Even if we know changing our behavior is good for us, change involves chartering unknown territories, putting forth effort, and letting go of familiar habits.
The mixed feelings we have about change can often get us stuck in ambivalence, which is where motivational interviewing can be most powerful.
The pioneering humanistic psychologist Carl Rogers (1995, p. 17) once said, ”The curious paradox is that when I accept myself just as I am, then I can change.” This quote captures something of the spirit of motivational interviewing.
Motivational interviewers help clients find their intrinsic motivation for change. They greet the client’s fears and resistance to change with empathy and guide them through ambivalence to facilitate action.
Are you interested in helping others mobilize their motivation to pursue positive change? In this article, we’ll walk you through a guide to motivational interviewing training and some of the top courses in this field to look out for.
Before you continue, we thought you might like to download our three Goal Achievement Exercises for free. These detailed, science-based exercises will help you or your clients create actionable goals and master techniques to create lasting behavior change.
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Training in Motivational Interviewing: A Guide
Motivational interviewing (MI) is an evidence-based treatment that can help people resolve ambivalence about change. Specifically, it is a “collaborative, person-centered form of guiding to elicit and strengthen motivation for change” (Miller & Rollnick, 2009; p. 137).
A core part of MI involves eliciting spoken motivation for change to help the client tap into their intrinsic motivation. MI is typically a brief intervention and can be combined with other forms of treatment (Miller & Rollnick, 2009).
MI began with a model of behavioral treatment for alcohol dependency developed by William Miller (Miller & Rose, 2009). As a clinical method, motivational interviewing has the following characteristics:
- Empathetic and person-centered practice centered around reflective listening
- Involves paying close attention and responding to client “change talk”
- Reinforces the client’s spoken motivation for behavior change
- Meets counter-change or “sustain talk” with empathy rather than resistance (Miller & Rose, 2009)
MI has proven to be an effective intervention to resolve ambivalence around change for substance use issues and health-positive behaviors, such as HIV testing, medication compliance, and healthy eating (Madson, Loignon, & Lane, 2009).
Due to how quickly MI took off in the therapeutic world, it has been misinterpreted and muddled with other approaches and methods over the years (Miller & Rollnick, 2009). To help clear up the confusion, Miller and Rollnick (2009) outlined “10 things that motivational interviewing is not.”
MI is not:
- Based on the trans-theoretical model of change
Although MI and the trans-theoretical model are often used together, MI is a clinical method used to facilitate motivation for change. The trans-theoretical model offers an account of the processes of change.
- A means to trick people into behavior change
Autonomy of the client is paramount in MI, and the client is always in control of their change journey. MI involves no manipulation, implanting of ideas, or out-smarting, but rather aims to pull out the client’s personal motivation for change. Motivation for change needs to exist within the client for MI to be effective.
- A technique
To avoid oversimplifying MI, Miller and Rollnick (2009, p. 131) suggest it’s best to think of it as a “clinical or communication method, a complex skill that is learned with considerable practice over time. It is a guiding style for enhancing intrinsic motivation to change.”
- Decisional balance
MI does not require the weighing up of the costs and benefits of change, although decisional balance is a technique that can be helpful when clients struggle with verbalizing pro-change talk. It should not be used to encourage the client to make a decision in a particular direction.
- Assessment feedback
Giving feedback from structured assessments is not fundamental or essential to delivering MI, although it can sometimes help initiate conversations about change.
- Cognitive-Behavioral Therapy (CBT)
MI was not based on formal cognitive-behavioral theories, although it may share links with certain theories, such as cognitive dissonance and self-perception theory. Whereas CBT assumes that the client needs to unlearn something or learn something new, MI aims to elicit motivation that the client already holds. The client is the agent of their motivation, and the therapist helps them tap into this.
- Simply client-centered counseling
Although the person-centered counseling approach of Carl Rogers is fundamentally important to delivering MI, MI differs in that it is both client centered and goal focused.
- Easy to learn
MI requires a complex set of skills that need to be implemented dynamically, which Miller and Rollnick (2009) liken to learning a new instrument. It takes time, discipline, and feedback to become skilled in the art of MI.
