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Motivational Interviewing: A Communication Tool for Change

Motivational interviewing is a communication style that helps people make behavior changes by exploring and resolving their own ambivalence. Instead of a directive approach, motivational interviewing allows people to sort through their own problems—and discover their own motivations to change.

This person-centered approach uses genuine empathy, respect and collaboration to elicit positive, sustainable behavioral change. Nurses, social workers and professional counselors often use this technique to help clients, but motivational interviewing is a versatile technique that anyone can use in many areas of life. Motivational interviewing is especially beneficial for older adults who may benefit from lifestyle changes, but do not want to be ignored or told what to do.

For example, if a family member feels their older loved one is having trouble living alone, but is met with hesitation, motivational interviewing can be a useful tool to begin the conversation about transitioning to senior living.

Motivational Interviewing Techniques

When practicing motivational interviewing, there are four techniques that help build engagement and trust between the two parties—the listener and the speaker. Remember OARS.

  1. Open-Ended Questions
    What are some open-ended questions you can ask to increase engagement? Open-ended questions give the speaker control while allowing them to share fears, hesitations and barriers that are preventing change.
  2. Affirmation Statements
    Using affirmation statements such as “I appreciate that you…” shows appreciation, support and encouragement by recognizing and acknowledging positive behaviors. It shows that you view the speaker as an equal partner and respect their sense of self.
  3. Reflection
    Reflecting on what the speaker says and labeling their feelings helps increase trust, improve communication and foster motivation to change. Reflective listening using phrases such as “So you feel…” or “It sounds like…” allows the speaker to feel heard and provides opportunities for clarification while boosting confidence for change.
  4. Summarizing
    Similar to reflective listening, summarizing ensures clear communication between the listener and speaker. Starting with phrases such as “Here is what I heard from you…” or “Let me see if I understand…” allow the speaker to hear their reasons and motivations expressed back to them.


Processes of Motivational Interviewing

The four processes of motivational interviewing help you use the OARS techniques in a strategic, powerful way.

  1. Engaging
    During the engagement step, you spend time listening to the other person and building your relationship—without trying to fix the problem. Open-ended questions prompt the speaker to be an active participant in the conversation and provide more information about their situation.
  2. Focusing
    The focusing process is where the listener hones in on the area that is most important to the other person. This is where affirmation statements and reflection techniques can help uncover a clear direction and target behavior.
  3. Evoking
    For motivational interviewing to be successful, it’s important for people to identify their own internal motivations and reasons for change. The listener can then use OARS techniques to reinforce positive points and guide the client to come up with a plan for change.
  4. Planning
    During the planning phase, the listener can work with the speaker to come up with specific, actionable goals that can be used to measure progress.

Motivational interviewing is only effective if a person is willing to change. If someone is angry or resistant about something, it can be difficult to engage. For someone with dementia, a regular routine helps maintain a sense of familiarity and control; any changes may feel too scary. Even in these challenging situations, motivational interviewing techniques can help change the dynamic to promote positive, progressive change.