Clients who struggle to find or maintain motivation for change often benefit from Motivational Interviewing (MI). MI is a client-focused approach that elicits behavior change by processing ambivalence about change. This is a non-confrontational approach that focuses on helping clients find intrinsic motivation for change. Intrinsic motivation is typically more impactful and longer-lasting than external motivation from loved ones, employers, or legal entities. In this post, I run through 15+ Motivational Interviewing techniques and interventions you can use with your clients.
MI is commonly used within substance use disorder treatment programs. Addictions are complex mental health disorders that involve physical and psychological symptoms that can contribute to hesitation or low motivation for sobriety. You can help your client explore the benefits and costs of a behavioral change, remembering that denial and resistance are not an end-all to treatment.
MI is a directive approach that is known for its style and techniques. In collaborative therapy, clinicians view their relationship with clients as a partnership, recognizing that the client is the expert on their mind, environment, and experiences. Research indicates that, in clinical settings, MI is 80% more effective than advice-giving. A benefit to MI interventions is that they can vary in duration, with effectiveness found in 15-minute sessions.
For more valuable resources, view our Motivational Interviewing Tools and Resources hub
10 Motivational Interviewing Techniques
Motivational interviewing techniques are core skills that are used in the moment during sessions. These are known as the building blocks of MI and are continuously used in treatment. MI techniques are used to evoke change talk while minimizing resistance and respecting your clients’ autonomy. While techniques can often be used in conversations, they do require precision and intention on the clinician’s part.
1) Open-Ended Questions
Open-ended questions are a key MI technique for promoting engagement.
What It Is: Open-ended questions cannot be answered with “yes” or “no” and require a more extensive response that includes reflection and elaboration.
How It Helps Clients: Using open-ended questions can help clients explore their ambivalence or hesitation about change and promote change talk. They can also promote participation in sessions, thereby guiding conversations.
How To Do It: Avoid asking multiple questions in a row, beginning your questions with “What,” “How,” or “Can you tell me about.” You can follow up on your clients’ responses to promote deeper exploration.
2) Affirmations
Affirmations can reinforce your client’s efforts and strengths.
What It Is: Affirmations are an MI intervention that uses genuine statements acknowledging your client’s strengths, resilience, or attempts at behavior change.
How It Helps Clients: Affirmations can help strengthen the therapeutic alliance and help your client feel heard and seen. It can boost their confidence and increase self-efficacy.
How To Do It: Ensure your affirmations are specific and relate to your current concerns. When possible, tie your affirmations to the values they express.
3) Reflective Listening
Reflective listening is a key motivational interviewing intervention used throughout the treatment process.
What It Is: With reflective listening, you can restate your clients’ thoughts or rephrase them to show your understanding of what they’re saying.
How It Helps Clients: Reflective listening can promote the therapeutic relationship and reduce resistance. When clients feel understood, they can focus on the deeper concerns that contribute to their ambivalence. You can also use it to amplify change talk.
How To Do It: You can use simple reflections for effectiveness, but complex reflections can lead to confusion or misunderstandings. Try to focus on reflecting change talk more than sustain talk.
4) Summarizing
Summarizing is an MI technique that demonstrates active listening and helps your client feel seen and heard.
What It Is: With summarizing, you will provide recaps of key statements, especially when clients are using change talk.
How It Helps Clients: Summarizing can help organize topics being discussed and signal transitions or turning points in the session.
How To Do It: Summaries can focus on discrepancies in the topic of discussion and highlight their strengths. You can use summaries when you’re about to change topics by ending them with an open-ended session.
5) DARN-CAT
DARN-CAT is a key MI technique for evoking change talk.
What It Is: DARN-CAT is an acronym used to guide questions during a session. This includes desire, ability, reasons, need, commitment, activation, and taking steps.
How It Helps Clients: Eliciting change talk can increase the likelihood of engaging in behavior change. It can also increase clients’ intrinsic motivation and help them move closer to the action stage of change.
How To Do It: Begin by asking, “What are some benefits of changing?” You can then reinforce their commitment statements and encourage a deeper conversation when change talk arises.
6) Rolling with Resistance
Rolling with resistance is a commonly used MI technique that reframes resistance as information rather than as opposition.
What It Is: Rolling with resistance focuses on how you respond to the pushback your client shows in session. Reflections are used rather than arguments.
How It Helps Clients: This MI technique can reduce defensiveness and prevent power struggles in session, thereby protecting the therapeutic alliance.
How To Do It: With this technique, you will avoid correcting or trying to persuade your client. You may shift the focus if needed, but try to maintain neutral change talk.
7) Eliciting Change Talk
Eliciting change talk is a central MI technique used to intentionally guide conversations toward motivation for change while maintaining a collaborative stance.
What It Is: This technique involves intentionally guiding the conversation to draw out the client’s own arguments for change, rather than imposing reasons externally.
How It Helps Clients: When clients verbalize their own reasons for change, it increases commitment and likelihood of behavior change. Change talk is one of the strongest predictors of outcomes in MI and signals movement toward readiness.
