Motivational interviewing

Tools in the E.P. Toolbox – Motivational Interviewing

There is a quote that says “no challenge, no change”, and anyone who has tried to encourage behavior change will know that it can indeed be challenging! Whether it’s in a personal context (like trying to get your partner to put their dishes away) or in a professional context (like improving employee habits) or even, our own behaviors! The simple truth is, most people don’t like being told what to do… And this is especially true when change involves creating brand new (often uncomfortable) habits, or getting rid of long-standing habits. 

In the Exercise Physiology profession, we are typically trying to encourage adherence to regular exercise and other healthy habits such as good sleep and nutrition. Whilst us health professionals have the knowledge needed to improve health, the truth is that it doesn’t translate into outcomes unless the client is on board with making the changes too!

So what to do when someone simply isn’t adhering to their exercise (or lifestyle change) program? This is where we pull out of our vast toolbox, Motivational Interviewing.


What is Motivational Interviewing?

Motivational interviewing is a behaviour change technique introduced by William Miller in 1983 (1). It is based on the understanding that;

People are generally better persuaded by the reasons which they have themselves discovered than by those which have come into the mind of others.

For this reason, it prioritises: 

  • Collaboration – instead of confrontation
  • Evocation – drawing out the clients thoughts and ideas about the behaviour, instead of imposing our own views
  • Client autonomy – instead of therapist authority (1).


It is particularly effective when individuals are ambivalent about making change (“why should I stop drinking / smoking / eating fast food when I enjoy it so much?”) or for those who are throwing barrier after barrier at you (“I didn’t exercise this week because I didn’t have time / my child was sick / I was too tired”).

Rather than telling people the solution, motivational interviewing involves guiding people to reach the answers themselves. No more dictator-style orders! Instead, it gently unpicks their reasons for resisting change and strengthens their intrinsic motivations to take positive action. People are supported towards developing their own solutions to the barriers that arise, and creating an action plan that they believe will work for them. 


This technique is actually often a difficult one for health professionals to adopt – it requires breaking some of our own habits! Being the holders of knowledge, the so-called experts on the matter, we are very prone to telling someone what they ‘need to do’ in an attempt to help them. This is known as the ‘righting reflex’ – when we try to ‘fix’ them, rather than helping them to make their own changes. Can you change someone who doesn’t want to change? Nope – It’s a lesson that we learn pretty fast in our work!!


So how does one go about educating someone, whilst not telling? Stay tuned for our blog next week that lays out the 4 stages of motivational interviewing!





Author: Yolanda van Vugt
Editor: Tessa Nielsen
Clinical Exercise Physiologist and Content Creator at Specialised Health


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