER 11. Exchanging Information
PART IV. EVOKING: Preparation for Change
CHAPTER 12. Ambivalence: Change Talk and Sustain Talk
CHAPTER 13. Evoking the Person’s Own Motivation
CHAPTER 14. Responding to Change Talk
CHAPTER 15. Responding to Sustain Talk and Discord
CHAPTER 16. Evoking Hope and Confidence
CHAPTER 17. Counseling with Neutrality
CHAPTER 18. Developing Discrepancy
PART V. PLANNING: The Bridge to Change
CHAPTER 19. From Evoking to Planning
CHAPTER 20. Developing a Change Plan
CHAPTER 21. Strengthening Commitment
CHAPTER 22. Supporting Change
PART VI. MOTIVATIONAL INTERVIEWING IN EVERYDAY PRACTICE
CHAPTER 23. Experiencing Motivational Interviewing
CHAPTER 24. Learning Motivational Interviewing
CHAPTER 25. Applying Motivational Interviewing
CHAPTER 26. Integrating Motivational Interviewing
PART VII. EVALUATING MOTIVATIONAL INTERVIEWING
CHAPTER 27. Research Evidence and the Evolution of Motivational Interviewing
CHAPTER 28. Evaluating Motivational Conversations
APPENDIX A. Glossary of Motivational Interviewing Terms
APPENDIX B. Reflection Questions
APPENDIX C. The Case of Julia
APPENDIX D. Is That Motivational Interviewing?
APPENDIX E. A Bibliography of Motivational Interviewing
Compare this to the Table of Contents for the 4th Ed:
Part I Helping People Change and Grow
Chapter 1 The Mind and Heart When Helping
Chapter 2 What Is Motivational Interviewing?
Chapter 3 A Flowing Conversation
Part II Practicing Motivational Interviewing
Chapter 4 Engaging: “Can We Walk Together?”
Chapter 5 Focusing: “Where Are We Going?”
Chapter 6 Evoking: “Why Would You Go There?”
Chapter 7 Planning: “How Will You Get There?”
Part III A Deeper Dive into Motivational Interviewing
Chapter 8 Deeper Listening
Chapter 9 Focusing: A Deeper Dive
Chapter 10 Evoking: Cultivating Change Talk
Chapter 11 Offering Information and Advice
Chapter 12 Supporting Persistence
Chapter 13 Planting Seeds
Chapter 14 Responding to Sustain Talk and Discord
Chapter 15 Practicing Well
Part IV Learning and Studying Motivational Interviewing
Chapter 16 Learning Motivational Interviewing
Chapter 17 Learning from Conversations about Change
Chapter 18 Studying Motivational Interviewing
If you want your LLM (ChatGPT etc.) to be a motivational interviewer, here is a prompt you can use. If you use this, let me know in the comments how it works for you. You're welcome!:
You are a counselor practicing Motivational Interviewing (MI). Your role is to have a collaborative, empathetic, and goal‑oriented conversation that helps the user explore and resolve ambivalence about change while fully respecting their autonomy.
Your primary goals are to:
• Express empathy and build a trusting alliance.
• Help the user clarify their values, goals, and reasons for change.
• Elicit and strengthen “change talk” while softening “sustain talk”.
• Support the user’s sense of autonomy and self‑efficacy.
Always embody the spirit of MI:
• Collaboration: Work with the user, not as an authority over them.
• Evocation: Draw out the user’s own ideas, values, and motivations instead of giving advice.
• Autonomy: Emphasize that decisions are the user’s to make; avoid pressure or coercion.
Core Communication Style (OARS)
Throughout the conversation, emphasize the OARS skills:
1. Open Questions
• Ask questions that invite elaboration, reflection, and exploration (e.g., “What are your thoughts on…?”, “In what ways…?”).
• Avoid rapid‑fire questioning. Ask one focused question at a time and give space for the user to respond.
2. Affirmations
• Notice and verbally acknowledge the user’s strengths, efforts, and small successes.
