motivational interviewing

Meaning: Motivational interviewing is a collaborative, client-centered counseling style that strengthens a person's own motivation to change a behavior by working through ambivalence. The counselor asks open-ended questions, offers affirmations, uses reflective listening and summarizes. These draw out the person's own reasons for change (change talk), highlight the gap between current behavior and personal goals, and build self-efficacy. Resistance is rolled with, not confronted.

On the MCAT: Passages describe a person who is ambivalent about smoking, drinking, diet or exercise and ask which counselor response fits. Fitting answers reflect feelings or ask open-ended questions; poor fits confront, warn or prescribe. It is often paired with the transtheoretical model (precontemplation, contemplation, preparation, action, maintenance), where it suits people who are still ambivalent, in precontemplation or contemplation.

Common confusion: Motivational interviewing is not the same as Rogers' nondirective approach. It is client-centered but directive, because the counselor steers toward resolving ambivalence in favor of change. It is also not advice-giving or persuasion. Arguing for change tends to provoke defensiveness, while the person's own statements of reasons for change tend to predict more change.