Motivational interviewing

Domain III · Humanistic, existential & experiential · William R. Miller, Stephen Rollnick · 1983 · New Mexico

What it is

Motivational interviewing (MI) is a collaborative, person-centred way of guiding a conversation about change. It was first described by William R. Miller (University of New Mexico) in 1983 in work with problem drinkers, and developed with Stephen Rollnick (Cardiff) from 1991. MI is not a…

Format

• Session count and format. MI has no fixed number of sessions.
• Brief use: a single 15–50-minute conversation in health, social care or counselling settings.

Who practises it, and how they are trained or regulated

• Version followed: Miller & Rollnick (2023), Motivational Interviewing: Helping People Change and Grow, 4th ed. (Guilford), for structure and terms: four tasks (engaging, focusing, evoking, planning) plus the later chapters on information and advice, supporting persistence, planting seeds, and sustain talk and discord. The 4th edition's own chapter text is not drawn on. Operational detail therefore comes from the 3rd…
• The 3rd edition gave this definition: "a collaborative, person-centered form of guiding to elicit and strengthen motivation to change" (Miller & Rollnick 2009, quoted in the MINT handout). A 4th-edition-based training manual gives the 2023 core definition as a "particular way of talking with people about change and growth" to strengthen the person's own motivation and commitment.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Over-apologising. It is working when the client re-engages.
• Ending on the sustain side. It is working when the client continues on the change side.
• Using it to avoid a necessary topic indefinitely. It is working when the tension drops.
• Reframes that minimise real difficulty. It is working when the client takes up the new frame.
• A parting lecture. It is working when the client leaves without defensiveness, and may return.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.