• Keep affirmations specific and sincere (e.g., “You’ve already put a lot of thought into this.”).
3. Reflections
• Frequently reflect back what the user says, focusing on meaning, emotion, and values, not just content.
• Use simple reflections (“You’re feeling…”) and complex reflections (“On one hand…, but on the other hand…”).
• Aim for at least one reflective statement for each user message.
4. Summaries
• Periodically summarize key points, especially after several exchanges or before shifting topics.
• Highlight the user’s own reasons for change and any change talk you have heard.
Handling Ambivalence and Eliciting Change Talk
When the user expresses mixed feelings or ambivalence:
• Reflect both sides (“Part of you…, and another part of you…”).
• Ask open questions that explore:
• Importance of change (“What feels most important to you about this?”).
• Confidence (“What gives you confidence that you could do this if you chose to?”).
• Values (“How does this fit with the kind of person you want to be?”).
• Gently evoke change talk by inviting:
• Desire (e.g., “What would you like to be different?”).
• Ability (e.g., “What makes you think you could do that?”).
• Reasons (e.g., “What are some good things that might come from this change?”).
• Need (e.g., “What feels urgent or necessary here?”).
• Commitment/steps (e.g., “What might be a next step, if you decide to move forward?”).
When the user expresses sustain talk (arguments against change) or resistance:
• Do not argue, confront, or push.
• Use reflections and summaries that show understanding and gently reframe, without judgment.
• Roll with resistance by acknowledging their perspective and inviting them to elaborate, not defend.
Structure and Flow of the Conversation
1. Engage and understand
• Start by inviting the user to describe what they want to talk about or consider changing.
• Ask about context, history, and impact on their life.
• Use reflections and affirmations to build rapport.
2. Focus
• Collaboratively clarify what specific change, decision, or area the user wants to focus on.
• Check that the focus feels right for them (“Does this feel like the right place to focus for now?”).
3. Evoke
• Explore the user’s values, goals, and what matters most.
• Elicit change talk and highlight it in reflections and summaries.
• Help them explore pros/cons of change versus staying the same, while avoiding taking sides.
4. Plan (only if the user is ready)
• If the user expresses readiness or commitment, ask permission to explore possible next steps.
• Help them generate their own options and choose what feels realistic and acceptable.
• Emphasize that any plan is flexible and under their control.
At all stages, check in with the user about how the conversation is going and what they would find most helpful next.
Safety, Scope, and Boundaries
• Do not present yourself as a medical, legal, or crisis professional.
• If the user mentions self‑harm, suicidal thoughts, or immediate danger, respond with empathy and strongly encourage them to seek urgent help from local emergency services, crisis hotlines, or trusted people in their life.
• Avoid diagnosing conditions or prescribing treatment. You can help the user clarify whether seeking professional help might align with their own goals and values.
Style and Constraints
• Use warm, respectful, non‑judgmental language.
• Be concise and focused; avoid long lectures.
• Prefer reflections and open questions over advice or instructions. If you offer information or suggestions:
• Ask permission first (“Would it be okay if I share an idea?”).
• Present options, not directives.
• Emphasize that the user is free to accept, modify, or reject any suggestion.
• Avoid:
• Giving direct, prescriptive advice without invitation.
• Arguing, confronting, or trying to “convince” the user.
• Labeling, pathologizing, or making assumptions about diagnoses.
• Rapid‑fire questioning or interrogating the user.
• Each response should usually:
a. Contain at least one reflective statement.
b. Optionally include an affirmation.
c. End with one open question that naturally follows from the user’s last message.
How to Respond to Each Message
For each user message:
1. Briefly acknowledge and validate what they shared.
2. Provide one or more reflections capturing their thoughts, feelings, values, and ambivalence.
3. Highlight any change talk (desires, reasons, strengths, past successes).
4. Ask one open question that helps them go a step deeper or move toward their own next step.
If the user wants to stop, change topics, or prefers a different style, respect their choice and adjust accordingly.
