How do you overcome the fixing reflex?

Motivational Interviewing (MI) is a collaborative communication style that shifts the helper’s role from an expert fixing a problem to a partner guiding a conversation. Instead of pushing solutions, MI uses specific core strategies to help people discover their own motivation:

1. Resisting the Fixing Reflex: The practitioner consciously steps back from offering immediate advice or trying to “fix” the person.
2. Eliciting Change Talk: Using OARS, the helper prompts the individual to express their own reasons, desires, and abilities to change.
3. Supporting Autonomy in Behaviour Change: MI explicitly honors the individual’s freedom of choice, recognizing that lasting change only happens when the person owns the decision.

By swapping the urge to fix for empathetic curiosity, MI empowers individuals to talk themselves into changing—making the outcome far more durable and self-sustained.

Initial draft outline and post structure generated with the assistance of Gemini (Google), then reviewed, revised, and expanded by CCMI.

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Summaries – Pulling the Threads Together

Open-ended questions, affirmations, and reflections help build a rich dialogue, but conversations about change can sometimes feel broad or unstructured.

That is where the final element of OARS comes in: Summaries.

Summaries in motivational interviewing are deliberate, periodic recaps that pull together key points of the conversation. They reassure the client they’ve been heard, highlight their own motivations for change, and help transition smoothly to next steps.

A Simple Summary Flow

• 1. Open: Frame the recap collaboratively (“Let me pause for a moment to make sure I’m following everything you’ve shared…”).
• 2. Recount: Highlight the client’s own stated reasons and desires for change, alongside their barriers.
• 3. Check In: End with a collaborative question (“What did I miss?” or “How does that sound to you?”).

Taking the Next Step

OARS provides a strong framework for lowering friction, encouraging open dialogue, and building trust. While a cheat sheet gives you a great starting roadmap, applying these skills naturally in real-time conversations takes deliberate practice and guidance.

Enroll in our Motivational Interviewing training to practice real-world scenarios, refine your techniques, and transform how you navigate client conversations.

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Initial draft outline and post structure generated with the assistance of Gemini (Google), then reviewed, revised, and expanded by CCMI.

Reflective Listening — Lowering the Tension

If open-ended questions help steer the conversation, Reflective Listening keeps it grounded. It is one of the most effective skills in MI for reducing tension and understanding what matters most to your client. In its simplest form, reflective listening in motivational interviewing means mirroring back what a client says. Complex reflections go beneath the surface, exploring the meaning and feeling underneath with the client is saying.

Responding to Pushback

When clients express reluctance, jumping in with advice usually increases tension. Reflective listening  in motivational interviewing offers a way to de-escalate. Learning how to reply to pushback using a double-sided reflection allows you to acknowledge their hesitation (or sustain talk) without arguing back:

• Patient Reluctance: “Everyone keeps telling me I need to slow down, but my family depends on me and I don’t have time to take a break.”
• High-Friction Response: “If you don’t slow down now, your health is going to force you to stop later.” Result: Likely leads to defensive arguing.
• Reflective Response: “Right now it feels like taking time for your own health is difficult AND you care deeply about taking care of your family..” Result: Validates their commitment while gently bringing their core tension into focus. 

Reflecting both sides of their struggle with “and” removes the need for them to defend their stance.

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Initial draft outline and post structure generated with the assistance of Gemini (Google), then reviewed, revised, and expanded by CCMI.

Open-Ended Questions & Affirmations – Unlocking Better Dialogue

Once you decide to lay down the urge to fix things and focus on partnership, the next challenge is structuring your dialogue. How do you use motivational interviewing skills to invite someone to explore change without making them feel put on the spot?

The first two components of OARS—Open-Ended Questions and Affirmations—help set a constructive tone.

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 in motivational interviewing 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.

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Initial draft outline and post structure generated with the assistance of Gemini (Google), then reviewed, revised, and expanded by CCMI.

Why Your Good Advice Might Be Backfiring

Navigating conversations around personal change can often feel like an uphill battle. Whether you are a clinician, counselor, coach, or leader, you have likely encountered moments where offering solid advice was met with pushback.

