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Applications of Motivational Interviewing
Motivational Interviewing, Third Edition: Helping People Change
This bestselling work has introduced hundreds of thousands of professionals and students to motivational interviewing (MI), a proven approach to helping people overcome ambivalence that gets in the way of change. William R. Miller and Stephen Rollnick explain current thinking on the process of behavior change, present the principles of MI, and provide detailed guidelines for putting it into practice. Case examples illustrate key points and demonstrate the benefits of MI in addictions treatment and other clinical contexts. The authors also discuss the process of learning MI. The volume’s final section brings together an array of leading MI practitioners to present their work in diverse settings.
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First published August 9, 1991
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About the author
William R. Miller
111 books58 followersWilliam Richard Miller is an American clinical psychologist, an emeritus distinguished professor of psychology and psychiatry at the University of New Mexico in Albuquerque. Miller and Stephen Rollnick are the co-founders of motivational interviewing.
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Displaying 1 - 30 of 176 reviews
December 25, 2013
I read an earlier addition of this manual when I was in school working towards my MA. I thought it was brilliant back then. But I had no idea how effective this stuff would be in practice. I'm currently doing my (MFT) internships and just beginning to implement this stuff, and WOW, it really works.
The first time I experienced a client drop dramatic, sudden, emphatic change talk in a session my jaw just about hit the floor. I was with a client who was on the verge of becoming homeless, but could not seem to take action due to depression and overwhelm. We explored the ambivalence, non-judgmentally, for just a few minutes, and suddenly she startled as if she were jerking awake from a deep sleep and said " oh my god, I have to go find a place to live". We scribbled out a quick list and she bolted for the door to go get some urgent and important stuff done. The next day she came into my office with the proud news that she got the apartment.
Listening with empathy and reflecting in a forward direction can transform an otherwise superficial or circular conversation into an insight and action provoking depth charge. KABOOM!
As an addendum I'm including the following progress update to the above mentioned clients status. She did in fact find and move in to the apartment. But as it turns out its is a meth house, and she has subsequently become hopelessly relapsed in her meth addiction (I was treating her opiate addiction at the time of writing, her meth addiction was in remission). One step forward three steps back I guess.
This of course does not at all reflect poorly on MI, but it does remind us that long term adaptive behavioral change takes sustained long term effort and commitment.
The first time I experienced a client drop dramatic, sudden, emphatic change talk in a session my jaw just about hit the floor. I was with a client who was on the verge of becoming homeless, but could not seem to take action due to depression and overwhelm. We explored the ambivalence, non-judgmentally, for just a few minutes, and suddenly she startled as if she were jerking awake from a deep sleep and said " oh my god, I have to go find a place to live". We scribbled out a quick list and she bolted for the door to go get some urgent and important stuff done. The next day she came into my office with the proud news that she got the apartment.
Listening with empathy and reflecting in a forward direction can transform an otherwise superficial or circular conversation into an insight and action provoking depth charge. KABOOM!
As an addendum I'm including the following progress update to the above mentioned clients status. She did in fact find and move in to the apartment. But as it turns out its is a meth house, and she has subsequently become hopelessly relapsed in her meth addiction (I was treating her opiate addiction at the time of writing, her meth addiction was in remission). One step forward three steps back I guess.
This of course does not at all reflect poorly on MI, but it does remind us that long term adaptive behavioral change takes sustained long term effort and commitment.
January 9, 2014
This is the most logical and effective approach I've learned for evoking change in people. I've seen it work in practice. It's pretty amazing. It would be a very good thing if this were required reading and training for everyone working in counseling, social work, medicine, criminal justice and teen mentoring as well as many other applications.
January 15, 2021
Several friends recommended William R. Miller and Stephen Rollnick’s Motivational Interviewing as a reliable and longstanding practice that would be useful for an aspiring counselor to explore. The book is a terrific resource for professionals and laypeople interested in the language of change and dynamics of personal development.
