Making changes in our lives can be a challenging and scary experience. Having reservations or concerns about making changes is a normal part of life, and can often present as a concern for the clients we work with. So what helps us reach a point where we are ready to make a change? Keep reading to explore 10 Motivational Interviewing Activities and exercises you can do with clients.
For more valuable resources, view our Motivational Interviewing Tools and Resources hub
There are three key factors needed for individuals to be ready to change. To begin, they need to feel as though they want to make the change. This is often connected to developing internal sources of motivation. We need to feel as though we have the skills to support us while we make the change. This can include learning and practicing skills that we have not developed yet. Lastly, feeling supported by those around us can have a lasting impact on our desire to change a behavior or work towards a goal. Connection is an important part of our lives, and it can help us feel safe when taking risks and making changes.
Motivational interviewing, also known as MI, combines the values of humanistic psychology and principles from person-centered counseling into a commonly used treatment modality (Seligman, L. & Reighenberg, L.W., 2010). Motivational interviewing was developed by William Miller and Stephen Rollnick in the 1980s and has continued to benefit clients in the decades since. Counselors and Therapists can use motivational interviewing techniques to promote behavioral change within our clients when they are ready (Seligman, L. & Reighenberg, L.W., 2010).
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When we use motivational interviewing strategies and skills in sessions, we allow our clients to control the sessions. They are viewed as the experts of their history and experiences, whereas we are allies that can help them reach goals that they may have. MI avoids talking about mental health diagnoses and persuasion.
The spirit of motivational interviewing the spirit of motivational interviewing includes:
- Collaboration
- Evocation
- Compassion
- Acceptance
The combination of the four components of the MI spirit helps develop an environment that allows clients to feel safe and welcome, even with reluctance about being there. A focus within motivational interviewing is developing a healthy therapeutic alliance so that there is a supportive environment for change. Counselors work to explore ambivalence that clients may have about making behavioral changes, and reframe their concerns rather than confronting the client.
Mental Health Concerns That Can Benefit from Motivational Interviewing Therapy
When motivational interviewing was initially developed by Miller and Rollnick, it was used to work with clients who were struggling with alcohol use and abuse (Seligman, L. & Reighenberg, L.W., 2010). A motivational enhancement therapy program was developed and included 4 sessions over a 12-week period for those who were struggling with their drinking behaviors (Seligman, L. & Reighenberg, L.W., 2010).
Since then, motivational interviewing has been used with clients living with other mental health concerns and behavioral issues. This includes individuals living with eating disorders, and clients living with a dual diagnosis (Seligman, L. & Reighenberg, L.W., 2010). Motivational interviewing can effectively be used with adolescents, couples, and individuals who are incarcerated (Seligman, L. & Reighenberg, L.W., 2010).
Motivational interviewing works best with individuals who are in the pre-contemplation or contemplation stage of change. These are clients who have not fully committed to behavioral change and still have reservations about making changes to their life. Because of this, MI may not be as effective for clients who are already committed to making changes in their lifestyles. Additionally, motivational interviewing may not be the best fit for clients who are struggling with trauma, post-traumatic stress disorder, depression, and other severe mental health concerns.
Motivational Interviewing Activities to do with Clients
Motivational interviewing activities can be an effective tool for counselors who are working with ambivalent clients. We know that motivational interviewing skills can be used to help our clients make a shift in their thinking, which can help them move towards making behavioral changes. If you are interested in using motivational interviewing activities with your clients, there are several options you can choose from.
Motivational Interviewing activities that can be used during therapy sessions include:
1. Core Values Exploration
When we are working with clients who have reservations or are unsure about making changes regarding a behavioral concern, a commonly used motivational interviewing exercise includes exploring the client’s core values. By exploring what is important to them, we can support our clients while they investigate the relationship between their values and their current behaviors. Thinking of important values in session can be challenging when put on the spot, so many clients may benefit from using a Core Values Worksheet, like the one available at TherapyByPro. Allow for time to process their experience after completing the worksheet, and explore any reflections they may have.
What It Is: A structured reflection on what matters most to the client, often supported by a Core Values Worksheet.
How It Helps Clients: Helps clients examine discrepancies between their values and current behaviors, which can naturally evoke motivation for change.
How to Do It: Invite clients to identify key values using a worksheet if needed. Process reflections together and explore how current behaviors align—or conflict—with those values without judgment or pressure.
2. Pros and Cons (Decisional Balance)
A simple MI exercise that we can do with our clients is to make a T chart that lists the pros and cons of making a change to their behavior. This list does not need to dive into the emotion behind the pros and cons but can focus on simply creating the list. Once we have a completed pro and con chart, we can then spend time exploring the two categories, and if seeing the pros and cons written out have any impact on the client’s motivation for change.
What It Is: A T-chart listing the pros and cons of changing versus maintaining a behavior.
How It Helps Clients: Normalizes ambivalence and helps clients gain clarity about their mixed feelings regarding change.