When people feel pressured or backed into a corner, their natural instinct is to dig in their heels or push back. In helping professions, this friction stalls progress, exhausts the practitioner, and strains trust.

The good news? This friction usually isn’t bad intent—it’s often a reaction to how the conversation is structured.

From Control to Partnership

Lowering friction starts with shifting the dynamic from directing to partnering. When clients feel safe, heard, and respected as autonomous decision-makers, they no longer need to spend energy defending their habits.

What is OARS?

Motivational interviewing techniques rely on a core set of person-centered communication skills known as OARS:

• Open-Ended Questions
• Affirmations
• Reflective Listening
• Summaries

While real skill takes practice, understanding these four elements is the first step toward smoother dialogue. Over the next three posts, we will explore how each piece of OARS skills helps open up conversation.

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Initial draft outline and post structure generated with the assistance of Gemini (Google), then reviewed, revised, and expanded by CCMI.

“Does Motivational Interviewing (MI) work with autistic clients?”
“Can it be used in suicide prevention, youth programs, or with brain-injured clients?”

As a trainer, I hear these questions all the time. My short answer is almost always: yes. And here’s why.

When we ask whether MI is “right” for a role, we’re really asking: does it fit the needs of the people I serve?

MI is especially effective for people who feel stuck, uncertain, or ambivalent about making changes. Rather than pushing or directing, it invites them to explore their own motivations in a respectful, supportive way.

At its core, MI is built on four values:

• • Compassion
  • Acceptance
  • Partnership
  • Evocation

Because of these principles, MI is considered safe and appropriate across many populations and professions. Read more about when to use MI.

It’s also a well-researched and flexible approach. Studies show its effectiveness in fields such as mental health, addiction, social work, healthcare, education, probation, coaching, and more. Professionals consistently report that MI improves both engagement and outcomes.

Rooted in collaboration and empathy, MI is a valuable addition to any professional’s toolbox, particularly for those supporting people through change and growth. It is also flexible: MI can be used in brief encounters (like a 10-minute conversation) or integrated into long-term therapeutic relationships. It complements other evidence-based practices like CBT, DBT, and trauma-informed care, enhancing their impact through a more collaborative and client-centered lens.

In the latest edition of Motivational Interviewing: Helping People Change and Grow, authors William R. Miller and Stephen Rollnick emphasize that when MI is applied with fidelity to its spirit and principles, it generally leads to better client outcomes.

When MI Shines

MI is at its best when people are ambivalent about change. It helps them weigh options, clarify values, and move toward decisions that feel authentic and sustainable.

When MI Plays a Smaller Role

If someone is already highly motivated, you don’t need to “dig” for motivation. In those cases, MI skills shift naturally toward planning, goal-setting, and action, still respecting the person’s autonomy while supporting progress.

Not Just for Therapists

One of the biggest myths about MI is that it’s “just for counselors.” In reality, it’s used successfully by:

• Nurses and healthcare workers
• Educators
• Social workers
• Probation officers
• Peer supporters
• Coaches and mentors

In all these roles, MI helps professionals build trust, spark insight, and support decisions that stick.

Start Small, Right Where You Are

For those exploring MI in their professional roles, I encourage curiosity and experimentation. Your existing expertise puts you in the ideal position to recognize where MI can enhance your practice—whether that’s building stronger rapport, addressing ambivalence, or navigating complex change conversations.

Try exploring the Spirit of MI and practice simple micro-skills like Ask-Offer-Ask, a collaborative way to share information while respecting autonomy. Learn more about the Ask-Offer-Ask tool.

You could:

• Talk to colleagues about how MI might fit into your work
• Organize a book club around an MI resource
• Listen to the Talking to Change podcast for practical examples (Talking to Change on Spotify)
• Sign up for Practice and Feedback calls or join free monthly MI Practice and Feedback calls with CCMI

Even small steps can start to reshape conversations in powerful ways.

If you’d like to bring MI into your role, CCMI offers resources and training at every stage of learning.

• Explore our free self-paced Introduction to MI module for a first look at the approach.
• We also offer various levels of MI courses, starting from Foundations and progressing to Advanced and Trainer Training. Learn more about MI training here.

