There are moments when part of you knows that something needs to change, but another part of you resists. You might want to cut back on drinking, set better boundaries, follow through on goals, or take better care of yourself, but you still find yourself doing the same things. This isn’t a lack of willpower. It’s often a reflection of ambivalence, two competing motivations existing at the same time.
Motivational Interviewing is a therapy technique that was developed to work directly with that tension. Rather than pushing you toward change or trying to convince you what to do, it helps you explore your own reasons for change in a way that feels collaborative and grounded.
Origins of Motivational Interviewing
Motivational interviewing, often referred to as MI, was originally developed by William R. Miller and later expanded with Stephen Rollnick. It began in the field of substance use treatment, where therapists noticed that confrontation and direct advice often led to resistance rather than change.
Instead of telling people what they should do, MI was built with a different aim. It states that people are more likely to change when they feel understood, when their autonomy is respected, and when their own motivations are brought into focus. At its core, MI is grounded in empathy, collaboration, and respect for your ability to make decisions about your own life.
What It Looks Like in Therapy
Motivational interviewing can feel different from more directive approaches. The therapist is not there to argue for change or to persuade you. Instead, they are listening carefully for what matters to you, what you care about, and where there may be a gap between your current behavior and your goals.
You might notice the therapist asking open-ended questions that help you reflect more deeply. For example, what concerns you about this pattern, what do you like about it, what feels hard about changing, and what might be different if you did. These are not random questions, they are designed to help you hear your own thoughts more clearly.
A key part of MI is exploring ambivalence. Rather than trying to eliminate hesitation, therapy makes space for both sides. You might talk about the benefits of a behavior and the costs, the reasons to stay the same and the reasons to change. Over time, this process helps clarify what feels most important to you.
The therapist may also reflect back what they are hearing, highlighting your own statements about change. This is often called “change talk,” and it plays a central role in building momentum.
Understanding the Stages of Change
Motivational interviewing is closely connected to the idea of stages of change, a model that helps explain how people move through the process of changing behavior.
In the “precontemplation stage”, change may not feel necessary or relevant. In “contemplation”, you begin to consider the possibility of change, but may feel unsure or conflicted. “Preparation” involves starting to think about how change might happen. “Action” is when you begin to take concrete steps. “Maintenance” involves sustaining those changes over time.
People do not move through these stages in a straight line. It is common to move back and forth between them, especially when change is difficult or when old patterns are deeply ingrained. MI is particularly helpful in the earlier stages, where motivation is still developing. It meets you where you are, rather than expecting you to already be ready.
How It Can Help with Behavioral Change
Motivational interviewing is widely used for issues that involve behavior change, especially when there is ambivalence or resistance. It is well known for its effectiveness in working with substance use, where people may feel both the pull to continue and the desire to stop. By helping people articulate their own reasons for change, MI can increase motivation and reduce defensiveness.
It can also be helpful for other areas, such as improving health behaviors, managing chronic conditions, addressing procrastination, or making changes in relationships or other areas in life. Any situation where there is a gap between intention and action can benefit from this approach. Rather than relying on external pressure, MI helps build internal motivation, which tends to be more sustainable over time.
The Limits of Motivational Interviewing
While motivational interviewing can be a powerful tool, it is not designed to address every aspect of mental health on its own.
MI focuses primarily on increasing motivation and readiness for change. It does not provide extensive skills training, deep emotional processing, or structured interventions for conditions like trauma, obsessive-compulsive disorder, or severe depression. In these cases, it is often used alongside other approaches rather than as a standalone treatment.
It is also less effective when someone is already highly motivated and ready to act. In those situations, more direct or skills-based approaches may be more appropriate.
Another limitation is that MI requires a certain level of engagement. If someone is not open to reflection or conversation, the process may feel slow or unclear.
A Collaborative Path Toward Change
Motivational interviewing respects that change is complex. It recognizes that you may have good reasons for doing what you are doing, even if those patterns are no longer serving you. Rather than pushing you, it works with you. It helps you hear your own voice more clearly, understand what matters to you, and move at a pace that feels realistic.
For many people, that shift alone can make change feel more possible. Not because someone else told you what to do, but because you were able to connect with your own reasons for doing it.
At Birchwood Clinic, we work with those who are struggling to make changes and feel frustrated with the lack of progress. We offer both virtual therapy and in-person sessions, allowing you to choose the format that fits best with your schedule and lifestyle. Birchwood Clinic accepts BCBS PPO, Aetna, Blue Choice, and Anthem plans.
When you’re ready to explore the changes you want to make, we’re here to help. Call, email, or book an appointment online to get started.