How to Do It: Create the chart collaboratively. Once complete, reflect back what you hear and explore whether seeing the list influences motivation or perspective.
3. Readiness Ruler
Another tool that counselors can use with clients who are unsure about making changes to their lifestyle or behaviors is a Readiness Ruler. The key to this motivational activity is the discussion that explores questions such as why they rated the importance of changing the behavior, what would make their desire for change increase, and what they would be giving up if they were to make this change. This discussion can provide clients with an opportunity to explore their ambivalence.
What It Is: A scaling tool (e.g., 0–10) that measures readiness, importance, or confidence related to behavior change.
How It Helps Clients: Encourages self-reflection and helps clients articulate their own reasons for change.
How to Do It: Ask why the client chose their number, what would increase it, and what they might lose by changing. Use reflective listening to explore ambivalence.
4. OARS Skill Practice
Counselors who are using motivational interviewing can use a variety of counseling skills including open-ended questions, making affirmations, using reflections, and summarizing. These skills can easily be remembered by using the acronym OARS. These skills help the client facilitate the session and have the clinician walk alongside the client as they progress through their counseling journey.
What It Is: Use of the OARS framework: Open-ended questions, Affirmations, Reflections, and Summaries.
How It Helps Clients: Enhances engagement, builds rapport, and encourages clients to lead the conversation toward change.
How to Do It: Intentionally incorporate OARS during sessions. Reflect change talk when it appears and summarize client statements to reinforce insight and motivation.
5. Change Plan Exercise
TherapyByPro offers a Change Plan Worksheet that can be used to explore questions such as what they are looking to change, why this change is important, obstacles that they may experience, and what skills they have that can support them while they make the change. Additionally, clients are asked to explore a challenge in the past that they were able to overcome and what helped them through that time. Using this worksheet to help guide a conversation would allow clients to talk about their concerns and hesitations without feeling judged or criticized.
What It Is: A structured worksheet exploring desired changes, reasons for change, potential obstacles, and existing strengths.
How It Helps Clients: Strengthens self-efficacy and helps clients feel supported rather than judged while planning change.
How to Do It: Complete the worksheet collaboratively. Highlight past successes and client strengths, and revisit the plan as motivation evolves.
6. Change Talk Psychoeducation
Motivational interviewing includes focusing on the importance of change talk. In order to do this, we can provide psychoeducation about change talk and the benefits that it can have on our reservations about changing. Spend time talking about the difference between change talk and sustain talk. Time can be spent exploring their personal examples of sustained talk, and how they can be modified to fit into a change talk mindset.
What It Is: Psychoeducation about the difference between change talk (statements favoring change) and sustain talk (statements favoring the status quo).
How It Helps Clients: Empowers clients to notice and strengthen their own motivation for change.
How to Do It: Explain both types of talk and invite clients to identify examples from their own language. Reflect and reinforce change talk as it emerges.
7. DARN: Desire Exploration
To build on the importance of change talk, TherapyByPro offers worksheets that align with the motivational interviewing acronym DARN. DARN stands for desire, ability, reasons, and need for change, which are key components of change talk. The Desire Questions Worksheet can help clients explore their own desire for change. This worksheet has three main questions, followed by a rating question that asks about the strength of their desire to change. Allow time to process this worksheet, and explore any shifts in their perspective that has occurred while completing this worksheet.
What It Is: A worksheet-based exercise focusing on the client’s desire to make a change, aligned with the DARN framework.
How It Helps Clients: Clarifies internal motivation and highlights emotional and personal reasons for change.
How to Do It: Guide clients through reflective questions and rating scales. Process any shifts in perspective that occur during completion.
8. DARN: Ability Exploration
Following the worksheet discussed above, TherapyByPro offers worksheets to explore the other aspects of the DARN acronym. The Ability Worksheet explores what skills are needed to accomplish their goal, tasks they need to do to accomplish their goal, and ideas that they have about how they can accomplish their goal. Each of the questions is followed by a rating scale regarding their perceived ability to accomplish the listed task. Time can be spent exploring any shifts in your client’s perspective that have occurred since completing the worksheet.
What It Is: A worksheet that examines skills, tasks, and strategies needed to accomplish a goal, with self-ratings of confidence.
How It Helps Clients: Builds self-efficacy and identifies areas where additional support or skill-building may be helpful.
How to Do It: Review responses together and reflect changes in confidence. Emphasize strengths and past experiences of success.
9. DARN: Reasons Exploration
The TherapyByPro Reasons Worksheet continues to explore the DARN acronym. This worksheet focuses on the reasons why they should work towards accomplishing their goal or making a behavioral change. This includes the downsides of staying as they currently are, the benefits of changing, and their motivation for wanting to change. After each question, the client is asked to rate the strength of their response in compelling them to make a change. Allow for time to explore any shifts in their perspective that may have occurred in their thinking since completing the worksheet.
What It Is: A worksheet focused on identifying personal reasons for change and rating their motivational impact.