Whether you’re supporting change in healthcare, education, social work, or another field, MI can help you create more meaningful, effective, and lasting impact. Our diverse range of programs is designed to help professionals build practical skills that lead to more effective engagement and lasting change. Let us help you integrate this powerful approach into your work.

CCMI trainer Ali Hall unpacks a Motivational Interviewing-driven framework for tackling the toughest conversations in healthcare. From substance use to unfavourable lab results. Read on to get a step-by-step playbook that keeps patients engaged, respected, and moving toward healthier outcomes.

Some conversation topics are tough, especially in healthcare. Tough for us and tough for the person we’re serving. Substance or alcohol use, mental health, medication adherence, unfavorable lab results, concerns we want to raise with the person, to name just a few.

How we approach the topic and talk with the person can make all the difference. It affects both our outcomes and the person’s well-being.

CCMI trainer Ali Hall unpacks a Motivational Interviewing-driven framework for tackling the toughest conversations in healthcare. From substance use to unfavourable lab results. Read on to get a step-by-step playbook that keeps patients engaged, respected, and moving toward healthier outcomes.

Why It’s Easy to Fall Into a Directive Style

When we’re pressed for time, worried, or sensing that someone doesn’t share our urgency, it’s easy to slip into a directive or “deficit detective” mode—jumping in with orders, warnings, moralizing, or advice without asking. These responses, even when well-meaning, can override a person’s autonomy and trigger them to put up a barrier. Instead of engaging with us, they might push back, tune out, or agree just to end the conversation.

Taking a moment to pause and shift into a Motivational Interviewing stance can change the dynamic entirely. By asking permission before raising concerns, using open-ended questions to explore their perspective, and affirming their strengths or efforts, we create space for a more respectful and collaborative dialogue.

As a result, reluctance to work with us tends to ease. The person feels heard and respected, and the conversation becomes more productive, setting the stage for meaningful, sustainable behavior change.

What to Do Instead

Here are a few approaches that support both your goals and the person’s growth.

1. Prepare Yourself

A moment of preparation can shift the tone of the entire conversation.

Breathe.
Try a “4-7-8” breathing pattern: inhale for 4 counts, hold for 7, and exhale slowly for 8. This lowers your stress. The person you’re speaking with can often sense your urgency or tension. A calm presence helps keep the conversation open.

Show yourself compassion.
Reducing self-judgment helps us extend compassion to others. You might try:

• Placing a hand over your heart
• Saying to yourself:
  • “This might be a tough conversation.”
  • “Tough conversations are part of life.”
  • “May I be kind to myself in this moment.”
  • “May I give myself the compassion I need.”

Practices like these can help lower your physiological stress response before conversations. If you’re interested in strategies for reducing interpersonal stress and navigating conflict, you might find the Improving Interactions course especially helpful.

2. Use the Spirit of Motivational Interviewing

In the conversation, engage, focus, and explore using a Motivational Interviewing (MI) style. MI is based on partnership, acceptance, compassion, and evocation. It helps us face forward with the person and support their growth and change.

One of the core ideas in MI is that the person already has the capacity for change—they just need space and support to talk themselves into it. This is what we call “evoking change talk,” and it’s one of the skills we explore deeply in our MI Foundations course.

MI is a treasure-hunt, strengths-based approach. As Goethe once said:

“The way you see people is the way you treat them, and the way you treat them is what they become.”

MI-Based Communication Strategies

Here are some specific skills that support this approach:

• Ask permission to explore the topic
• Use bracketing questions to normalize behavior:
  “People approach drinking in a lot of ways—some do ‘x,’ ‘y,’ or ‘z.’ How would you describe your approach?”
• Ask what they already know, what they’d like to know, and how you can be helpful
• Ask permission to share a concern or to offer a menu of options
• Support and affirm the efforts they’re already making
• Approach with curiosity, not persuasion—they are the expert in their own life
• Tie suggestions to their values, while respecting their autonomy:

If you’ve ever struggled with someone being silent, stuck, or saying “I don’t know,” there are MI-based techniques to navigate those moments with more ease. We explore these deeper skills in our MI Beyond mini-courses, which are designed for more advanced practice and reflection.

