![A garden path forking in two around a young shrub, with a bench set at the fork](https://viacara.com/img/content/approaches-motivational-interviewing-feature-light.webp) # Motivational interviewing Learn what motivational interviewing is, how its four tasks work with being in two minds about a change, and what the evidence does and does not show. ## What is motivational interviewing? Motivational interviewing is a way of talking about change. The National Institute for Health and Care Excellence defines it as helping people explore and resolve ambivalence towards change. Being in two minds is the point of it. Miller and Rollnick describe it as a tool for when someone is reluctant or ambivalent about a change. Nobody argues you into anything. NHS Education for Scotland says the approach does not apply coercive methods to impose change. Sources: [NICE NG181](https://viacara.com/approaches/motivational-interviewing/#ref-1), [Miller & Rollnick 2009](https://viacara.com/approaches/motivational-interviewing/#ref-2), [NES: Matrix MI guide](https://viacara.com/approaches/motivational-interviewing/#ref-5) ## The four *tasks* The conversation moves through four tasks. Miller and Rollnick name them as engaging, focusing, evoking and planning. They used to be called processes. The fourth edition of their book renamed them tasks in 2023. Miller and Rollnick also name four words for its spirit. They are partnership, acceptance, compassion and empowerment. Empowerment is the newest of the four. They broadened the earlier idea of evocation, to stress your own strengths and your autonomy. Four connected *tasks* - **Engage** The professional listens and works to understand what matters to you. - **Focus** Together, you agree what the conversation will address. - **Evoke** You explore your own reasons for change and your mixed feelings about it. - **Plan** When you are ready, you consider how you might make a change. These tasks can overlap and recur. The professional draws out your reasons rather than telling you to change. Sources: [Miller & Rollnick 2023](https://viacara.com/approaches/motivational-interviewing/#ref-3), [MINT: understanding MI](https://viacara.com/approaches/motivational-interviewing/#ref-12) ## Why it is a *style*, not a therapy Motivational interviewing is not a school of therapy. Miller and Rollnick call it a guiding style for strengthening your own motivation to change. They are blunt about its reach. They write that it would make little sense to run a practice offering only this. So you are most likely to meet it inside other work. Miller reports that its commonest use now is alongside other methods, such as [cognitive behavioural therapy](https://viacara.com/approaches/cbt/). Sources: [Miller & Rollnick 2009](https://viacara.com/approaches/motivational-interviewing/#ref-2), [Miller 2023](https://viacara.com/approaches/motivational-interviewing/#ref-4) ## What *sessions* look like It is meant to be short. Miller and Rollnick write that they would not expect it to fill more than a session or two. Research has run it longer than that. A 2023 Cochrane review found most of its studies used a single session, and some used up to nine. Length varies a great deal. The same review reports sessions from ten minutes to well over two hours. 1–9 sessions in the trials 93 trials [Schwenker et al. 2023](https://viacara.com/approaches/motivational-interviewing/#ref-6) 10 minutes, the shortest session session length [Schwenker et al. 2023](https://viacara.com/approaches/motivational-interviewing/#ref-6) the longest ran well over 2 hours Sources: [Miller & Rollnick 2009](https://viacara.com/approaches/motivational-interviewing/#ref-2), [Schwenker et al. 2023](https://viacara.com/approaches/motivational-interviewing/#ref-6) ![The same fork in the path later, with one way now catching the afternoon light](https://viacara.com/img/content/approaches-motivational-interviewing-mid-light.webp) Nobody argues you down one path. You talk until you hear your own reasons ## Who it might *suit* It can be a good fit if you: - Want a change and keep putting it off - Find that part of you wants it and part of you does not - Bristle when someone tells you what you ought to do - Know what would help and are not doing it - Have been pushed towards a change by somebody else - Would rather reach your own reasons before you act It may suit you less