Motivational interviewing (MI) is a collaborative approach to conversations about change. The clinician helps a person explore their own reasons, priorities and readiness, while respecting their choices. For nurses, it offers a way to discuss a shared goal without turning the encounter into a lecture.
The Motivational Interviewing Network of Trainers (MINT) describes MI as a guiding style. It cautions against treating MI as a technique for getting people to do what the clinician wants. Partnership and attention to the person's perspective are central.
Understand the purpose before using a technique
Mixed feelings are a normal part of considering change. SAMHSA's motivational interviewing chapter, written for substance use disorder treatment, identifies ambivalence as a central focus. An MI conversation makes room to explore those mixed feelings.
Before beginning, clarify the topic with the patient. “We need to discuss everything you should change” is an unworkable agenda. A narrower, mutually understood focus gives the conversation a purpose.
MINT describes four processes:
- Engaging: develop a working relationship.
- Focusing: agree on what the conversation will address.
- Evoking: explore the person's own reasons for change.
- Planning: work on how a change might happen when the person is ready.
These processes are flexible; a conversation may return to an earlier one. Planning is not a compulsory endpoint for every encounter.
Recognize OARS skills
SAMHSA summarizes core MI skills with OARS: open questions, affirmations, reflective listening and summaries. The following fictional examples show the differences:
| Skill | Illustrative nursing language |
|---|---|
| Open question | “What has made arranging the follow-up visit difficult?” |
| Affirmation | “You kept looking for an appointment that would fit your work schedule.” |
| Reflection | “The visit matters to you, and losing work hours is a serious concern.” |
| Summary | “You want the follow-up, need a workable time and would like help checking the options. Have I understood?” |
These examples concern access to follow-up. They do not prescribe treatment or demonstrate a complete MI session. A reflection should be offered as an understanding the patient can correct, rather than an authoritative explanation of the person's motives.
Separate motivation from practical barriers
In the example, the next useful step might be checking appointment availability. Do not keep asking for reasons to change while leaving the patient's stated scheduling problem unanswered.
Record the patient's expressed goal, concern and agreed next step in the appropriate care plan. Avoid translating hesitation into a character judgment or documenting agreement that the patient did not express.
Build skill through practice and feedback
MINT emphasizes that MI takes practice and self-awareness. A team can use role-play to review whether questions are open, reflections are accurate and the agenda remains shared. Ask whether a suggested response invites the patient's thinking or hides an instruction inside a question.
This introduction does not establish MI proficiency. Use appropriate training and supervision for the role and setting. Related topics include patient goals in care planning and shared decision-making.
Sources
- Understanding Motivational Interviewing (accessed 2026-09-17) — Motivational Interviewing Network of Trainers.
- Motivational Interviewing as a Counseling Style (accessed 2026-09-17) — SAMHSA, TIP 35, updated 2019, via NCBI Bookshelf.