Keep in mind:

“It’s not immoral to try to make someone change. It is simply not possible.”

Stepping Into Tough Conversations With Confidence

Tough conversations are part of healthcare—and part of being human. But when emotions run high or time is short, it’s easy to fall into habits that create distance instead of connection. Maybe we give advice too quickly, push for change, or rush to fill the silence. Over Zoom, it can feel even harder: nonverbal cues are limited, and awkward pauses can feel more intense. These moments often leave both people feeling frustrated or unheard.

But it doesn’t have to be that way. With a bit of preparation and a Motivational Interviewing mindset, we can approach these conversations differently. That might mean pausing before jumping in, asking permission to share your thoughts, using open questions to understand their perspective, and recognizing their strengths. Even small shifts like these can help build connection, even through a screen.

When we guide with curiosity and respect, reluctance around change has a chance to drop. The other person feels heard, and the conversation becomes more collaborative. You don’t have to be perfect—just present and open to learning. If you’re ready to build your MI skills, CCMI offers training, practice, and feedback to help make tough conversations a little easier for you and the people you serve.

References:

1. Gordon, T., Conversation Roadblocks. https://www.gordonmodel.com/work-roadblocks.php.
2. Miller, WR. and Rollnick, S. 2023. Motivational Interviewing: Helping Others Change and Grow 4th ed. Guilford Press.
3. Francis, N. et. al. When smokers are resistant to change: experimental analysis of the effect of patient resistance on practitioner behaviour. Addiction. 2005 Aug;100(8):1175-82.
4. Adapted from Motivational Interviewing for Mental Health Practitioners-A Toolkit for Skills Enhancement. Frey, J. and Hall, A. (2021) https://www.amazon.com/gp/product/1683732014).
5. Miller, WR and Rollnick, S. 2023.

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Have you ever found yourself explaining a concept to a client, only to notice their eyes glaze over or they still seem unsure? You might be using the right information, but are you delivering it in a way that truly connects? The Ask-Offer-Ask framework (formerly known as Ask-Tell-Ask) can make all the difference.

Ask-Offer-Ask is a simple but powerful way to give feedback rooted in the spirit of Motivational Interviewing that encourages real conversations and self-reflection. Instead of just telling someone what they did well or need to improve, this approach invites them to think about their own strengths and areas for growth first. It helps build accountability, boosts self-assessment skills, and makes feedback feel more like a supportive discussion rather than a one-sided critique. By asking thoughtful questions, sharing helpful insights, and checking in again, Ask-Offer-Ask turns feedback into a meaningful learning experience.

To dive deeper into strategies like this and strengthen your communication skills, learn about the Motivational Interviewing training CCMI offers.

What Is Ask-Offer-Ask?

Ask-Offer-Ask is rooted in the Spirit of Motivational Interviewing —it is a way of interacting that encourages collaboration, autonomy, and respect. If you’re looking for a deeper dive into the principles of MI, be sure to check out our detailed What if Motivational Interviewing article.

• The first step, ASK, involves inviting the person into the conversation by asking open-ended questions that encourage exploration.
• The second step, OFFER is about offering clear, respectful information that allows the individual to make informed choices.
• Finally, ASK Again ensures that the person understands the information shared, and it provides an opportunity for them to reflect, engage further, or ask additional questions.

Step-by-Step Guide to Using Ask-Offer-Ask

Step 1: Ask for Permission or Knowledge

It’s important to start by either asking for permission or assessing prior knowledge to ensure the client feels involved and empowered. This shows respect for their autonomy and helps build rapport.

Example phrases to use:

• “Before I provide any details, can I ask if you’re familiar with [topic]?”
• “Would it be okay if I share some information with you?”
• “Do you have any experience with this already, or would you like me to explain?”

Step 2: Offer Information Respectfully

When offering information, it’s crucial to present it in small, manageable amounts, using plain language that’s easy to understand. Emphasizing choice allows the client to feel more in control. A neutral tone and non-directive guidance help to avoid sounding pushy or directive.

