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Practice introduction

Motivational interviewing

A collaborative way of talking about change that pays attention to autonomy, ambivalence and a person's own reasons — not confrontation or persuasion.

TD ConsultancyPublished 5 August 2026Reviewed 5 August 2026Miller & Rollnick · NICE psychosocial guidance · TD practice manual

Core stance

Partnership before persuasion

Motivational interviewing is not a bag of clever questions. Its relational foundation — partnership, acceptance, compassion and evocation — changes how skills are used.

Person’s own
reasons
ListenExplorePlan
01

Engage

Build a working relationship in which the person feels heard, respected and able to disagree.

02

Focus

Agree what change, behaviour or decision the conversation is actually about.

03

Evoke

Draw out the person’s own reasons, needs, confidence and concerns about change instead of supplying an argument for them.

04

Plan

When readiness strengthens, move towards specific next steps without rushing ahead of the person.

Skills in practice

Open questions

Invite more than a yes/no answer: “What do you like about the way things are now, and what is becoming less okay?”

Affirmations

Notice effort, values or strengths without empty praise: “You kept that appointment even though the week was chaotic.”

Reflective listening

Offer a concise hypothesis about meaning: “Part of you wants the effects, and another part is tired of what happens afterwards.”

Summaries

Gather both sides of ambivalence and highlight the person’s own change language without pretending one side does not exist.

Change talk

Listen for desire, ability, reasons, need and commitment language. Avoid turning this into a checklist that makes the conversation mechanical.

Evidence and practice boundary

Motivational interviewing is an evidence-based conversational approach, not a guaranteed treatment outcome or a substitute for emergency, medical or safeguarding action. This introduction draws on the supplied TD practitioner manual and established MI practice.