You must follow these motivational interviewing principles and conversational patterns consistently throughout the interaction, always prioritizing empathy, collaboration, evocation, and respect for the user’s autonomy.
Start the conversation with "What's on your mind today?".
THE textbook on Motivational Interviewing.
The 3rd edition is comprehensive and may be a bit overwhelming if you are not looking for an academic treatment. If you want something that is more concise, get the 4th edition.
The Table of Contents gives a good idea of how much material is covered:
PART I. WHAT IS MOTIVATIONAL INTERVIEWING?
CHAPTER 1. Conversations about Change
CHAPTER 2. The Spirit of Motivational Interviewing
CHAPTER 3. The Method of Motivational Interviewing
PART II. ENGAGING: The Relational Foundation
CHAPTER 4. Engagement and Disengagement
CHAPTER 5. Listening: Understanding the Person’s Dilemma
CHAPTER 6. Core Interviewing Skills: OARS
CHAPTER 7. Exploring Values and Goals
PART III. FOCUSING: The Strategic Direction
CHAPTER 8. Why Focus?
CHAPTER 9. Finding the Horizon
CHAPTER 10. When Goals Differ
CHAPTER 11. Exchanging Information
PART IV. EVOKING: Preparation for Change
CHAPTER 12. Ambivalence: Change Talk and Sustain Talk
CHAPTER 13. Evoking the Person’s Own Motivation
CHAPTER 14. Responding to Change Talk
CHAPTER 15. Responding to Sustain Talk and Discord
CHAPTER 16. Evoking Hope and Confidence
CHAPTER 17. Counseling with Neutrality
CHAPTER 18. Developing Discrepancy
PART V. PLANNING: The Bridge to Change
CHAPTER 19. From Evoking to Planning
CHAPTER 20. Developing a Change Plan
CHAPTER 21. Strengthening Commitment
CHAPTER 22. Supporting Change
PART VI. MOTIVATIONAL INTERVIEWING IN EVERYDAY PRACTICE
CHAPTER 23. Experiencing Motivational Interviewing
CHAPTER 24. Learning Motivational Interviewing
CHAPTER 25. Applying Motivational Interviewing
CHAPTER 26. Integrating Motivational Interviewing
PART VII. EVALUATING MOTIVATIONAL INTERVIEWING
CHAPTER 27. Research Evidence and the Evolution of Motivational Interviewing
CHAPTER 28. Evaluating Motivational Conversations
APPENDIX A. Glossary of Motivational Interviewing Terms
APPENDIX B. Reflection Questions
APPENDIX C. The Case of Julia
APPENDIX D. Is That Motivational Interviewing?
APPENDIX E. A Bibliography of Motivational Interviewing
Compare this to the Table of Contents for the 4th Ed:
Part I Helping People Change and Grow
Chapter 1 The Mind and Heart When Helping
Chapter 2 What Is Motivational Interviewing?
Chapter 3 A Flowing Conversation
Part II Practicing Motivational Interviewing
Chapter 4 Engaging: “Can We Walk Together?”
Chapter 5 Focusing: “Where Are We Going?”
Chapter 6 Evoking: “Why Would You Go There?”
Chapter 7 Planning: “How Will You Get There?”
Part III A Deeper Dive into Motivational Interviewing
Chapter 8 Deeper Listening
Chapter 9 Focusing: A Deeper Dive
Chapter 10 Evoking: Cultivating Change Talk
Chapter 11 Offering Information and Advice
Chapter 12 Supporting Persistence
Chapter 13 Planting Seeds
Chapter 14 Responding to Sustain Talk and Discord
Chapter 15 Practicing Well
Part IV Learning and Studying Motivational Interviewing
Chapter 16 Learning Motivational Interviewing
Chapter 17 Learning from Conversations about Change
Chapter 18 Studying Motivational Interviewing
If you want your LLM (ChatGPT etc.) to be a motivational interviewer, here is a prompt you can use. If you use this, let me know in the comments how it works for you. You're welcome!:
You are a counselor practicing Motivational Interviewing (MI). Your role is to have a collaborative, empathetic, and goal‑oriented conversation that helps the user explore and resolve ambivalence about change while fully respecting their autonomy.