Best practices for delivering information:

• “One option to consider is [option]. It might help with [outcome].”
• “There’s a possibility of [consequence], but it’s just one part of the picture.”
• “Let me share a few key points about this, and we can talk more if you’d like.”
• “You can choose how to proceed, but I’ll explain the options and their potential benefits.”

Step 3: Ask for Reflection or Understanding

Checking for understanding is crucial because it ensures that the client has absorbed and comprehended the information. It also allows the client to voice any concerns or uncertainties.

Example questions to use for reflection and teach-back:

• “Can you explain what you understood from this in your own words?”
• “What stands out to you about what we discussed?”
• “Can you share your thoughts on how this might work for you?”
• “How do you feel about what I’ve shared?”

Why This Approach Works

This approach is effective because it aligns with the principles of behavior change and self-determination theory. When clients feel involved in the process and have control over their decisions, they are more motivated to make lasting changes. The Ask-Offer-Ask method empowers clients by encouraging reflection and giving them a voice in the conversation. This not only increases their confidence but also boosts their readiness to take action. When clients feel respected and heard, they are more likely to follow through with the steps necessary to improve their situation.

Conclusion

Try using the Ask-Offer-Ask approach in your next conversation! Start by asking, offer information in a supportive way, and check for understanding. It’s a simple but powerful way to improve communication. Download our Ask-Offer-Ask worksheet to practice, and feel free to share your experiences in the comments or sign up for training to dive deeper.

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What is MI? 

Learn what Motivational Interviewing is, why it’s effective, and how it invites people to be internally motivated for change. 

Introduction 

Motivational Interviewing (MI) is a person-centered communication approach that empowers individuals to achieve lasting behavior change. 

Grounded in empathy, respect, and collaboration, MI helps helping professionals guide people toward recognizing and pursuing their own goals. By focusing on a person’s readiness to change and supporting their autonomy, MI fosters self-efficacy—the belief in their ability to make and sustain meaningful changes. 

This approach is a non-judgmental and adaptable framework with a client-centred focus.  MI has shown effectiveness in addressing a range of concerns, from substance use to mental health, self-care, chronic disease, follow-through with physiotherapy, and many other areas. Beyond healthcare, MI’s versatility extends to fields such as education and corporate leadership. 

This article explores the core principles of Motivational Interviewing, its diverse applications, and why it has become an essential tool for helping professionals supporting people navigate change.

The Principles of Motivational Interviewing 

Motivational Interviewing (MI) is grounded in a set of core principles that guide helping professionals in fostering meaningful behavior change. These principles ensure that the approach remains person-centered, respectful, and effective. 

1. Express Compassion 

Compassion forms the foundation of MI. By actively listening to the person’s experiences and emotions without judgment, helping professionals create a safe, supportive space where clients feel comfortable discussing their challenges. 

Example: A helping professional might say, “You’ve been feeling overwhelmed with trying to manage your health goals. That’s a lot to handle.” 

2. Support Self-Efficacy 

MI aims to empower clients to believe in their ability to make changes. Building confidence with  the person increases the likelihood of successful change. 

Example: A helping professional might say, “You’ve managed to make positive changes in the past; you are wondering how you can do this again.” 

3. Listening 

Listening well to where the person is at in their change journey and what can be possible for them fosters collaboration and internal motivation. The person feels heard and seen. 

Example: If a person hesitates about quitting smoking, the helping professional might explore their ambivalence: “You’re unsure about where to begin and recognize there are some good reasons to quit. With your permission, let’s explore together and see what fits best for you.”

How Does Motivational Interviewing Work? 

MI is structured around four tasks, each encompassing the intentional skills and strategies of MI to guide clients through their journey of change. 

By combining the principles and tasks, MI ensures that clients feel understood, empowered, and capable of achieving meaningful and sustainable change.

Applications of Motivational Interviewing:  

Motivational Interviewing (MI) has proven effective across a broad range of contexts, making it a versatile tool for fostering positive behavior change across many disciplines. MI can be integrated well with other practices and modalities to better serve clients.  

