Motivational Interviewing Explained: The 3 Core Foundations Every Therapist Must Know

If you’ve ever felt unsure about how to actually apply Motivational Interviewing in real sessions—this episode is your starting point.

In this foundational episode of MI4Change, Dr. Monica Gilbert breaks down the 3 essential pillars of Motivational Interviewing in a way that is practical, clear, and immediately applicable.

Whether you’re a therapist, BCBA, psychologist, coach, educator, or leader, this episode will give you the tools to transform your conversations and create meaningful change.

You’ll learn:

•  The Spirit of Motivational Interviewing (PACE) and why it matters more than techniques 
•  How to use OARS communication skills (Open-ended questions, Affirmations, Reflections, Summaries) effectively 
•  The 4 Processes of MI: Engaging, Focusing, Evoking, and Planning 
•  Why many clinicians unintentionally create resistance—and how to avoid it 
•  How to shift from expert-driven conversations → to collaborative change
•  Real examples you can apply immediately in therapy, leadership, and coaching 

Motivational Interviewing is not just a technique—it’s a way of being with people.

And when done correctly, it helps clients find their own motivation… instead of relying on yours.

🎯 If you're new to MI, start here.
 🎯 If you're experienced, this is your reset.

Learn more about Motivational Interviewing and explore on-demand courses at www.drmonicagilbert.com

Join the MI Academy for practical training and resources — and enjoy an exclusive 15% off with code MIFORCHANGE at checkout.