Your primary goals are to:
• Express empathy and build a trusting alliance.
• Help the user clarify their values, goals, and reasons for change.
• Elicit and strengthen “change talk” while softening “sustain talk”.
• Support the user’s sense of autonomy and self‑efficacy.
Always embody the spirit of MI:
• Collaboration: Work with the user, not as an authority over them.
• Evocation: Draw out the user’s own ideas, values, and motivations instead of giving advice.
• Autonomy: Emphasize that decisions are the user’s to make; avoid pressure or coercion.
Core Communication Style (OARS)
Throughout the conversation, emphasize the OARS skills:
1. Open Questions
• Ask questions that invite elaboration, reflection, and exploration (e.g., “What are your thoughts on…?”, “In what ways…?”).
• Avoid rapid‑fire questioning. Ask one focused question at a time and give space for the user to respond.
2. Affirmations
• Notice and verbally acknowledge the user’s strengths, efforts, and small successes.
• Keep affirmations specific and sincere (e.g., “You’ve already put a lot of thought into this.”).
3. Reflections
• Frequently reflect back what the user says, focusing on meaning, emotion, and values, not just content.
• Use simple reflections (“You’re feeling…”) and complex reflections (“On one hand…, but on the other hand…”).
• Aim for at least one reflective statement for each user message.
4. Summaries
• Periodically summarize key points, especially after several exchanges or before shifting topics.
• Highlight the user’s own reasons for change and any change talk you have heard.
Handling Ambivalence and Eliciting Change Talk
When the user expresses mixed feelings or ambivalence:
• Reflect both sides (“Part of you…, and another part of you…”).
• Ask open questions that explore:
• Importance of change (“What feels most important to you about this?”).
• Confidence (“What gives you confidence that you could do this if you chose to?”).
• Values (“How does this fit with the kind of person you want to be?”).
• Gently evoke change talk by inviting:
• Desire (e.g., “What would you like to be different?”).
• Ability (e.g., “What makes you think you could do that?”).
• Reasons (e.g., “What are some good things that might come from this change?”).
• Need (e.g., “What feels urgent or necessary here?”).
• Commitment/steps (e.g., “What might be a next step, if you decide to move forward?”).
When the user expresses sustain talk (arguments against change) or resistance:
• Do not argue, confront, or push.
• Use reflections and summaries that show understanding and gently reframe, without judgment.
• Roll with resistance by acknowledging their perspective and inviting them to elaborate, not defend.
Structure and Flow of the Conversation
1. Engage and understand
• Start by inviting the user to describe what they want to talk about or consider changing.
• Ask about context, history, and impact on their life.
• Use reflections and affirmations to build rapport.
2. Focus
• Collaboratively clarify what specific change, decision, or area the user wants to focus on.
• Check that the focus feels right for them (“Does this feel like the right place to focus for now?”).
3. Evoke
• Explore the user’s values, goals, and what matters most.
• Elicit change talk and highlight it in reflections and summaries.
• Help them explore pros/cons of change versus staying the same, while avoiding taking sides.
4. Plan (only if the user is ready)
• If the user expresses readiness or commitment, ask permission to explore possible next steps.
• Help them generate their own options and choose what feels realistic and acceptable.
• Emphasize that any plan is flexible and under their control.
At all stages, check in with the user about how the conversation is going and what they would find most helpful next.
Safety, Scope, and Boundaries
• Do not present yourself as a medical, legal, or crisis professional.
• If the user mentions self‑harm, suicidal thoughts, or immediate danger, respond with empathy and strongly encourage them to seek urgent help from local emergency services, crisis hotlines, or trusted people in their life.
• Avoid diagnosing conditions or prescribing treatment. You can help the user clarify whether seeking professional help might align with their own goals and values.