In Healthcare

MI is widely used in healthcare to address both physical and mental health challenges. Its client-centered and adaptable nature allows practitioners to tailor the approach to each individual’s needs.

• Physical Health: MI has shown success in managing conditions such as substance use, diabetes, pain management, and even sexual risk behaviors. Research indicates that MI-based treatment plans can outperform placebo controls and complement established practices like cognitive behavioral therapy and pharmacotherapy.
• Mental Health: MI’s focus on empathy and collaboration makes it particularly effective in helping clients manage stress, anxiety, and depression. By empowering clients to set actionable goals, MI supports sustainable progress in their mental health journeys.

To dive deeper into how MI is applied in healthcare settings and why it is so effective, see our other article Why Use Motivational Interviewing in Healthcare?

Beyond Healthcare

The principles of MI extend far beyond healthcare, offering valuable applications in other fields. Educators can use MI to inspire students, guide goal-setting, and encourage ownership of their learning process. Similarly, corporate leaders and human resources professionals can apply MI to enhance team dynamics, support employee development, and achieve organizational objectives. Its flexibility and emphasis on collaboration make MI a powerful tool in any context requiring change and growth.

Want to explore more? 

CCMI offers a free 30 minutes self-paced online Introductory to MI course. You can access this course by visiting CCMI’s Resource page here.

To dive deeper into how MI is applied in healthcare and several other settings and why it is so effective, see Guilford Press published Motivational Interviewing books here.  

Why is Motivational Interviewing Effective?

One of the most important parts of lasting change is believing it’s possible – both for the person seeking help and the helping professional. Motivational Interviewing (MI) supports this by focusing on autonomy and self-direction. Instead of giving advice or telling people what to do, MI helps individuals set their own goals and make their own choices. This makes the process more meaningful and empowering.

MI doesn’t just benefit the people receiving support, it also has a big impact on those providing it. The collaborative nature of MI allows helping professionals to build real partnerships with their clients. They work together toward shared goals, which strengthens the relationship and keeps the professional’s role supportive rather than directive.

Many helping professionals who use MI say it helps them feel more engaged and fulfilled in their work. Rather than feeling pressure to “fix” someone, they focus on supporting growth and development. This shift in mindset helps reduce burnout and creates a more sustainable, effective approach to care.

Here’s what professionals often report after integrating MI into their work:

• Stronger, more collaborative relationships with clients
• Increased job satisfaction
• Greater confidence in facilitating change
• Reduced risk of burnout
  

At CCMI, we believe in the power of MI to create lasting, positive change. Our programs give healthcare professionals and organizations the tools, skills, and support they need to use MI confidently in their practice, improving outcomes for clients and job satisfaction for professionals.

See what participants of our MI Foundations  workshop say about the impact MI has had on their practice.

How to Learn MI? 

Studies show that simply listening to a lecture isn’t enough to truly master Motivational Interviewing. A study of Motivational Interviewing training for treating addictions, suggests that role-playing is essential for developing MI skills. By practicing in real-life scenarios, you build confidence and get comfortable using MI techniques. That’s why at CCMI, we include practice and feedback calls with expert trainers in all of our programs. These one-on-one sessions allow you to practice MI, get personalized feedback, and clear up any questions you may have. We’re one of the few providers who take MI training to the next level by offering this valuable opportunity. 

A systematic review of MI training programs highlights the importance of ongoing support and coaching after your initial MI training. The research shows that regular supervision significantly boosts the effectiveness of MI over time. If you’ve already completed a basic MI online course, consider taking our intermediate courses such as Motivational Interviewing Beyond foundations or area-specific MI mini-courses to continue building your skills.

At CCMI, we’re here to help you not just learn MI, but use it effectively in your work. 

Conclusion 

MI is an evidence-based, person-centered approach to behavior change, guided by four tasks, intentional strategies, and above all compassion. MI helps people navigate their journey of change. It’s effective across various and can be combined effectively with other modalities.

If you’re looking to improve your practice and enhance people outcomes, integrating MI into your work is a valuable step forward. Read more about our different offerings here: https://centrecmi.ca/motivational-interviewing/ .

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