Miller and Rollnick originally invented motivational interviewing (MI) in the 1980s as a talk therapy treatment for alcohol addiction. They have continued to evolve its theory and practice over the last several decades; MI is now used in a variety of contexts and has been fruitfully integrated with other therapeutic methods. The approach borrows the conceptual foundations of Rogerian client-centered therapy, but also departs from it by being considerably more goal-oriented. The explicit purpose of MI is to help clients change their lives in ways that will minimize harm and promote growth and flourishing:
"Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion." (29)
In MI, the counselor’s prime directive is to draw out a client’s intrinsic motivations for change, rather than confronting them with extrinsic motivations or taking an authoritative tone:
"Telling someone that 'You can’t,' and more generally trying to constrain someone’s choices typically evokes psychological reactance, the desire to reassert one’s freedom. On the other hand, directly acknowledging a person’s freedom of choice typically diminishes defensiveness and can facilitate change. This involves letting go of the idea and burden that you have to (or can) make people change. It is, in essence, relinquishing a power that you never had in the first place." (19)
Motivational Interviewing is a process-oriented text that provides many concrete examples of how Miller and Rollnick’s theories succeed or fail in practice, as well as discussions of MI’s efficacy as demonstrated by academic research. The authors also have a talent for metaphor, often invoking creative references to music, dance, travel, and the natural world. The book strikes an excellent balance between instructional information and values-driven reflections on the art of therapeutic consultation.
Miller and Rollnick break down the method of MI into four stages: engaging, focusing, evoking, and planning. Their simplest articulation is as follows:
"Engaging is about 'Shall we travel together?'
Focusing asks 'Where to?'
Evoking is about 'Whether?' and 'Why?'
Planning is about 'How?' and 'When?'" (271)
The four stages occur in sequence as the client makes their way toward change, but Miller and Rollnick point out that any stage can be revisited as needed.
Engaging is the stage of MI that most closely resembles client-centered therapy. It is all about listening well, creating a safe and acceptant space for the client, and demonstrating empathic attention to the client’s perspective and needs. Miller and Rollnick’s descriptions and examples of “reflective listening” are especially helpful, making it easy to see why their method is so effective when utilized properly. “Processes for engaging do differ across cultures,” they write, “but listening lies at the heart of nearly all of them” (349).
Once a solid rapport has been established, the consultation enters the focusing stage. This is where counselor and client collaboratively explore goals for change and agree on an intended outcome or set of outcomes. Miller and Rollnick recommend that counselors adopt a “guiding” style––a compromise between “following” (allowing the client to dictate the direction of the conversation) and “directing” (taking the reins in order to produce the counselor’s desired outcome):
"Midway between directing and following sits a guiding style. Guiding promotes a collaborative search for direction, a meeting of expertise in which the focus of treatment is negotiated. The client’s agenda is important, and any limitations inherent in the context are taken into account. The clinician’s expertise is also a possible source of goals. The focusing process of MI commonly starts in this middle ground between directing and following, where the focus, momentum, and content are mutually forged." (99)
After focusing comes evoking, which is arguably the most crucial and challenging of the four stages. Evoking is the process by which a counselor seeks to elicit and strengthen the client’s personal reasons for change. This is done through delving into the client’s ambivalence––their reasons for and against making the change or changes identified during the focusing stage. Careful attention is paid to “change talk” and “sustain talk”:
"Sustain talk and change talk are conceptually opposite––the person’s arguments against and for change––and they predict different outcomes. A predominance of sustain talk or an equal mix of change and sustain talk is associated with maintenance of the status quo, whereas a predominance of change talk predicts subsequent behavior change." (165)
Affirming and encouraging change talk is the main mechanism by which MI practitioners help clients articulate and commit to their intrinsic motivations for change. “Evoking is a co-creative process through which the person’s potential for change is released,” Miller and Rollnick tell us. “The motivation for change is emerging even as you speak together.” (182) Here we see another strong connection to Carl Rogers’s theory of personal growth, which prizes client autonomy and asserts that meaningful and lasting change typically stems from behavioral adaptations that are self-chosen rather than imposed from the outside.