How To Do It: Use evocative, open-ended questions such as “What concerns you about this?” or “How might things be different if you decided to make a change?” Listen carefully for change talk and reinforce it through reflections, affirmations, and summaries. Avoid over-directing the conversation, and allow space for clients to generate their own motivations.
8) Exploring Ambivalence
Exploring ambivalence is a foundational MI technique used to help clients safely examine mixed feelings about change without pressure or judgment.
What It Is: This involves helping clients openly examine both sides of their internal conflict about change, including both sustain talk and change talk.
How It Helps Clients: It allows clients to feel understood while clarifying competing motivations, which naturally supports movement toward change without increasing resistance.
How To Do It: Use open-ended questions and reflective listening to explore both sides of the ambivalence. You can use double-sided reflections to capture the tension (e.g., “On one hand…, and on the other…”). Avoid resolving the ambivalence for the client, and instead guide them toward their own conclusions.
9) Developing Discrepancy
Developing discrepancy is a core MI strategy for increasing motivation by gently highlighting inconsistencies in a client’s experience.
What It Is: This technique focuses on helping clients recognize the gap between their current behaviors and their broader goals, values, or identity.
How It Helps Clients: When clients become aware of this discrepancy, it can create internal discomfort that motivates change in order to restore alignment.
How To Do It: Use reflections, summaries, and values-based questions to highlight differences between what the client wants and what they are currently doing. Anchor the conversation in the client’s own stated values rather than imposing external standards. Be careful to maintain a nonjudgmental tone to avoid eliciting defensiveness.
10) Emphasizing Autonomy
Emphasizing autonomy is a core MI technique that reinforces client agency and supports a non-authoritarian therapeutic stance.
What It Is: This technique involves explicitly acknowledging that the client has full control over their choices and the direction of change.
How It Helps Clients: It reduces resistance, minimizes power struggles, and increases intrinsic motivation by reinforcing personal responsibility and ownership.
How To Do It: Use autonomy-supportive language such as “It’s completely up to you,” “You’re in charge of what happens next,” or “You know yourself best.” Avoid prescriptive or directive language, and consistently return decision-making power to the client, even when offering guidance or feedback.
7 Motivational Interviewing Interventions to Use in Sessions
Motivational interviewing interventions are structured applications of MI principles used at different stages of change. Interventions can organize the techniques listed above to help clients process their ambivalence and move closer to making changes in their behaviors. MI interventions maintain the MI spirit in sessions, specifically through collaboration, evocation, and support for autonomy.
1) Decisional Balance Intervention
You can use the decisional balance when clients experience high levels of ambivalence.
What It Is: This intervention is a structured exploration of the pros and cons of making behavioral changes in a safe and respectful way.
How It Helps Clients: Decisional balance can help you better understand your clients’ ambivalence and identify discrepancies. It can also promote thoughtful decision-making.
How To Do It: You can begin by exploring the benefits and costs of their current behavior. You can then compare the two without judgment, considering the facts.
2) Importance and Confidence Rulers
Importance and confidence rulers can be used to assess your client’s readiness to change.
What It Is: These are self-rating measures that rate motivation or confidence on a 0-10 scale.
How It Helps Clients: You can use these interventions to assess your clients’ current stage of change and elicit change talk. It can also help identify perceived barriers to change.
How To Do It: Begin by asking about the importance of change, then ask about their confidence in their ability to make the change. Follow up by asking questions like, “What makes it a 4 instead of a 2?” You can explore steps higher and lower to understand their reasoning.
3) Values Exploration Intervention
Values exploration is an intervention used to identify connections between a client’s behaviors and identity, thereby enhancing motivation.
What It Is: Values exploration exercises are structured conversations that help link behaviors to core values and highlight discrepancies.
How It Helps Clients: This can increase clients’ awareness of discrepancies between their values and behaviors, thereby increasing their intrinsic motivation.
How To Do It: You can begin by asking what matters most in your client’s life and encouraging them to focus on their core values. You can then explore how their current behaviors align with these values, and process emotional reactions they have to discrepancies.
4) Elicit–Provide–Elicit (EPE)
Elicit–Provide–Elicit is a structured intervention used to share information while maintaining the collaborative and client-centered spirit of MI.
What It Is: This intervention involves first eliciting what the client already knows, then providing information with permission, and finally eliciting the client’s interpretation or response.
How It Helps Clients: It prevents the “expert trap,” supports collaboration, and increases the likelihood that new information will be integrated in a meaningful and personalized way.
How To Do It: Begin by asking what the client already knows or believes about a topic. Ask permission before offering additional information (e.g., “Would it be okay if I shared something?”). Provide information briefly, neutrally, and without persuasion. Then follow up with questions like “What do you make of that?” or “How does that fit for you?” to process their response.
5) Agenda Mapping
Agenda mapping is a structured intervention used to collaboratively guide the focus and flow of a session.
What It Is: This involves identifying, organizing, and prioritizing topics for discussion in partnership with the client.
How It Helps Clients: It increases engagement, reinforces collaboration, and ensures that sessions remain aligned with the client’s goals and concerns.