- Something you already do
Although reflective listening practices and motivating clients may feel like intuitive elements of many therapeutic approaches, MI goes beyond usual forms of communication and is a deliberate and focused method of reflective listening that aims to guide the client through a journey from ambivalence to action.
- A panacea
MI has a specific use in the context of change-ambivalence and is not a suitable clinical method for all people and problems. Equally, if a client is not showing any motivation for change, then continuing with MI is likely not appropriate. It is not the therapist’s job to convince the client to change their mind.
What MI training involves
To begin your training journey in motivational interviewing, Miller and Moyers (2006) suggest that an openness to the collaborative, evocative, and client-centered “spirit” of MI can be important to how easily you learn it. Trainees need to be willing to explore the perspective that people are experts in their lives and will typically move in a positive direction when given the right support (Miller & Moyers, 2006).
Gaining competency in client-centered counseling approaches is central to MI, including accurate empathy, reflective listening, affirming, reflecting, and summarizing (Miller & Moyers, 2006).
The next steps involve learning to pick up on change talk and sharpening your perception of elements of client’s speech that show a willingness, need, or motivation to change. Once you’ve mastered this, you can learn to reinforce and elicit change talk, while also responding in ways that reduce counter-change talk (Miller & Moyers, 2006).
Rolling with resistance is another key skill you’ll acquire. Rather than challenging or opposing resistance, which can actually generate more pushback, you’ll learn to roll with it. This could involve affirming the client’s autonomy and reflecting their resistant speech with empathy (Miller & Moyers, 2006).
Next, you’ll learn how and when to introduce the development of a change plan, which naturally progresses from the client’s change talk and reinforcement of their “why” to the plans they need to put in place to make change happen. Here, motivation for change has been established, and the skill is to develop a change plan at the client’s pace that doesn’t trigger resistance (Miller & Moyers, 2006).
When a change plan is in place, the therapist’s next job is to help cement the client’s commitment at the appropriate time, paying close attention to and eliciting the client’s commitment talk (e.g., “I do” rather than “I could”; Miller & Moyers, 2006).
When motivation for change has been crystalized and ambivalence resolved, MI has fulfilled its purpose. From there, the therapist would typically switch to a more action-focused therapeutic approach, while still holding on to the collaborative and empathetic elements of MI (Miller & Moyers, 2006).
5 Motivational Interviewing Courses to Consider
Finding the right MI training route for you will depend on your goals and level of experience.
Are you looking to rack up some continuing education (CE) credits? Or would you like to add a new skill in the clinical or therapeutic work you already do?
There are many introductory courses for beginners wishing to understand the basic principles of motivational interviewing, and more extensive and often more expensive learning options can set you up to be a proficient MI practitioner in clinical and community settings. Nowadays, the online options for training are bountiful, so you can often access several top-notch MI courses wherever you are in the world.
If you’re looking to learn from the best, with Psychwire, you’ll be trained by the founders of MI, Dr. William Miller and Dr. Stephen Rollnick, as well as a roster of expert MI trainers and clinicians.
Motivational Interviewing: Foundational
This beginner’s course introduces students to MI theory and practice with 10 CE hours of video lessons over six weeks. Among the many learning outcomes, you’ll be able to help clients identify their motivation for change; become more aware of client change and counter-change talk; and use questions, reflections, and summarizing to encourage change. You can preview the course online before making a decision.
Motivational Interviewing in Health Care
This is an eight-hour course aimed at healthcare professionals working in hospitals or the community. You’ll learn how to engage patients with the change process on their terms by tapping into their personal motivation to take care of their health.
Modules that are particularly useful for health professionals include:
- Time Pressures and Brief Consultations
- Difficult Consultations
- Giving Information and Advice
Motivational Interviewing for Addiction
This 10-hour course delivered over six weeks is aimed at behavioral health professionals working with clients struggling with substance use – the treatment area MI was first applied to.
A few course goals include “learn[ing] how to use MI at every stage of change” and “understand[ing] addiction treatment as an ongoing ‘primary care’ process, not a discrete event” (Psychwire, n.d.). You can preview a range of videos from the course, such as the MI approach to addiction and an MI demonstration for opioid addiction.
The Association for Psychological Therapies (APT)
The APT is a top provider of accredited motivational interviewing training courses in the United Kingdom and Ireland, and offers online self-paced, virtual, and on-site training options for individuals and teams.
