Motivational Interviewing

Health workers regularly encounter patients whose behaviors pose serious threats to their health and the health of their loved ones. Motivational Interviewing (MI) is a method in which the health worker guides the client to resolve his/her ambivalence about behavior change by evoking the client’s motivation to change and then fortifying that motivation. Developed from the study of addiction, MI is now widely applied as a method in a variety of settings and populations. Some areas of behavior change in which MI is applied include:

  • Mental Health
  • Diabetes
  • Weight change
  • Nutrition
  • Medication Adherence
  • Gambling
  • Smoking
  • Substance Abuse

The materials on this page were adapted from the UIHI’s workshop: Introduction to Motivational Interviewing. The workshop was specifically targeted to direct clinical providers at urban Indian health organizations working with American Indian and Alaska Native communities. These materials are intended to support health workers wishing to use MI.

The Spirit of Motivational Interviewing (Philosophy)

This document illustrates the spirit of MI by highlighting MI fundamentals such as “Motivation for change is elicited from the client, not imposed by the counselor.” Health workers must embody the Spirit of MI in order to effectively practice the method with clients.

The Four Processes of Motivational Interviewing

In MI, the health worker guides the client towards behavioral change through four continuous processes: engage, focus, evoke, and plan. This document describes the role of the healthcare practitioner and the objective of each process.

Interaction Techniques in MI

Interactions between the health worker and client in MI are captured by the acronym OARS: Open-ended questions, Affirmations, Reflective Listening, and Summaries. Using OARS interaction techniques, the health worker helps the client resolve his/her own ambivalence about behavior change. The worksheets below provide a detailed description of each OARS interaction technique and examples of how to them with a client.

Change Talk in MI

The goal of MI interaction techniques is to guide the client to make statements offering reasons for or a commitment to change a behavior. These statements are called Change Talk. These documents outline strategies to help the health worker evoke Change Talk from the client; provide examples of different clients’ statements to help the health worker recognize the Change Talk present; and finally offer ways for the health worker respond to clients’ Change Talk.

Metacognition in MI

These documents help the health worker practice being aware of his/her own thoughts about, and reactions to, clients’ behaviors. Gaining awareness of these thoughts will help the health worker respond to their clients in MI-consistent ways and help the health worker set reasonable goals for further development of MI skills.


These resources offer supplemental information to support the development of MI skills. The resource guide is a quick reference to other sources of information about MI; the tip sheet provides clarification on common interactions with clients that are not consistent with MI and how to respond to a client’s resistance to behavior change; finally, the Personal Values Card Sort Activity is a tool to help the client prioritize and articulate what values are important to him/her to help evoke the client’s motivation for change and Change Talk.

Why Motivational Interviewing for Urban Indian Health Organizations? In this video Dr. Lonnie Nelson (Eastern Band Cherokee) discusses the Native values compatible with MI and why this clinical method is relevant for American Indian and Alaska Native communities. July 10, 2013 Seattle, WA

Funding for this project was provided by a grant from the Department of Health and Human Services, Office of Minority Health. Grant number MPCMP101055-01-00. The contents of this workshop are solely the responsibility of the Urban Indian Health Institute and do not necessarily represent the official views of the Office of Minority Health.

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