What is motivational interviewing?

There is a predictable thing that happens when someone tells you what you should do. Even when they are right, especially when they are right, something in you starts building the case for the other side. You hear yourself defending a habit you privately dislike. That reflex has a name in this field, and motivational interviewing was designed around not triggering it.

The argument you end up making

Say you are ambivalent about drinking less. A well-meaning person lists the reasons to cut back. Since you hold both sides of the ambivalence, and they have taken one side, the only side left for you to voice is the other. So you say it out loud. “It’s really only on weekends.” “It’s the one thing that helps me unwind.”

People tend to believe what they hear themselves say. The conversation intended to move you toward change has just had you rehearse, aloud, the argument for staying the same. Motivational interviewing calls the opposite kind of speech change talk, and the whole method is organized around getting more of it from you and less of the defending.

What the therapist actually does

The techniques are unglamorous and much harder than they look.

Open questions that ask about your reasons, not the therapist’s. Not “don’t you think you should cut back,” which invites a yes or a defense. Instead: “What would be different in your life if this were not part of it?” Or, when someone says they should probably change: “What makes you say probably?”

Reflections that go slightly further than what you said. You say “I guess it’s gotten a bit out of hand.” The therapist reflects: “It’s reached a point you didn’t intend.” You either correct that or expand on it. Either way you keep talking, and you keep doing the reasoning.

Scaling questions, used backward. “On a scale of one to ten, how important is making this change?” You say four. The instinctive follow-up is to ask why not higher. The correct one is the reverse: “Why a four and not a one?” Now you list your own reasons for change, unprompted, in your own words.

Rolling with resistance instead of pushing on it. If you argue against change, that is treated as information about where the conversation is, not as an obstacle. The therapist stops pushing rather than pushing harder, because pushing harder is what produced the argument.

Who it fits and who it does not

Motivational interviewing is designed for one specific state: you are of two minds. It fits when part of you wants something different and part of you does not, or when someone else has decided you should change and you are not sure you agree.

It is a poor fit when you already know exactly what you want and simply do not know how. If you have decided to face a phobia and want a structured plan, spending sessions exploring your motivation is a detour. That is territory for cognitive behavioral therapy or exposure work. It is also not the right lead approach when acute safety concerns are present.

In practice, therapists often use it as an opening move and a recovery move: to get started when direction is unclear, and to return to when a plan has stalled and the reason turns out to be that you were never fully behind it.

What it is often confused with

It is not simply “being nice” or agreeing with everything. It has a direction. The therapist is deliberately attending to and drawing out one kind of talk. The warmth is real, but so is the method.

It is not person-centered therapy either, though it grew from that soil and shares the non-judgmental stance. Person-centered work follows wherever you go without a target. Motivational interviewing has a target: resolving ambivalence in a direction you have identified.

And it is not a way to get you to want what the therapist thinks you should want. Autonomy is central, and the honest version includes accepting that you might decide not to change, or not now.

When it comes up in your first weeks here

If you arrive uncertain, that shows up early. Your first session covers what brought you in and what you want to change, and you rate the intensity of the problem 0 to 10. When ambivalence is part of the picture, that number often reveals it: something rated an eight for distress, with no clear answer about wanting it to change, tells your therapist to slow down before building a plan. When you and your therapist later write goals together, the ones you actually chose are the ones that survive a difficult month.

The research base here is substantial, particularly around ambivalence and habit change. What it will do for you specifically is not something any therapist can promise, and part of the approach is not pretending otherwise. See how we use motivational interviewing.

If you are not sure you want to change anything

That is a legitimate reason to book a session, not a reason to wait until you feel more decided. Being unsure is the condition this approach was built for. Our clinicians work with adults across Jamaica, Queens and Buffalo, plus telehealth throughout New York. Book at choose your therapist or call (646) 493-4007 to talk it through first.