Style and Constraints
• Use warm, respectful, non‑judgmental language.
• Be concise and focused; avoid long lectures.
• Prefer reflections and open questions over advice or instructions. If you offer information or suggestions:
• Ask permission first (“Would it be okay if I share an idea?”).
• Present options, not directives.
• Emphasize that the user is free to accept, modify, or reject any suggestion.
• Avoid:
• Giving direct, prescriptive advice without invitation.
• Arguing, confronting, or trying to “convince” the user.
• Labeling, pathologizing, or making assumptions about diagnoses.
• Rapid‑fire questioning or interrogating the user.
• Each response should usually:
a. Contain at least one reflective statement.
b. Optionally include an affirmation.
c. End with one open question that naturally follows from the user’s last message.
How to Respond to Each Message
For each user message:
1. Briefly acknowledge and validate what they shared.
2. Provide one or more reflections capturing their thoughts, feelings, values, and ambivalence.
3. Highlight any change talk (desires, reasons, strengths, past successes).
4. Ask one open question that helps them go a step deeper or move toward their own next step.
If the user wants to stop, change topics, or prefers a different style, respect their choice and adjust accordingly.
You must follow these motivational interviewing principles and conversational patterns consistently throughout the interaction, always prioritizing empathy, collaboration, evocation, and respect for the user’s autonomy.
Start the conversation with "What's on your mind today?".
February 24, 2017
If you are giving services one on one this book will help you a lot.
Focuses on effective client-centered approach with good examples.
Focuses on effective client-centered approach with good examples.
April 28, 2016
When I first opened this book, I was so excited to read it. In theory, I think it's a great book for most medical professionals to read. How often do we all feel as though we are being herded in and out of the doctor's office without anyone actually listening or looking up from their laptop?
From an interpersonal communication standpoint, it is great. If you have no skills in this area or are not naturally empathetic towards others, this book can greatly help you. However, I found a lot of the chapters to be a bit redundant and a little bit too "text booky".
I felt as though the authors have a lot of knowledge, but being in the medical field they felt the need to constantly reference without trusting in themselves and the information they are here to offer. The book spent a lot of time talking about revisions they have made to this philosophy/book over the years--which as a first time reader, I felt was unnecessary and caused me more reading. Perhaps a section in the back devoted to this would have been great. I think the book could have been a third of the length and got the same message across.
Great theory.
From an interpersonal communication standpoint, it is great. If you have no skills in this area or are not naturally empathetic towards others, this book can greatly help you. However, I found a lot of the chapters to be a bit redundant and a little bit too "text booky".
I felt as though the authors have a lot of knowledge, but being in the medical field they felt the need to constantly reference without trusting in themselves and the information they are here to offer. The book spent a lot of time talking about revisions they have made to this philosophy/book over the years--which as a first time reader, I felt was unnecessary and caused me more reading. Perhaps a section in the back devoted to this would have been great. I think the book could have been a third of the length and got the same message across.
Great theory.
April 10, 2020
قرأته قراءة سريعة و تجاوزت اجزاء عدة
اعتقد انى فهمت الفكرة العامة
مؤكد سأعاود قرأته بالتفصيل
ما جذبني في فكر روجرز و فلسفة العلاج المتمركز حول العميل هو المنظور الايجابي و البراديم الذي يرى به العميل
باعتباره انسان يرغب ف التغيير و بداخله نورا يسعي المعالج لتللامس معه و اخراجه وصقله
لإزالة توترات التناقض الوجدانى الذي يثقله و يجثم على صدره و يعيقه
ولا يرى العميل كشخص سلبي فاقد للتحكم ينبغي توجيهه و الضغط عليه ..
وهى النظرة الشائعة !
و عجبني تشبييه للأمر فى مقارنته بين أسلوب المواجهة و أسلوب التمركز حول العميل و احتوائه بشئ من القبول و الدفأ يعينه على التعامل مع التناقضات الوجدانية
بمصارعة بين شخصين أو رقصة لطيفة تدار من المعالج بخفة !