The planning stage is precisely what it sounds like. “Planning is the clutch that engages the engine of change talk,” where client and counselor work out the details of how to transform the client’s desires for change into reality (30). Miller and Rollnick provide many useful examples and resources for how this can be accomplished, all the while staying true to their ethos of supporting the client as they discover what works best for them.
Although MI certainly seems like a great system, there are a couple apparent limitations I’d like to highlight. The first is simply that much of MI won’t apply to clients who aren’t seeking change or don’t need to change their behavior in any profound way. The second is that, by locating the potential and responsibility for change primarily within the client, MI runs the risk of downplaying or ignoring structural factors that may render change difficult or even impossible. To their credit, Miller and Rollnick are aware of this issue and mention it several times in the book. It’s important to remember that, due to external circumstances completely beyond their control, some people seeking counseling may not have the power to transform their lives in the way MI suggests. This isn’t really a criticism, but rather an acknowledgment that MI is just one of many effective tools we can use to meet humanity’s variety of mental health needs.
This review was originally published on my blog, words&dirt.
Miller and Rollnick originally invented motivational interviewing (MI) in the 1980s as a talk therapy treatment for alcohol addiction. They have continued to evolve its theory and practice over the last several decades; MI is now used in a variety of contexts and has been fruitfully integrated with other therapeutic methods. The approach borrows the conceptual foundations of Rogerian client-centered therapy, but also departs from it by being considerably more goal-oriented. The explicit purpose of MI is to help clients change their lives in ways that will minimize harm and promote growth and flourishing:
"Motivational interviewing is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion." (29)
In MI, the counselor’s prime directive is to draw out a client’s intrinsic motivations for change, rather than confronting them with extrinsic motivations or taking an authoritative tone:
"Telling someone that 'You can’t,' and more generally trying to constrain someone’s choices typically evokes psychological reactance, the desire to reassert one’s freedom. On the other hand, directly acknowledging a person’s freedom of choice typically diminishes defensiveness and can facilitate change. This involves letting go of the idea and burden that you have to (or can) make people change. It is, in essence, relinquishing a power that you never had in the first place." (19)
Motivational Interviewing is a process-oriented text that provides many concrete examples of how Miller and Rollnick’s theories succeed or fail in practice, as well as discussions of MI’s efficacy as demonstrated by academic research. The authors also have a talent for metaphor, often invoking creative references to music, dance, travel, and the natural world. The book strikes an excellent balance between instructional information and values-driven reflections on the art of therapeutic consultation.
Miller and Rollnick break down the method of MI into four stages: engaging, focusing, evoking, and planning. Their simplest articulation is as follows:
"Engaging is about 'Shall we travel together?'
Focusing asks 'Where to?'
Evoking is about 'Whether?' and 'Why?'
Planning is about 'How?' and 'When?'" (271)
The four stages occur in sequence as the client makes their way toward change, but Miller and Rollnick point out that any stage can be revisited as needed.
Engaging is the stage of MI that most closely resembles client-centered therapy. It is all about listening well, creating a safe and acceptant space for the client, and demonstrating empathic attention to the client’s perspective and needs. Miller and Rollnick’s descriptions and examples of “reflective listening” are especially helpful, making it easy to see why their method is so effective when utilized properly. “Processes for engaging do differ across cultures,” they write, “but listening lies at the heart of nearly all of them” (349).