well if you have already decided and want to get on with it. Miller and Rollnick note that people who are ready for change do not need it. They add that it may even slow such a person down. If the change you want is a goal outside mental health, [coaching](https://viacara.com/approaches/coaching/) may fit better. Coaching is not a therapy. Source: [Miller & Rollnick 2009](https://viacara.com/approaches/motivational-interviewing/#ref-2) ## If your question is about *addiction* Much of the research on this approach is about substance use. A 2023 Cochrane review of it pooled 93 trials. Our [addiction pages](https://viacara.com/support/addiction/) put specialist services first, and talking support alongside them. Every service listed there is free. Source: [Schwenker et al. 2023](https://viacara.com/approaches/motivational-interviewing/#ref-6) ## The *evidence* The evidence base is wide and mostly weak. A 2018 review of 104 reviews graded most of the pooled evidence as low or very low quality. Little of it reached moderate quality. Those authors found moderate quality evidence of small, mainly short-term benefits in eleven of their 155 comparisons. 7% of comparisons found moderate-quality evidence of a small benefit 104 reviews [Frost et al. 2018](https://viacara.com/approaches/motivational-interviewing/#ref-8) Physical activity shows the same shape. A 2024 review in The BMJ pooled 97 trials and found more activity than weaker comparisons, at low certainty. Those gains did not last. Its authors report that evidence of an effect beyond one year was lacking. They also found no difference against comparisons of similar intensity. On substance use, Cochrane is cautious. Its authors say the approach may make little to no difference against usual care or another active treatment. They hold that view loosely. The review reports moderate to no confidence in its evidence, and expects future studies to change its conclusions. NICE names motivational interviewing in several of its guidelines. NG98 says to consider it when hearing aids are first discussed. NG252 says to consider it to encourage lifelong change around physical activity. NICE has also declined to recommend it. PH49, its guideline on individual behaviour change, says the evidence made it impossible to recommend the approach. If you are weighing up a few options, our [guide to the different approaches](https://viacara.com/guides/understanding-approaches/) sets them side by side. Sources: [Frost et al. 2018](https://viacara.com/approaches/motivational-interviewing/#ref-8), [Zhu et al. 2024](https://viacara.com/approaches/motivational-interviewing/#ref-7), [Schwenker et al. 2023](https://viacara.com/approaches/motivational-interviewing/#ref-6), [NICE NG98](https://viacara.com/approaches/motivational-interviewing/#ref-9), [NICE NG252](https://viacara.com/approaches/motivational-interviewing/#ref-10), [NICE PH49](https://viacara.com/approaches/motivational-interviewing/#ref-11) On this page [What is motivational interviewing?](https://viacara.com/approaches/motivational-interviewing/#what-is-motivational-interviewing) [The four tasks](https://viacara.com/approaches/motivational-interviewing/#the-four-tasks) [Why it is a style, not a therapy](https://viacara.com/approaches/motivational-interviewing/#why-it-is-a-style-not-a-therapy) [What sessions look like](https://viacara.com/approaches/motivational-interviewing/#what-sessions-look-like) [Who it might suit](https://viacara.com/approaches/motivational-interviewing/#who-it-might-suit) [If your question is about addiction](https://viacara.com/approaches/motivational-interviewing/#if-your-question-is-about-addiction) [The evidence](https://viacara.com/approaches/motivational-interviewing/#the-evidence) Related [Coaching](https://viacara.com/approaches/coaching/) [Cognitive Behavioural Therapy (CBT)](https://viacara.com/approaches/cbt/) [Person-Centred Therapy](https://viacara.com/approaches/person-centred/) [Counselling](https://viacara.com/approaches/counselling/) [Addiction](https://viacara.com/support/addiction/) [Understanding Different Approaches](https://viacara.com/guides/understanding-approaches/) Thanks for your interest. We're not taking on new clients at the moment. ## In two minds about a change? We ask what matters to you, then find professionals who fit. Leave your email and we'll let you know as soon as we're ready