How To Do It: Offer a menu of possible topics based on clinical relevance, then invite the client to add their own priorities. Use reflective listening to clarify what matters most to them, and collaboratively decide where to begin. Revisit the agenda as needed to maintain alignment throughout the session.
6) Menu of Options
Providing a menu of options is an intervention that supports autonomy by expanding perceived choices around behavior change.
What It Is: This involves offering multiple possible strategies or pathways for change rather than directing the client toward a single solution.
How It Helps Clients: It reduces resistance, enhances autonomy, and increases the likelihood that clients will choose an option that feels achievable and personally meaningful.
How To Do It: Ask permission before offering suggestions. Present options neutrally and without preference, and include the option of making no change. Encourage the client to select, modify, or generate their own options, reinforcing that the final decision is theirs.
7) Change Plan (or Change Planning)
Change planning is a structured intervention used to translate motivation into concrete, actionable steps once readiness for change has increased.
What It Is: This intervention involves collaboratively developing a personalized and realistic plan for behavior change.
How It Helps Clients: It strengthens commitment, increases clarity, and helps bridge the gap between intention and action.
How To Do It: Begin by assessing readiness and ensuring sufficient change talk is present. Collaboratively explore specific goals, actionable steps, potential barriers, and sources of support. Use summaries to reinforce commitment language and clarify next steps. Maintain flexibility, allowing the client to adjust the plan as needed.
Other Helpful Motivational Interviewing Resources
MI therapy is a collaborative approach that is highly effective for clients who struggle to find or maintain intrinsic motivation to change. Clinicians rely on TherapyByPro’s evidence-based, customizable resources to enhance their work. Whether you need note templates, worksheets, activities, or a treatment plan reference, we are here for you. Below are examples of popular resources available on our website:
- Creating a Motivational Interviewing Treatment Plan
- 40 Motivational Interviewing Questions to ask Clients
- Motivational Interviewing Activities & Exercises
- View all of our Motivational Interviewing Worksheets you can use with clients.
Frequently Asked Clinical Questions
Below are FAQs clinicians are asking:
How does a clinician differentiate between healthy ambivalence and a structural rupture in the therapeutic alliance during high-resistance sessions?
Observe whether the client’s pushback targets the behavior change itself or the immediate person and direction of the therapist. Healthy ambivalence manifests as mixed feelings or internal conflict regarding change (sustain talk), whereas an alliance rupture involves explicit interpersonal tension, defensiveness, or personal withdrawal from the collaborative partnership, requiring immediate therapeutic repair before utilizing standard motivational techniques.
What is the recommended clinical protocol if rolling with resistance fails and a power struggle begins over substance use or lifestyle habits?
Pause the current line of questioning immediately, step back from the persuasive stance, and explicitly emphasize client autonomy. Pivot away from trying to correct or convince the client, and utilize simple reflections or double-sided reflections to validate their absolute agency, acknowledging that the final choice to make a behavioral change rests completely in their hands.
How should a therapist handle a client who consistently provides low ratings on both the importance and confidence rulers?
Shift the clinical focus toward exploratory values clarification rather than trying to force concrete change planning or action steps. Use open-ended, evocative questions to investigate what matters most in their broader life, slowly developing discrepancy between their deeply held personal values and their current self-defeating behavioral patterns to build foundational intrinsic motivation.
When is it clinically appropriate to transition from open-ended exploration to a structured change plan intervention?
Initiate the change planning phase when the client’s dialogue demonstrates a clear and consistent shift from preparatory change talk (DARN) to mobilizing change talk (CAT). Attempting to draft a structured menu of options or action steps before the client explicitly voices commitment, activation, and readiness will trigger defensive resistance and increase sustain talk.
Can advanced motivational interviewing techniques be effectively utilized with mandated or involuntary clients under legal pressure?
Yes, provided the practitioner avoids the expert trap and remains entirely non-confrontational throughout the treatment process. Explicitly acknowledge the external legal pressure during agenda mapping, maintain an unconditional, non-judgmental stance, and consistently offer a menu of choices to demonstrate that their personal responsibility and freedom of choice remain intact within those external constraints.
Final Thoughts on Using Motivational Interviewing in Sessions
Motivational Interviewing operates within a respectful, collaborative framework that can gently guide your client towards meaningful change. Clients are encouraged to explore their own reasons for change and work through hesitation at their own pace. This can help ensure your client feels safe and in control of their progress, thereby strengthening the therapeutic alliance and promoting treatment engagement.
With that said, our overview of MI interventions and techniques is a brief introduction to skills that you can use. Using MI requires precision, intentionality, and practice. Developing competency can include formal training, supervised practice, and continued feedback. If this article has piqued your interest in the spirit of MI, we encourage you to pursue structured training and continuing education to deepen your skills and ethically incorporate MI into your clinical work.
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View all of our Motivational Interviewing Therapy Worksheets
- References:
Rubak S, Sandbaek A, Lauritzen T, Christensen B. Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract. 2005 Apr;55(513):305-12. PMID: 15826439; PMCID: PMC1463134