Definition
Motivational Interviewing (MI) is a communication approach developed by William R. Miller and Stephen Rollnick. Its premise is that motivation to change is not imposed from outside — it is evoked from within. The professional does not convince or instruct: they facilitate the person in articulating their own reasons to change. Ambivalence toward change is normal and the starting point, not an obstacle.
How it's used
MI is built on four processes that are not linear: Engaging (creating a working alliance), Focusing (agreeing on the direction of change), Evoking (eliciting "change talk" — the client's own reasons), and Planning (designing a concrete plan when there is sufficient motivation).
The practitioner's technical skills are grouped in the OARS acronym: Open questions, Affirmations, Reflections, and Summaries. The professional pays special attention to "change talk" — client verbalizations expressing desire, ability, reasons, or need to change — and to "sustain talk" — verbalizations in favor of the status quo.
The spirit of MI rests on four values: collaboration (not confrontation), acceptance, compassion, and evocation. When a professional corrects, instructs, or warns without having listened, they activate "resistance" — MI calls this discord.
When to apply
MI has strong empirical evidence for health behavior change (alcohol, tobacco, medication adherence, exercise, diet). It is also applied in mental health, social work, education, and coaching. It is especially useful when the client has not directly sought help or is in early stages of contemplation.
Historical origin
William Miller developed the first principles of MI in a 1983 article in Behavioural Psychotherapy, based on his work with people with alcohol problems. Stephen Rollnick joined as co-author and co-developer. The reference work, Motivational Interviewing: Helping People Change, is now in its third edition and has been translated into more than 25 languages.
How CauceOS supports it
CauceOS can configure alerts to detect in real time when the professional is using confrontational or direct instruction language instead of reflections and open questions. The MI note template records the type of change talk identified in session and the client's perceived motivational stage.
Related terms
- ACT — shares emphasis on values and non-confrontation of resistance
- GROW — goal-oriented coaching framework, complementary to MI
- CBT — frequent integration: MI as motivational preamble to CBT
References
- Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). Guilford.
- Rollnick, S., Miller, W. R., & Butler, C. (2008). Motivational Interviewing in Health Care. Guilford.
- Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy.