Motivational Interviewing (MI) is a collaborative, person-centered counseling style designed to address the common problem of ambivalence about change. Developed by Bill Miller and Stephen Rollnick in 1983, it focuses on strengthening a person's own motivation and commitment to a specific goal.
The "Spirit" of MI (PACE)
MI is defined less by technical skills and more by its underlying mindset, often summarized by the acronym PACE:
Partnership: A collaborative relationship between equals, rather than an "expert-recipient" dynamic.
Acceptance: Respecting the client’s absolute worth, supporting their autonomy, and showing accurate empathy.
Compassion: Prioritizing the client's welfare and well-being.
Evocation: Drawing out the client’s own ideas and reasons for change rather than imposing external ones.
Core Processes
Practitioners navigate four overlapping processes to guide the conversation:
Engaging: Establishing a helpful connection and working relationship.
Focusing: Developing and maintaining a specific direction or goal for change.
Evoking: Eliciting the client's own motivations and "change talk" (reasons for change).
Planning: Formulating a specific action plan once motivation is high enough.
Key Skills (OARS)
These four interaction skills are the foundational tools used throughout the session:
Open-ended questions: Invite the client to tell their story (e.g., "What worries you about your health?").
Affirmations: Acknowledging the client’s strengths, efforts, and past successes.
Reflective listening: Rephrasing or repeating what the client says to demonstrate empathy and explore deeper meaning.
Summaries: Gathering and reflecting back the main points of the conversation to ensure mutual understanding.
Guiding Principles (RULE)
Clinicians follow these four guiding principles to maintain the spirit of MI:
Resist the righting reflex: Suppressing the urge to fix the client's problems or offer unsolicited advice.
Understand motivation: Focusing on the client's personal reasons for changing.
Listen with empathy: Spending significant time listening to the client's perspective.
Empower the client: Fostering hope and the belief that the client is capable of change.