Once a solid rapport has been established, the consultation enters the focusing stage. This is where counselor and client collaboratively explore goals for change and agree on an intended outcome or set of outcomes. Miller and Rollnick recommend that counselors adopt a “guiding” style––a compromise between “following” (allowing the client to dictate the direction of the conversation) and “directing” (taking the reins in order to produce the counselor’s desired outcome):
"Midway between directing and following sits a guiding style. Guiding promotes a collaborative search for direction, a meeting of expertise in which the focus of treatment is negotiated. The client’s agenda is important, and any limitations inherent in the context are taken into account. The clinician’s expertise is also a possible source of goals. The focusing process of MI commonly starts in this middle ground between directing and following, where the focus, momentum, and content are mutually forged." (99)
After focusing comes evoking, which is arguably the most crucial and challenging of the four stages. Evoking is the process by which a counselor seeks to elicit and strengthen the client’s personal reasons for change. This is done through delving into the client’s ambivalence––their reasons for and against making the change or changes identified during the focusing stage. Careful attention is paid to “change talk” and “sustain talk”:
"Sustain talk and change talk are conceptually opposite––the person’s arguments against and for change––and they predict different outcomes. A predominance of sustain talk or an equal mix of change and sustain talk is associated with maintenance of the status quo, whereas a predominance of change talk predicts subsequent behavior change." (165)
Affirming and encouraging change talk is the main mechanism by which MI practitioners help clients articulate and commit to their intrinsic motivations for change. “Evoking is a co-creative process through which the person’s potential for change is released,” Miller and Rollnick tell us. “The motivation for change is emerging even as you speak together.” (182) Here we see another strong connection to Carl Rogers’s theory of personal growth, which prizes client autonomy and asserts that meaningful and lasting change typically stems from behavioral adaptations that are self-chosen rather than imposed from the outside.
The planning stage is precisely what it sounds like. “Planning is the clutch that engages the engine of change talk,” where client and counselor work out the details of how to transform the client’s desires for change into reality (30). Miller and Rollnick provide many useful examples and resources for how this can be accomplished, all the while staying true to their ethos of supporting the client as they discover what works best for them.
Although MI certainly seems like a great system, there are a couple apparent limitations I’d like to highlight. The first is simply that much of MI won’t apply to clients who aren’t seeking change or don’t need to change their behavior in any profound way. The second is that, by locating the potential and responsibility for change primarily within the client, MI runs the risk of downplaying or ignoring structural factors that may render change difficult or even impossible. To their credit, Miller and Rollnick are aware of this issue and mention it several times in the book. It’s important to remember that, due to external circumstances completely beyond their control, some people seeking counseling may not have the power to transform their lives in the way MI suggests. This isn’t really a criticism, but rather an acknowledgment that MI is just one of many effective tools we can use to meet humanity’s variety of mental health needs.
This review was originally published on my blog, words&dirt.
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April 21, 2025I am embarrassed about how long it took me to read this book (grad school is tough, man...). However, I LOVED it and highly recommend it to any therapist who is starting their psychotherapy training. The four basic Motivational Interviewing skills that the authors talk about: engaging, focusing, evoking, and planning are highly applicable to any type of psychotherapy you practice with your clients.
June 15, 2025
Den bästa boken om psykoterapi jag har läst. Ingen nonsens, full av praxis. Utstrålar en varm och empatisk syn på terapeutiska samtal vars utgångspunkt är att hjälpa personen hitta sin egna motivation (som vi alla har!) till förändring i livet.
July 26, 2018
Read for work. Written with clinicians in mind but has a lot of useful advice for people who want to become better listeners in all types of settings. Has some really tangible advice on how to divorce yourself from the impulse of offering people unsolicited advice, and instead working with others to find what they want and how they can get to that goal on their own. Also found it super useful for personal goal setting, and thinking about how I work towards my goals and react to failure. I'm not much of a reader of "self-help" style books but really did like this one!
January 3, 2018
One of my textbooks this semester. I thought it was a decent read, however I felt as if the concepts were very straight forward. This book was presented as a groundbreaking theory of sorts but I got the feel that MI is simply an explanation of current concepts counselors face. It was valuable for learning a few new skills though!
June 2, 2019
ספר מעולה, קריא וברור, מאורגן היטב בנושא של גישה מוטיבציונית כגישה טיפולית.
ממליצה מאוד לכל עמיתי הפסיכולוגים. מומלץ גם לרופאים, אחיות, עובדים סוציאלים וכל אנשי הטיפול באשר הם.