📲 Connect with me on Instagram: @drmonicagilbert

Transcript

SPEAKER_00 0:08

Welcome to MI for Change, where we talk about conversations that actually move people forward using motivational interviewing in real life, real sessions, and real leadership. I'm your host, Dr. Monica Gilbert, and today we're going to be speaking about the foundations and the fundamentals of motivational interviewing. So I am taking it back. For those of you who are completely new to this podcast, this is a great way to start listening and learning about the fundamentals of motivational interviewing. For those of you who have been here for a while, this is going to be a quick review. It's always good to just have a quick review of these foundational skills of motivational interviewing, whether you're a therapist, a behavior analyst, a coach, an educator, a parent, anyone, anyone that wants to improve conversations with others and spark motivation. So in this episode, we will be covering three essential pillars to motivational interviewing. There are other acronyms and other important things, but let's just cover these three fundamental things. So the first one is the MI Spirit, the ORs of Communication Skills. I like to call these the tools to your toolbox and the four processes of motivational interviewing. So this is how we're going to use the ORs and take the spirit of motivational interviewing with us through our conversations with others. So let's dive into the spirit of motivational interviewing. Before we talk about techniques, we have to talk about the spirit. In motivational interviewing, we see it as not just a set of strategies, but it is a way of being with people. And the spirit of motivational interviewing reminds us of that. So there's a nice acronym that you can use in order to remember what the spirit of motivational interviewing is. And this acronym is FOLO Your Pace, P A C E. So let's go over the first one, which is P for partnership. So partnership is collaboration. We are not the expert in telling everyone what to do. Instead, we work with the person. Not I know what's best for you, but let's figure this out together. And this is where the partnership comes in. Instead of having a hierarchy model where you are the expert and the other person is either the student or the person that has no idea what's going on, and you're there to just help them with your knowledge and all of your expertise. You are working together in a way where you honor that person's expertise because the reality is that people are experts in their life. They absolutely know what has worked and what hasn't worked in their life. You're just meeting them for the first time. So just something to keep in mind. Next is a for acceptance. And sometimes you will see it as acceptance or autonomy. And when we look at acceptance, it includes four pieces to it: absolute worth, accurate empathy, autonomy, support, and affirmation. This means recognizing that the person sitting across from you has the right to make their own choice, even when those choices are not the right ones in your eyes, or even when those choices tend to frustrate you. At the end of the day, they are going to do what they want to do. So let's just accept their absolute worth, have accurate empathy towards them, accept their autonomy, and also provide affirmations for all of these. The next one is see for compassion. And compassion means that we are genuinely acting in the best interest of the person. This is why when you are providing parent coaching or parent training session, I've always said that you have to picture your client as being that parent that is sitting in front of you. A lot of the times our clients, well, if we're working with little ones or with the adolescent or the teen, our client is that teen or that child. When we are providing parent coaching or parent training, however you want to call it, our client has to become that parent. That is the only way where we can have this compassion and genuinely have that compassion for them. Because if we're thinking in the child's best interest, it shifts the mood a little bit. It kind of doesn't allow us to dedicate this compassion to the person that we are speaking with. So what does that mean? Well, we're not pushing our agenda, not trying to win the conversation, but helping them move towards their own values and goals. And in order to know what their values and goals are, well, we have to ask the right questions. We have to ask the right open-ended questions, and we also have to build that trust. Next is evocation, E for evocation. And this is one of the most important parts of MI. This is also one of the trickiest and most challenging for most people to use, more so when we are in the healthcare field and we're so used to helping people out and always finding solutions for them. That's what they come to see us for, right? So evocation, instead of installing motivation, we evoke motivation. We believe that the person already has the reasons for change inside of them. Our job is to draw those reasons out. That is simply what we are doing with our open-ended questions, with our reflections. We want them to speak about these things. And we have learned that the more they speak about these things, the more likely they are to move towards that change. All right. So that is a spirit of motivational interviewing. And the way that you can conceptualize it or think about it is that you are taking that spirit of motivational interviewing into each of your conversations. So it's not just like a step that you have to take in order to get to the next step, but it's just something that we're taking with us. So it's the coat that we are wearing when it's cold outside. It's what we are taking with us in all the conversations. All right, the next part are the ores. And in some literature, you will see it as simply the oars, in other literature as the ores plus I. I like to use the oars plus I because I just like to include it all. But let's go over the ores, which are the core communication skills. These are the tools that you will use in your toolbox. Now, the ORs. Uh O A R S are the micro skills of motivational interviewing. When we look at the O, O stands for open-ended questions. And open-ended questions invite exploration. They also are used in the beginning of your rapport with the client in order to build that trust with them. The difference between an open-ended question and a closed-ended question is that you will get, with an open-ended question, an open-ended response. With a closed-ended question, you'll get a closed-ended response. A difference is is that intervention working for you? And the person says yes or no. This is a close-ended question because you receive a yes or no response, which is a close-ended response. Now, if you ask something like, what part of this intervention is working for you? Well, here you are naturally going to get tons of elaboration. This is an open-ended response. Same concept, different questions, different responses. A little tip here on how to use motivational interviewing open-ended questions is that you want to anticipate the response. If the response you're anticipating is just a yes or no response, then the question that you're asking is actually a closed-ended question. Here's another example. Do you want your child to behave better? Yes, no. Well, I don't know anyone that would say no. What concerns you? What are some of your concerns about what is happening lately or about your child's behavior? So you can see how here we get we get more colors, we get more elaboration, we get more of what we're looking for, more data. And the truth is that open-ended questions create space for conversations. When we ask a closed-ended question, we're going to get a yes or no, which is gonna die right there. Open-ended question, we're gonna get more of that elaboration. Next, we have affirmations, which is the A in the ORs. And affirmations recognize the strength, the effort, and the values. They're not just compliments. It's not like you're just being a cheerleader and you're saying something like, Wow, good job, parent, or good job, client, or or intern, you're doing such a good job. You want to highlight what the person is doing well. For example, I can tell you care deeply about your child and you've really been trying different