Motivational Interviewing in Mental Health
August 12, 2026 2026-08-12 14:19Motivational Interviewing in Mental Health
Motivational Interviewing in Mental Health
Motivational Interviewing can support conversations where people are uncertain about treatment, medication, substance use, self-care, recovery goals or other changes connected with their wellbeing.
Its value is not in persuading someone towards the practitioner’s preferred decision, but in creating a purposeful conversation in which the person can explore what matters to them, what makes change difficult and what they may want to do next.
Ambivalence makes sense
Mental health decisions can carry real benefits, costs and uncertainties. Someone may want relief from distress while feeling unsure about medication. They may want relationships to improve while finding substance use one of the few ways they currently cope. They may want greater independence while also fearing what change could demand of them.
Listening to both sides can help people hear themselves more clearly and can reduce the pressure that sometimes develops when professionals become responsible for arguing in favour of change.
Keeping the person’s goals visible
Professionals may understandably focus on symptoms, risk, treatment adherence or service priorities. The person may be thinking about sleep, relationships, work, housing, identity, confidence or simply getting through the week.
Engaging and focusing help practitioners find a direction that takes professional responsibilities seriously while connecting the conversation with what matters to the person.
Reflective listening
Helps communicate understanding and can bring meaning, feeling and values into conversations that might otherwise become a sequence of assessment questions.
Change talk
Helps practitioners notice the person’s own language about hopes, reasons, ability and possible movement towards change.
Sustain talk
Allows reasons for not changing to be heard without immediately turning them into something that must be challenged.
Information exchange
Provides a way to share professional knowledge, options and concerns while continuing to involve the person in making sense of that information.
Medication, treatment and information
Mental health practitioners often hold information that genuinely matters. MI does not require them to withhold it.
Ask-Offer-Ask can help turn advice into an exchange. Explore what the person already understands or wants to know, offer information clearly, then return to their response.
The final step matters. It communicates that providing information has not ended the conversation.
MI does not replace risk assessment or clinical judgement
MI is a way of communicating about change. It does not replace safeguarding procedures, risk assessment, diagnosis, treatment planning or the practitioner’s professional and legal responsibilities.
There will be circumstances in which professionals need to be direct about concerns or actions that must be taken. Even then, clarity can coexist with respect. Practitioners can distinguish what is required from what remains the person’s choice and continue listening to how the person experiences the situation.
Develop MI for mental health practice
Explore the communication skills behind MI or consider training adapted to the realities of mental health practice.