ממליצה מאוד לכל עמיתי הפסיכולוגים. מומלץ גם לרופאים, אחיות, עובדים סוציאלים וכל אנשי הטיפול באשר הם.
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September 30, 2024Nu är jag färdig. Den är utläst. Slut! Skönt. Hade jag kunnat gjort något bättre med tiden? Förmodligen, framförallt all ineffektiv tid som lagts på att tänka att jag borde läsa ut den, men nu är det gjort. Sånt här behöver väl övas på, inte bara läsas om. Tycker ändå de 18 första kapitlena gav matnyttig info och jag gillar MI som metod och koncept. Hade velat omsätta det bara – för att det ska stanna kvar. Det försöker jag ju dock så gott det går i egna samtal med patienter. En del saker hade kunnat kortas ner. Tycker även vissa översättningar fungerar sådär. Nya upplagan är förmodligen bättre. Hej och hå
July 3, 2025
the OGs of motivation interviewing. great introduction to this practice. humble reminder that theory isn't enough. applying what we read, is the final test. nevertheless, this will be a timeless toolkit. glad I make a habit of writing my own index(thanks pmac)
August 31, 2025
This is *the* MI guidebook, written by the masters. This edition has moved with the research and is even more person-centred than the last. It’s written in an incredibly engaging and straightforward way that equips you to start practising immediately. It also describes ways to improve and refine MI practice. An absolute must have for any therapist, coach, teacher, or leader.
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December 13, 2024Fantastic
March 29, 2021
Read for work!!
April 25, 2024
I forgot to mark this as finished last week. but this was a really helpful book for my motivational interviewing class. I liked that it was not a boring school text but rather it had scenarios and example in the book, it kept it interesting!
February 24, 2017
If you are giving services one on one this book will help you a lot.
Focuses on effective client-centered approach with good examples.
Focuses on effective client-centered approach with good examples.
April 28, 2016
When I first opened this book, I was so excited to read it. In theory, I think it's a great book for most medical professionals to read. How often do we all feel as though we are being herded in and out of the doctor's office without anyone actually listening or looking up from their laptop?
From an interpersonal communication standpoint, it is great. If you have no skills in this area or are not naturally empathetic towards others, this book can greatly help you. However, I found a lot of the chapters to be a bit redundant and a little bit too "text booky".
I felt as though the authors have a lot of knowledge, but being in the medical field they felt the need to constantly reference without trusting in themselves and the information they are here to offer. The book spent a lot of time talking about revisions they have made to this philosophy/book over the years--which as a first time reader, I felt was unnecessary and caused me more reading. Perhaps a section in the back devoted to this would have been great. I think the book could have been a third of the length and got the same message across.
Great theory.
From an interpersonal communication standpoint, it is great. If you have no skills in this area or are not naturally empathetic towards others, this book can greatly help you. However, I found a lot of the chapters to be a bit redundant and a little bit too "text booky".
I felt as though the authors have a lot of knowledge, but being in the medical field they felt the need to constantly reference without trusting in themselves and the information they are here to offer. The book spent a lot of time talking about revisions they have made to this philosophy/book over the years--which as a first time reader, I felt was unnecessary and caused me more reading. Perhaps a section in the back devoted to this would have been great. I think the book could have been a third of the length and got the same message across.
Great theory.
April 10, 2020
قرأته قراءة سريعة و تجاوزت اجزاء عدة
اعتقد انى فهمت الفكرة العامة
مؤكد سأعاود قرأته بالتفصيل
ما جذبني في فكر روجرز و فلسفة العلاج المتمركز حول العميل هو المنظور الايجابي و البراديم الذي يرى به العميل
باعتباره انسان يرغب ف التغيير و بداخله نورا يسعي المعالج لتللامس معه و اخراجه وصقله
لإزالة توترات التناقض الوجدانى الذي يثقله و يجثم على صدره و يعيقه
ولا يرى العميل كشخص سلبي فاقد للتحكم ينبغي توجيهه و الضغط عليه ..