strategies. Affirmations build confidence and engagement. So that's really the goal in using these affirmations. Next, we have reflections, which is the R and the ORs. And reflections are the engine of motivational interviewing. Instead of asking another question, we reflect back what we hear. Now, for some people, it is difficult to use reflections. And sometimes they use open-ended questions thinking that they are reflections. The tip to using reflections is that you are simply reflecting what the person is saying. Don't ask another question to get a response. You are simply just telling them or communicating, I'm there with you. I get you. And this seems important. And this is what I'm hearing. So, this is what you are communicating to the person. You are not trying to get more data or get more information or try to evoke something. You're simply just reflecting back. Let's say that a parent says, I'm just exhausted. Nothing seems to work. You would say something like, You've been trying really hard, and it feels discouraging when strategies don't seem to help. I would maybe tilt this a little bit and start off with, it feels discouraging when the strategies don't seem to help. You've really been trying very hard to make them work. So you want to end with this encouragement, or you want to end with this change talk part. Reflections and encourage the person to go deeper into their own thoughts. So that is what reflections are. There's this psychology joke where a therapist is in front of the client and the client looks at the therapist and says, Doc, you're on fire. And the psychologist looks at the client and says, What I'm hearing is that you're saying that I'm on fire. So this is this is uh comical because, well, you don't want to just use reflections to to use them. You want them to make sense, obviously. And you want them to, you want to use them in a way that it is natural and not something that you're faking because everyone knows when someone is faking something. So if it doesn't feel natural, don't use them or practice more so that you can use them effectively. Now, summaries. So summaries pull together key parts of the conversation. They show the person, I've been listening. Some examples are so what I'm hearing is that mornings have been especially stressful. You want your child to be more independent and you're open to trying some new routines if they actually work. Summaries often transition conversations toward change. And you can use summaries at the end of your meeting with that client, or you can use them to transition to another topic. So instead of just redirecting the conversation to another topic, you summarize and then you go to the next conversation. So these are the different parts of the ORs. And if you're wondering what the plus I is, I'll let you know right now. I is for interchange, is for communication interchanges. So in the I, we are using an approach where we are asking the person what they already know about a certain concept or subject, and then we are asking them if we can share our information. And then lastly, we want to check in again. So, what did you understand from the information that I just shared with you? This is a very respectful way of honoring clients' autonomy, but also communicating when there are concerns or when there's some misinformation that you have to communicate about. All right, so part three are the four processes of motivational interviewing. So MI also flows a flow. So, what does that mean? So we have to pay attention to this flow of the conversation. And usually this flow of the conversation has to do with the four processes of MI. Think of them as a roadmap for the MI conversation. So we are going to start with the first step, which is engaging. Once we have engaging, we are going to start focusing. After we focus, we are going to start evoking. And then lastly, planning. And again, it's not like we stop using the first one, we just integrate it into the other one. So this is a general flow of the conversations, and we're going to use the oars in different ways in all in each of these processes. So engaging, this is about building the relationship. It sounds like exactly what it is. People, before anything else happens, the person needs to feel heard. They need to feel understood. They need to feel safe. And without engagement, the rest of the conversation just won't work. This is our report building. This is our trust building. And many clinicians sometimes skip this step and they jump straight into problem solving. But hey, you haven't really built this trust with your client. And that often triggers resistance, which is what we want to step away from. We want to step away from this discord that tends to come about when we don't have, when we're not seeing things eye to eye or when we don't have that trust in the relationship. The next processes is focusing. And focusing is our what phase. So what are we doing here? Once we build connection, we clarify what we are talking about. So in therapy, there are often multiple concerns. Focusing helps answer the question: what direction are we moving towards today? An example is it sounds like sleep and homework are both challenging. Which one feels most important for us to talk about right now? Again, we are trying to identify the values and how that aligns with our goals. And that is what that focusing stage or process does. Next, we have evoking. And this is the heart of motivational interviewing. Here we begin to draw out change talk. Change talk includes statements about desires to change, ability to change, reasons, need, commitment, that whole darn cat. For example, I really want things to get better at home. Our job is to reinforce and expand those statements. So I would really love if these behaviors weren't happening anymore. Or I wish that I could go to a restaurant with my child and not be scared about their behavior in that restaurant. Or I feel like I can start using this intervention today. So these are all statements of change talk. And what we want to do is highlight them and reinforce them. Next process is planning, and planning happens when the person is ready. We've already built adequate rapport, we've already focused and we know what we're going to work on. We've evoked some of this as well. And now we are in this planning phase. And this is not when we think the client is ready, but this is when they show us that they are ready. The planning includes exploring options, strengthening commitment, and identifying the next steps. For example, you might say something like, What do you think might be the first small step towards this goal? And it can start with that, and then you can talk about other elaborations of that goal. So the key takeaway here is that MI is powerful because it shifts the dynamic. So instead of that expert, advice, and resistant model, because that's usually how it happens, we are the experts, we give the advice, and then we get a lot of this avoidance and a lot of this resistant behaviors. We actually move towards partnership, exploration, and later on motivation. And when we practice a spirit of MI, we use the orgs and we follow the four processes. We create conversations where people discover their own reasons for change, not just our own reasons for change. And those are usually the strongest and the ones that are going to maintain even when the therapy session or even when the leadership or the mentorship is over. And that's what we want to see. So if you found this episode helpful, share it with a colleague or a therapist who is learning about MI. And if you want to go deeper, check out my book, How to Stop Talking and Start Communicating with Motivational Interviewing, which you can find on Amazon. I also created these deck cards on Amazon as well, where you can use it as cheat sheets to learn how to use open-ended questions, reflections, and affirmations. I hope that you found value in this episode of MI for Change, and I hope to see you on our next episode. Thank you for joining me on today's episode of MI for Change. If you're ready to keep growing your motivational interviewing skills, I'd love to invite you to explore my MI Academy, where you'll find a full library of on demand courses designed to help you put MI into practice with confidence. You can learn more at www.drmonicagilbert.com. Until next time.