for you. This conversation helps us find you the right support. What you share helps us understand what you're looking for and find someone who fits. Your email keeps you updated on what's happening next and isn't shared with anyone we introduce you to. [Privacy policy](https://viacara.com/privacy/) [Terms of service](https://viacara.com/terms/) ## References 1. National Institute for Health and Care Excellence (2020). *Rehabilitation for adults with complex psychosis (NG181)*. [nice.org.uk](https://www.nice.org.uk/guidance/ng181) 2. Miller, W. R. & Rollnick, S. (2009). *Ten things that motivational interviewing is not*. Behavioural and Cognitive Psychotherapy. [doi:10.1017/S1352465809005128](https://doi.org/10.1017/S1352465809005128) 3. Miller, W. R. & Rollnick, S. (2023). *What's new (and not new) in the 4th edition of Motivational Interviewing*. [motivationalinterviewing.org (PDF)](https://motivationalinterviewing.org/sites/default/files/what_new_in_mi-4.pdf) 4. Miller, W. R. (2023). *The evolution of motivational interviewing*. Behavioural and Cognitive Psychotherapy. [doi:10.1017/S1352465822000431](https://doi.org/10.1017/S1352465822000431) 5. NHS Education for Scotland (2025). *Motivational interviewing, The Matrix: a guide to delivering evidence-based psychological therapies in Scotland*. [matrix.nhs.scot](https://matrix.nhs.scot/matrix-evidence-tables/substance-use-adults/motivational-interviewing-mi/) 6. Schwenker, R., Dietrich, C. E., Hirpa, S., Nothacker, M., Smedslund, G., Frese, T. & Unverzagt, S. (2023). *Motivational interviewing for substance use reduction*. Cochrane Database of Systematic Reviews. [doi:10.1002/14651858.CD008063.pub3](https://doi.org/10.1002/14651858.CD008063.pub3) 7. Zhu, S., Xu, H., Zhang, X., Zhu, S., Wang, Y., Zhao, X. & others (2024). *Effectiveness of motivational interviewing on health-related outcomes: a systematic review and meta-analysis of randomised controlled trials*. The BMJ. [doi:10.1136/bmj-2023-078713](https://doi.org/10.1136/bmj-2023-078713) 8. Frost, H., Campbell, P., Maxwell, M., O'Carroll, R. E., Dombrowski, S. U., Williams, B., Cheyne, H., Coles, E. & Pollock, A. (2018). *Effectiveness of motivational interviewing on adult behaviour change in health and social care settings: a systematic review of reviews*. PLOS ONE. [doi:10.1371/journal.pone.0204890](https://doi.org/10.1371/journal.pone.0204890) 9. National Institute for Health and Care Excellence (2023). *Hearing loss in adults: assessment and management (NG98)*. [nice.org.uk](https://www.nice.org.uk/guidance/ng98) 10. National Institute for Health and Care Excellence (2025). *Rehabilitation for chronic neurological disorders (NG252)*. [nice.org.uk](https://www.nice.org.uk/guidance/ng252) 11. National Institute for Health and Care Excellence (2014). *Behaviour change: individual approaches (PH49)*. [nice.org.uk](https://www.nice.org.uk/guidance/ph49) 12. Motivational Interviewing Network of Trainers (n.d.). *Understanding motivational interviewing*. [motivationalinterviewing.org](https://motivationalinterviewing.org/understanding-motivational-interviewing) ## Related ### [Coaching](https://viacara.com/approaches/coaching/) Learn how coaching works, what the main coaching styles are, how it differs from therapy and how to tell whether a coach is the right person for you. ### [Cognitive Behavioural Therapy (CBT)](https://viacara.com/approaches/cbt/) Learn how CBT works, what happens in sessions and what NICE says about it, and read about its forms for sleep, pain and self-help. ### [Person-Centred Therapy](https://viacara.com/approaches/person-centred/) Learn how person-centred therapy works, what sessions look like and why the relationship with your therapist matters most. ### [Counselling](https://viacara.com/approaches/counselling/) Learn what counselling is, what sessions look like, how it differs from CBT and psychotherapy and how to find a counsellor on a recognised register. ### [Addiction](https://viacara.com/support/addiction/) Alcohol, drugs, gambling, chemsex, smoking and compulsive habits each have their own specialist service. Find the right route, then support alongside it. ### [Understanding Different Approaches](https://viacara.com/guides/understanding-approaches/) A plain-English guide to the main therapeutic approaches including CBT, person-centred therapy, psychodynamic and integrative methods.