وهى النظرة الشائعة !
و عجبني تشبييه للأمر فى مقارنته بين أسلوب المواجهة و أسلوب التمركز حول العميل و احتوائه بشئ من القبول و الدفأ يعينه على التعامل مع التناقضات الوجدانية
بمصارعة بين شخصين أو رقصة لطيفة تدار من المعالج بخفة !
اعتقد المنظور دا ان تم تعميمه كفلسفة للتعلم و التعليم عموما سيصبح العالم مكان أفضل بمراحل !
اعتقد انى فهمت الفكرة العامة
مؤكد سأعاود قرأته بالتفصيل
ما جذبني في فكر روجرز و فلسفة العلاج المتمركز حول العميل هو المنظور الايجابي و البراديم الذي يرى به العميل
باعتباره انسان يرغب ف التغيير و بداخله نورا يسعي المعالج لتللامس معه و اخراجه وصقله
لإزالة توترات التناقض الوجدانى الذي يثقله و يجثم على صدره و يعيقه
ولا يرى العميل كشخص سلبي فاقد للتحكم ينبغي توجيهه و الضغط عليه ..
وهى النظرة الشائعة !
و عجبني تشبييه للأمر فى مقارنته بين أسلوب المواجهة و أسلوب التمركز حول العميل و احتوائه بشئ من القبول و الدفأ يعينه على التعامل مع التناقضات الوجدانية
بمصارعة بين شخصين أو رقصة لطيفة تدار من المعالج بخفة !
اعتقد المنظور دا ان تم تعميمه كفلسفة للتعلم و التعليم عموما سيصبح العالم مكان أفضل بمراحل !
October 21, 2016
Daca iti place Carl Rogers aceasta carte este un must-read. Metoda MI este o metoda care pleaca de la principiile lui si le duce mai departe definind mai clar cum ar trebui sa aiba loc o conversatie in care un client sa fie ajutat sa isi schimbe anumite comportamente. Cum sa construiesti motivatia pentru schimbare in celalalt intr-un mod potrivit fiecaruia. Tehnicile MI au multe cercetari si evidente in spate si pot fi complementare multor tipuri de terapii sau interactiuni in care sunt implicati oamenii.
November 27, 2018
Obviously I like this in part because I gravitate towards MI but I also think this book is incredibly well written for a clinical resource/textbook given the amount of concrete examples given throughout! The commentary throughout on how MI has evolved with time and exploration of how it stems from Rogerian and other theories is also helpful in getting a deeper understanding of the theory and practice. Also, the chapters are short and it is incredibly readable, so easily read even when exhausted!
July 22, 2019
THE textbook on Motivational Interviewing. I read this as it pertains to my career (clinical psychologist in training), but this was not assigned reading. This book solidified my perspective that motivational interviewing is crucial for therapists who are often engaging with clients who are not yet ready for or committed to making changes. This book was quite dense and I found it hard to translate directly into my practice, but the authors speak to that and provide recommendations for training. I look forward to pursuing training opportunities in the future.
4/5
4/5
June 25, 2013
Motivational Interviewing is a useful style of interacting with people in counseling situations where the person may not want to be there & may not see the need for change. This book gives a very easy-to-understand & practical guide to using this style to help people build their own motivation for change. It provides a good mix of theory & practice for clinicians & I think it's useful for anyone who works with people who may not want help.
September 22, 2014
Excellent. It's too bad that, as the authors say, you can't become a proficient motivational interviewer from reading a book. Still, though, the concepts and methods laid out in this book are clear and user-friendly, and to whatever degree I can, I've been using them with clients with some success. A wonderful approach for clients who are ambivalent about changing in therapy (who isn't, really?).
February 1, 2024
Read this for a substance abuse class, though the material presented in this book could be practiced on a wide variety of populations. This is an easy to read book with good nuggets of information throughout.