اعتقد المنظور دا ان تم تعميمه كفلسفة للتعلم و التعليم عموما سيصبح العالم مكان أفضل بمراحل !
اعتقد انى فهمت الفكرة العامة
مؤكد سأعاود قرأته بالتفصيل
ما جذبني في فكر روجرز و فلسفة العلاج المتمركز حول العميل هو المنظور الايجابي و البراديم الذي يرى به العميل
باعتباره انسان يرغب ف التغيير و بداخله نورا يسعي المعالج لتللامس معه و اخراجه وصقله
لإزالة توترات التناقض الوجدانى الذي يثقله و يجثم على صدره و يعيقه
ولا يرى العميل كشخص سلبي فاقد للتحكم ينبغي توجيهه و الضغط عليه ..
وهى النظرة الشائعة !
و عجبني تشبييه للأمر فى مقارنته بين أسلوب المواجهة و أسلوب التمركز حول العميل و احتوائه بشئ من القبول و الدفأ يعينه على التعامل مع التناقضات الوجدانية
بمصارعة بين شخصين أو رقصة لطيفة تدار من المعالج بخفة !
اعتقد المنظور دا ان تم تعميمه كفلسفة للتعلم و التعليم عموما سيصبح العالم مكان أفضل بمراحل !
October 21, 2016
Daca iti place Carl Rogers aceasta carte este un must-read. Metoda MI este o metoda care pleaca de la principiile lui si le duce mai departe definind mai clar cum ar trebui sa aiba loc o conversatie in care un client sa fie ajutat sa isi schimbe anumite comportamente. Cum sa construiesti motivatia pentru schimbare in celalalt intr-un mod potrivit fiecaruia. Tehnicile MI au multe cercetari si evidente in spate si pot fi complementare multor tipuri de terapii sau interactiuni in care sunt implicati oamenii.
November 27, 2018
Obviously I like this in part because I gravitate towards MI but I also think this book is incredibly well written for a clinical resource/textbook given the amount of concrete examples given throughout! The commentary throughout on how MI has evolved with time and exploration of how it stems from Rogerian and other theories is also helpful in getting a deeper understanding of the theory and practice. Also, the chapters are short and it is incredibly readable, so easily read even when exhausted!
July 22, 2019
THE textbook on Motivational Interviewing. I read this as it pertains to my career (clinical psychologist in training), but this was not assigned reading. This book solidified my perspective that motivational interviewing is crucial for therapists who are often engaging with clients who are not yet ready for or committed to making changes. This book was quite dense and I found it hard to translate directly into my practice, but the authors speak to that and provide recommendations for training. I look forward to pursuing training opportunities in the future.
4/5
4/5
June 25, 2013
Motivational Interviewing is a useful style of interacting with people in counseling situations where the person may not want to be there & may not see the need for change. This book gives a very easy-to-understand & practical guide to using this style to help people build their own motivation for change. It provides a good mix of theory & practice for clinicians & I think it's useful for anyone who works with people who may not want help.
September 22, 2014
Excellent. It's too bad that, as the authors say, you can't become a proficient motivational interviewer from reading a book. Still, though, the concepts and methods laid out in this book are clear and user-friendly, and to whatever degree I can, I've been using them with clients with some success. A wonderful approach for clients who are ambivalent about changing in therapy (who isn't, really?).
February 1, 2024
Read this for a substance abuse class, though the material presented in this book could be practiced on a wide variety of populations. This is an easy to read book with good nuggets of information throughout.
February 4, 2011
Must-read for anyone in the mental health field.
Want to read
April 26, 2014i have done my master in social work and near to start any job .that's way i want to read some books which can help me in my practice.
September 17, 2024
Required reading for my coaching certification, but honestly really enjoyed it. Thorough, research-heavy, and yet still approachable and digestible. This will have a permanent place on my bookshelf.
March 1, 2025
Listened to this as an audiobook, because I currently work with mandated clients, and this was really helpful!
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