How It Helps Clients: Deepens intrinsic motivation and clarifies what makes change meaningful to the client.
How to Do It: Discuss each response and reflect emotionally salient reasons. Explore whether completing the worksheet shifted motivation.
10. DARN: Need Exploration
The Need Worksheet focuses on exploring the urgency in reaching their goal or making the identified behavior change. Questions included on this worksheet are what needs to change, why the change is important, and what they need to do. Time can be spent exploring if their need to change is compelling, and the importance of their to-dos. Allow for time to explore any shifts in their perspective that may have changed while completing this worksheet.
What It Is: An exercise exploring why change matters now and what steps feel necessary.
How It Helps Clients: Helps clients articulate urgency and prioritize action while maintaining autonomy.
How to Do It: Review responses collaboratively and explore whether the sense of urgency feels compelling or evolving. Reinforce client-led conclusions.
Frequently Asked Questions About Motivational Interviewing (MI) Activities
Below are the practical questions clinicians ask when facilitating Motivational Interviewing (MI) exercises and behavioral activities to help clients navigate ambivalence, elicit change talk, and strengthen internal motivation.
How should a clinician decide whether to introduce a core values exploration or a decisional balance worksheet first?
The choice depends on the client’s current location within the early stages of change and the nature of their ambivalence. For clients in the pre-contemplation stage who do not yet recognize a problem, a core values worksheet is an effective initial activity to gently highlight discrepancies between long-term priorities and present behavioral choices. Conversely, for clients in the contemplation stage who are actively torn between changing and maintaining a habit, a decisional balance chart is typically more useful to systematically map their mixed feelings without introducing clinical pressure.
What clinical adjustments should a therapist implement if a readiness ruler exercise causes a client to double down on sustain talk?
If a scaling exercise accidentally provokes a defensive justification for keeping things the same, the therapist should immediately pivot back to the spirit of MI by rolling with resistance and utilizing open-ended reflection. For example, if a client rates their readiness as a 3, instead of asking why it is not a higher number, the clinician should ask what makes it a 3 rather than a 0. This targeted inquiry prompts the client to articulate their own internal reasons for desire, ability, or need, safely redirecting the dialogue back toward change talk.
How do MI change plan activities fundamentally differ from CBT goal-setting worksheets?
While CBT goal-setting tasks usually assume the client is already fully committed to action and focus on structuring highly specific, observable homework steps, MI change plans are explicitly designed to honor client autonomy during ambivalence. An MI change plan worksheet explores not just the ‘what’ and ‘how’ of change, but deeply investigates internal motivations, potential lifestyle obstacles, and past resilience strategies. The clinician acts strictly as an ally, allowing the client to remain the primary expert on their personal timeline and readiness parameters.
Why are intensive philosophical or deep trauma-processing activities often contraindicated when introducing MI change talk?
MI activities are specifically engineered to build self-efficacy and resolve mixed motivations regarding targeted behavioral patterns, making them ideal for pre-contemplation and contemplation stages. Introducing heavy existential reflections or deep trauma processing during these phases can inadvertently amplify psychological distress, overwhelm the client’s coping capacity, and stall their readiness to change. In these scenarios, the clinician should keep the focus on immediate lifestyle goals and intrinsic motivators before attempting deeper emotional exploration.
How can a therapist objectively measure progress when utilizing the DARN framework across consecutive client sessions?
Progress should be measured by monitoring the evolving ratio of change talk to sustain talk within the client’s natural language patterns rather than tracking mere verbal compliance. Clinicians can review a client’s input across desire, ability, reasons, and need worksheets to observe if their spoken statements show an increasing sense of urgency or confidence. Growth is demonstrated when the client voluntarily steps out of passive ambivalence, begins formulating their own practical to-do steps, and actively initiates change talk without prompt.
Final Thoughts On Choosing Activities for Motivational Interviewing
The list of clients who can benefit from the use of motivational interviewing has grown significantly since it was developed in the ‘80s. The truth about our work is that we work with clients who are seeking help to please others. Whether this is a spouse, another family member, school, an employer, or a legal entity, external motivation can sometimes be more impactful than internal motivation.
Motivational interviewing can be used to help clients develop internal motivation as the explore the behavioral change or goal that brought them to you. Motivational interviewing can be used as a tool to help facilitate and promote a healthy therapeutic relationship when you begin meeting with new clients. Once your client has moved into the action phase of the stages of change, you can then begin using other therapeutic approaches.
TherapyByPro is a trusted resource for mental health professionals worldwide. Our therapy tools are designed with one mission in mind: to save you time and help you focus on what truly matters-your clients. Every worksheet, counseling script, and therapy poster in our shop is professionally crafted to simplify your workflow, enhance your sessions, reduce stress, and most of all, help your clients.
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View all of our Motivational Interviewing Therapy Worksheets
Resources:
- Seligman, L. & Reichenberg, L.W. (2010). Theories of counseling and psychotherapy: Systems, strategies, and skills (3rd Edition, pp 159). Pearson Education, Inc.