February 4, 2011
Must-read for anyone in the mental health field.
Want to read
April 26, 2014i have done my master in social work and near to start any job .that's way i want to read some books which can help me in my practice.
September 17, 2024
Required reading for my coaching certification, but honestly really enjoyed it. Thorough, research-heavy, and yet still approachable and digestible. This will have a permanent place on my bookshelf.
March 1, 2025
Listened to this as an audiobook, because I currently work with mandated clients, and this was really helpful!
December 13, 2024
I audiobooked the fourth edition of this book, but it didn’t seem like there was a listing with it created underneath the proper author. At times, I thought this was going to be very boring, but I chugged through all 10 hours of it pretty fast. There was honestly a lot to take away. It’s always interesting to see the effect that Carl Roger’s had on the psychotherapy industry, because he was so correct about so many things (despite my 3 star review of his book). It’s nice to see client centered therapy at the crux of what truly motivates people to change. Some concepts I really enjoyed were identifying change vs sustain talk, the OARS and DARN mnemonics, asking lots of questions/making lots of reflections, and my continued observation that the client has the most expertise about themselves and information about how to change in the room. It’s about getting people to come to their own conclusions, I like the quote: “you learn what you believe in the same way other people learn what you believe, by hearing yourself talk”. A lot of change happens in the client by just listening to them. Emphasis on patient autonomy/freedom is essential. This is just a stream of consciousness, so I’m going to randomly transition to another thought I had. I liked how this book talked about thinking about how the patient might respond to what you say. A command to make someone change like “you will do this” immediately evokes a “no I won’t” in the client. It’s just human nature. That’s why we are careful when it comes to asking about peoples ambivalence and getting to the bottom of their feelings about certain things. An ambivalent person will always list the cons in response to you providing the pros. Lastly, I liked the audio recordings of live interviews. And I think that the author/authors are a reliable source of information and intellectually humble, with the desire to make motivational interviewing to accessible to everyone.
While I am not a psychotherapist, this information is important for me to know. I care deeply about a lot of my friends, some of whom have bad habits. I’ve never been the one to tell people what to do, or make people feel shame for their actions. But I think I’ve done some damage in the way I’ve advised people before, or the way I’ve made them feel in a conversation about change. I don’t think just merely reading this book will make me much better at that, without practicing or having clinical experience. But, at the very least, I can try to mitigate damage that I may have done otherwise.
While I am not a psychotherapist, this information is important for me to know. I care deeply about a lot of my friends, some of whom have bad habits. I’ve never been the one to tell people what to do, or make people feel shame for their actions. But I think I’ve done some damage in the way I’ve advised people before, or the way I’ve made them feel in a conversation about change. I don’t think just merely reading this book will make me much better at that, without practicing or having clinical experience. But, at the very least, I can try to mitigate damage that I may have done otherwise.
August 5, 2023
This book is written by the people who created the concept of motivational interviewing - a specific way of communicating with people - and it's a thorough look at all the different aspects of it.
The basic idea is that telling people what to do often just results in a defensive response. Instead the aim is to encourage people to hear themselves, their own ambivalence about problems and their own wish to improve the situation. Or you give them the opportunity to talk through their opposition to making any changes. Periodically you may ask if you can make a suggestion, but this needs to be rare - nearly all talking is done by the client.
Methods include:
Listening to the client and reflecting back what you have heard.
Asking open ended questions eg asking them how they might feel about something if the situation hasn't changed in several years time. Or to what degree their current behaviour supports their relationships.
Supporting and encouraging the client any time they talk about anything that is positive or helpful to them, especially any comments showing a willingness to change and improve their situation.
Summing up what has been said as you progress in your journey with the client. Helping them see their progress.
If there is resistance you acknowledge rather than oppose it, and using the above methods you try and open their issues up for discussion.
