Motivational Interviewing explained

Motivational Interviewing is an evidence-based counselling method for working with ambivalence about change. It was originally developed in the context of alcohol and other drug treatment and is now used across a broad range of health and mental health presentations, including trauma recovery.

The approach is defined less by a set of techniques than by an underlying stance, sometimes called the spirit of motivational interviewing. This stance is collaborative, evocative and respectful of autonomy. The counsellor works in partnership with the client, draws out the client's own reasons for change, and recognises that decisions about behaviour ultimately rest with the person themselves.

Four processes structure the work. Engaging establishes a working alliance and an accurate understanding of what the person is experiencing. Focusing identifies the specific area of change under discussion — for example, sleep, substance use, avoidance of trauma reminders, or attendance at appointments. Evoking draws out the person's own motivations for change through careful listening and reflective questioning. Planning translates motivation into a concrete, workable next step when the person is ready.

Core skills include open questions, affirmations, reflective listening and periodic summaries. The counsellor listens for and selectively reinforces change talk — the person's own statements about the desire, ability, reasons and need for change — while avoiding argument and direct persuasion.

In trauma-focused practice, motivational interviewing is often used at the beginning of treatment to explore readiness for exposure-based work, to address ambivalence about accessing support, or to work with co-occurring substance use, sleep difficulties or health behaviours that affect recovery. It can be integrated with other modalities rather than delivered as a stand-alone treatment.

Telehealth delivery is straightforward. The method relies on structured conversation and does not require any specialised equipment or in-room activity.

If you have a Victims Services approval and would like to discuss how motivational interviewing might support your goals, submit an enquiry through the contact form.