Looking at the difference between open and closed questions examples helps illustrate the shift:
- Closed (Higher Pressure): “Did you take your medication this week?”
Result: Often prompts a quick “yes” or a defensive excuse.
- Open (Lower Pressure): “How has your medication routine been working out for you lately?”
Result: Invites honest reflection on barriers without judgment.
- Closed (Higher Pressure): “Are you going to start following your physical therapy home exercise plan?”
Result: Pressures the client into a commitment they might not be ready for.
- Open (Lower Pressure): “What are some ideas you have for fitting those physical therapy exercises into your routine?”
Result: Invites the client to think through practical strategies on their own terms.
Affirmations: Recognizing Effort
While open-ended questions explore possibilities, affirmations help build confidence.
In MI, an affirmation isn’t generic praise (e.g., “I’m so proud of you!”). Instead, it’s about noticing the client’s actual efforts, strengths, and perseverance (e.g., “You showed real persistence by coming in today despite a chaotic week.”).
Noticing these strengths helps lower a client’s guard and supports their belief in their own capability.