The document outlines the key principles and techniques of motivational interviewing including: collaboration, evocation, autonomy, empathy, developing self-efficacy, rolling with resistance, developing discrepancy, open-ended questions, affirmations, reflections, summaries, change talk, and implementing change. It then provides several client vignettes and asks the reader to consider potential barriers to MI, how to overcome them, signs of change talk, and how to apply MI skills in each case.

2.  Collaboration
› A non-hierarchical partnership
› Focus on mutual understanding
 Evocation
› Supporting client in discovering own
motivation for change
 Autonomy
› Clients capable of and responsible for
making change
› There’s lots of ways to make change

3.  Express Empathy
› Working to see world as the client sees it
 Support Self-Efficacy
› A basic belief that people can change. Focus
on skills and strengths
› Instilling hope that people can reach goals
 Roll with Resistance
› Resistance emerges when clients worldview not
seen or autonomy threatened
› Avoid the “righting reflex”
 Develop Discrepancy
› People change when they see the gap
between where they are and where they want
to be

4.  Open-Ended Questions
› Invite elaboration and thinking
 Affirmations
› Recognize client strengths
 Reflections
› Focus on negatives of status quo and
positives of change
 Summaries
› A special, extended reflection

5.  Preparatory Change Talk (DARN)
› Desire (want to)
› Ability (can)
› Reason (it’s important)
› Need (I should change)
 Implementing Change Talk (CAN)
› Commitment (I will)
› Activation (I am ready & prepared)
› Taking Steps (I am taking specific steps)

6.  For each vignette, lets consider:
› Potential barriers to the spirit and principles
of motivational interviewing
› Ideas for overcoming these barriers
› Signs of change talk
› How you might implement the MI skills

7.  Susie is a 23 year old single mother who is
referred to you for court ordered therapy
by DHS. Her 4 year old daughter is
currently in foster care and Susie has just
completed one month of inpatient drug
and alcohol treatment. In order to
regain custody of her daughter, she must
complete counseling, submit to random
UAs, enroll her daughter in child care
and pass regular home visits.

8.  Fred is a 22 year old student athlete on
the honor roll who comes to see you at
the counseling center reporting vague
complaints of being “out of control” and
having panic attacks. After a few
sessions, he discloses that he has been
using Ritalin he buys from a friend to help
with his concentration and maintaining
weight for wrestling. He has not told
anyone about his substance use.

9.  Susan is a 69 year old woman who
comes to see you in a primary care
mental health clinic. Her A1C levels are
significantly elevated and medical
records indicate she is not refilling her
medications on a consistent basis. She
reports that she is feeling fatigued and
tearful and that the only thing which
brings her joy is time with her
grandchildren.

10.  Jason comes to see you regarding his
alcohol use. He states that he does not
see his drinking as a problem, but that his
wife “made him come.” He reports
currently drinking 2-3 drinks/night and
“partying” more on weekends.

11.  Richard and Marlene come to see you
for family counseling. They report that
they need help “fixing” their son Jacob.
Jacob is 15 and is frequently breaking
curfew and speaking rudely to his
parents. They report that they are
currently managing this behavior by
“giving him the what for.”

12.  Someone you’d love to change!
 How could you apply the principles of
motivational interviewing – both in
technique and in spirit?

13.  www.motivationalinterview.org