Motivational Interviewing and How to Use It Effectively
This is a three-day foundational course covering fundamental MI skills. The course is well suited for a range of health professionals and teams working with people in clinical or community settings.
Course topics include the spirit of motivational interviewing, eliciting change talk, crystalizing commitment, and combining MI with other therapeutic approaches. You can complete the course anytime online, attend a live online course, or organize a face-to-face course in your organization (in the United Kingdom).
The Motivational Interviewing Masterclass
This three-day course is aimed at people with over six months of MI practice after receiving Level-three accreditation from the APT.
The course expands on the fundamental topics of MI, with more emphasis on refining the skills of MI, including role-play and video demonstrations. You can expect to walk away with a greater level of confidence in your MI practice, better ability to prepare case presentations, and a deeper understanding of how to develop and enhance your MI practice.
4 Best Certification Options
If you’re looking for a certificate-based option, here are four standout courses that each offer a slightly different focus and structure.
Certificate of Intensive Training in Motivational Interviewing, University of Massachusetts Medical School
This semester-long course in MI aims to go “beyond the academic understanding of active skills practice” by offering live online skills practice with other students (University of Massachusetts Medical School, n.d.).
There are 10 pre-recorded online lessons, 5 interactive learning labs, and 2 practice sessions with an acting patient. You also get two coaching sessions with an experienced MI coach and feedback on your skills using the MITI-4 coding system.
There are no requirements to apply for the course, and it is aimed at people working in healthcare who’d like to apply MI skills in their work. All trainers are members of the Motivational Interviewing Network of Trainers.
Find out more on their website.
Motivational Interviewing Certificate, University of Maryland School of Social Work
This certificate is taught in person and online and includes experiential MI learning exercises, feedback, and coaching to enhance both knowledge of and skills in MI.
Students are assessed on their MI skills before and after completing the course to capture how their practice has improved. The course is limited to 30 people, so students can get the most from the individualized feedback and coaching provided.
Find out more on their website.
Motivational Interviewing, Take Courage Coaching
This six-week course is approved by the National Board for Health and Wellness Coaching and offers 12 hours of CE credits.
The course involves a two-hour commitment every week and is completed online. Each week, you’ll learn a core process of motivational interviewing and take part in interactive role-play sessions with an instructor.
Find out more on their website.
Discovering and Building Motivation for Change Certificate, University of Wisconsin–Superior
This certificate involves four days of foundational module workshops and four days of more advanced module workshops.
Across the two modules, you’ll learn the basic principles and techniques used in motivational interviewing and develop your competence in generating change-talk through skills practice and demonstrations.
The workshops are very reasonably priced and led by an experienced trainer.
Find out more on their website.
Online MI Training: 5 Courses
Many of the courses in MI already covered can be completed online or virtually, but here are a few more of our top picks that can be accessed anywhere and offer great value for money.
Motivational Interviewing Network of Trainers (MINT), Online facilitator-led instruction
MINT is an international professional organization of independent MI trainers that seeks to promote excellence in the field of MI. There’s a wealth of training events posted on their site, and you can also seek specific trainers for public training events.
MINT has a calendar full of online facilitator-led workshops for people at introductory, intermediate, and advanced levels of MI practice. The training courses vary in length but are typically between a half and a full day.
You can explore all the course details, objectives, and trainer information on the website.
The Tavistock and Portman NHS Foundation Trust
This National Health Service organization offers two online courses. The introductory course is suited to anyone working with people on behavior change, and an advanced course is suitable for those wishing to sharpen their skills.
Introduction to Motivational Interviewing
This two-day course covers the basics, principles, and spirit of MI theory to facilitate behavior change. The course involves practical and taught components, including live demonstrations, coaching, and didactic teaching.
Advanced Motivational Interviewing
After completion of the introductory course, this two-day training builds on the skills you’ve gained to increase your confidence in applying MI methods in your work.
Find out more on their website.
The Varalli Group (TVG)
20 Lessons in Motivational Interviewing
TVG offers 20 MI lessons that you can pay for individually or as a whole. The blended-learning courses are approved by the National Association for Alcoholism and Drug Abuse Counselors for CE credits.
