Motivational Interviewing

Motivational interviewing is a counselling style, developed by the clinical psychologists William Miller and Stephen Rollnick, which seeks to elicit behavioural changes in clients by helping them to recognize, explore, and resolve ambivalent feelings they may have towards change. Motivational interviewing works by activating the patient’s own motivation for change and follows four guiding principles:

Resist the righting reflex
Caregivers must learn to inhibit their tendency to control their patient’s behaviour even though their intentions may be good. When they see that a patient is engaging in harmful behaviour their inclination is to warn them and tell them to stop. The problem is that this may have a paradoxical effect due to a natural human tendency to resist persuasion.

Understand your patient’s motivations
Patients have their own reasons for change and it is their motivations and not the caregiver’s motivations which are most likely to elicit change. It is important for the caregiver to elicit and respect the patient’s reasons for change.

Listen to your patient
Motivational interviewing involves listening as much as it does informing, and counsellors will often have to develop their ability to elicit the answers which already lie within the patient.

Empower your patient
Helping patients explore how they themselves can make a positive difference in their own lives empowers them. A patient who is active in the process of changing vs. a passive acceptor of counselling advice is more likely to stick to the goals set in therapy.


Rollnick, S., Miller W. R., Butler, C. (2008). Motivational interviewing in health care: helping patients change behavior. New York: Guilford Press.