The book is full of examples, which are very helpful. The first half of the book is practical: the second half is more about how MI has been assessed, and how it works in different contexts eg as someone working with people having problems with drugs or alcohol, or someone working with patients in a medical practise, or someone working with people who are incarcerated. It has many potential applications, although its main one so far has been in helping people with substance abuse disorders.
When it comes to putting MI into practise I have found it difficult - partly because I have little experience with these things, partly because my elderly ossifying brain finds it hard to remember to do these things on the hoof. On the rare occasions when it has been appropriate for me to try and use it I've been pleasantly surprised.
For anyone interested in this subject one of the authors - William Miller - is featured in various You Tube videos, and probably podcasts as well.
The basic idea is that telling people what to do often just results in a defensive response. Instead the aim is to encourage people to hear themselves, their own ambivalence about problems and their own wish to improve the situation. Or you give them the opportunity to talk through their opposition to making any changes. Periodically you may ask if you can make a suggestion, but this needs to be rare - nearly all talking is done by the client.
Methods include:
Listening to the client and reflecting back what you have heard.
Asking open ended questions eg asking them how they might feel about something if the situation hasn't changed in several years time. Or to what degree their current behaviour supports their relationships.
Supporting and encouraging the client any time they talk about anything that is positive or helpful to them, especially any comments showing a willingness to change and improve their situation.
Summing up what has been said as you progress in your journey with the client. Helping them see their progress.
If there is resistance you acknowledge rather than oppose it, and using the above methods you try and open their issues up for discussion.
The book is full of examples, which are very helpful. The first half of the book is practical: the second half is more about how MI has been assessed, and how it works in different contexts eg as someone working with people having problems with drugs or alcohol, or someone working with patients in a medical practise, or someone working with people who are incarcerated. It has many potential applications, although its main one so far has been in helping people with substance abuse disorders.
When it comes to putting MI into practise I have found it difficult - partly because I have little experience with these things, partly because my elderly ossifying brain finds it hard to remember to do these things on the hoof. On the rare occasions when it has been appropriate for me to try and use it I've been pleasantly surprised.
For anyone interested in this subject one of the authors - William Miller - is featured in various You Tube videos, and probably podcasts as well.
June 4, 2025
This book definitely did not disappoint. Not only did it reach my expectations, but it surpassed it by a mile far. I think anyone going into healthcare, interacting with patients needs to read this book. Rolnick and Miller has struck a delicate balance between holding a holistic view of human flourishing and having the empirical and technical foundations to properly verify and evaluate its reliability and validity. This book provides a clear, step by step guide to properly engage in the craft of motivating patients to change for the better, while still promoting the patient’s autonomy to decide what is best for them. Their extensive use of examples, of citations, of analogies, of metaphors and clear instructions, of summaries, key words makes this book incredibly well thought-out and reflective. For each chapter, they outline the sources for their claims. They are not shy of engaging deeply in empirical research; Motivational Interviewing is an evidence-based therapeutic practice. They also outline towards the end of the book the reliable ways to measure MI, through rating scales and recordings, while still emphasizing that nothing is as good as being properly evaluated by experts in the practice. I especially appreciate their mention of therapeutic drift, which is a crucial concern I’ve seen first-hand. For sure, MI is heavily intertwined with humanist principles. But MI is not humanism; while humanism functions under specific assumptions and has specific objectives, MI is simply a way of engaging with individuals, no matter what kind of service you provide. It has given me a greater appreciation of the importance of valuing the autonomy of patients. I truly believe that MI is pushing for a paradigmatic shift in thinking about how to engage with patients who are discordant with their therapists and doctors. Your use of MI should always be flexible and dependent on your interlocutor’s personality and readyness to change. After all, MI was developed originally for patients with substance use disorders, ambivalent about their desire to change. It would be of little use to go through all the steps of MI from beginning to end with patients who are very invested in their change of lifestyle. Still, the principles of MI can still be helpful no matter what steps of change a person is engaged in. I think this book has the power to lead to important changes in the healthcare industry if people invest themselves more in the betterment of people and their autonomy.
This entire review has been hidden because of spoilers.
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