Lesson 1 begins with an “Introduction to Motivational Interviewing,” and Lesson 20 ends with “Putting Motivational Interviewing Into Practice.”
5 Motivational Interviewing Interactive Courses for Supervisors and Managers
For proficient MI practitioners supervising and managing other practitioners in this work, TVG offers five interactive lessons covering topics like ‘Modeling and Demonstrating MI for Staff’ and ‘Feedback and Coaching of MI.’
Find out more on their website.
If you’re interested in getting a sense of what motivational interviewing looks like, you may find this comprehensive exercise in Motivational Interviewing Techniques a good place to start. It is an exercise from our Positive Psychology Toolkit©, which is an online repository for mental healthcare exercises, interventions, and assessments.
This tool equips you with five key strategies to facilitate your motivational interviewing:
- Eliciting/Evoking “Change Talk”
This strategy encourages the client to talk about change. The purpose of eliciting change talk from the client is to empower him/her to generate intrinsic motivation to change and subsequently outline possible solutions. For instance, an example “change talk” interview question could be: “What makes you want to change?”
- Decisional Balancing
Decisional balancing helps clients see both sides of the change. Motivational interviewing embraces ambivalence by encouraging the discussion of both the positives and negatives of change. The clinician asks questions about both aspects to build understanding and resolve ambivalence in favor of a change. Illustrating this, an example interview question might be: “What are some of the good things about (the target behavior)?”
Normalizing helps communicate to clients that they are not alone in struggling to make changes. The statements below are meant to help your client put their experience in context, broadening their perspective on the process while also reducing shame and isolation. For example, one common normalizing statement is: “In my experience, many people feel like you do.”
- Asking Permission
Motivational interviewing empowers clients to generate their solutions, and it centers on respecting clients’ agency in their own treatment. Therefore, the practitioner might ask for permission before broaching a topic by asking, “Do you mind if we talk about (topic)?”
- Open-Ended Questions
Motivational interviewing could feel a bit like conducting an interview or an interrogation. Using open-ended questions is a way to prevent a basic question-and-answer format. For instance, an example open-ended question could be: “If you make this change successfully, what do you imagine your life will look like?”
This is just a sample of what you will find in the Motivational Interviewing Techniques tool, available through the Positive Psychology Toolkit©, so be sure to check out this wealth of valuable practitioner resources today.
Further, if you’re looking for more science-based ways to help others reach their goals, this collection contains 17 validated motivation and goal achievement tools for practitioners. Use them to help others turn their dreams into reality by applying the latest science-based behavioral change techniques.
A Take-Home Message
We know other people cannot change us, so why would we assume we can convince other people to change?
At its core, motivational interviewing recognizes that the client is the only person who can bring about change for themselves, and if given the right conditions, the client can persuade themselves that their intrinsic motivation for change is important, meaningful, and worthy.
Motivational interviewing is an evidence-based clinical method that involves using a complex set of skills to reflect, amplify, and reinforce the client’s motivation for change through conversation.
Training in the art of motivational interviewing takes time, practice, and feedback, but it can be an incredibly rewarding experience to help people move toward positive changes in their lives.
We hope you enjoyed reading this article. Don’t forget to download our three Goal Achievement Exercises for free.
- Madson, M. B., Loignon, A. C., & Lane, C. (2009). Training in motivational interviewing: A systematic review. Journal of Substance Abuse Treatment, 36, 101–109.
- Miller, W. R., & Moyers, T. B. (2006). Eight stages in learning motivational interviewing. Journal of Teaching in the Addictions, 5(1), 3–17.
- Miller, W. R., & Rollnick, S. (2009). Ten things that motivational interviewing is not. Behavioural and Cognitive Psychotherapy, 37, 129–140.
- Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. American Psychologist, 64(6), 527–537.
- Psychwire. (n.d.). Motivational interviewing for addiction. Retrieved August 23, 2021, from https://psychwire.com/motivational-interviewing/mi-addiction
- Rogers, C. (1995). On becoming a person: A therapist’s view of psychotherapy. Mariner Books.
- University of Massachusetts Medical School. (n.d.). Certificate of intensive training in motivational interviewing. Retrieved August 23, 2021 from https://www.umassmed.edu/cipc/continuing-education/MotivationalInterviewing/