Motivational Interviewing
Help people find their own reasons to change instead of giving them yours
Motivational interviewing, developed by clinical psychologist Bill Miller and Stephen Rollnick, starts from the premise that you rarely motivate someone else to change. You are better off helping them find their own motivation. The central insight is that when you try to persuade people through logic and evidence, their psychological immune system often activates resistance, making them more entrenched in their position.
The technique involves three core practices: asking open-ended questions, engaging in reflective listening, and affirming the person's desire and ability to change. Instead of telling someone what to do, you hold up a mirror so they can see themselves more clearly. You help them break out of overconfidence cycles by discovering the limits of their own reasoning.
Grant describes motivational interviewing as being used by tens of thousands of practitioners worldwide. It has been the subject of more than a thousand controlled trials. It has proven effective in helping people stop smoking, overcome addictions, improve health behaviors, and even change minds on vaccination, prejudice, and climate change. Psychologists and physicians using it have found it to be significantly more effective than traditional advice-giving in around three out of four studies.
- People rarely change when told what to do; help them discover their own reasons for change
- Resistance to persuasion strengthens existing beliefs like a psychological immune response
- Ask open-ended questions that invite reflection rather than closed questions that invite defense
- Engage in reflective listening to show you understand their perspective before attempting to shift it
- Affirm the person's autonomy and ability to change; respect for their choice paradoxically increases willingness to change
- Start with humility and genuine curiosityEnter the conversation not knowing what will motivate the other person. Resist the urge to diagnose or prescribe. Your job is to understand their perspective, not to fix it. Approach the conversation like a scientist, not a preacher.
- Ask open-ended questionsUse questions that begin with how, what, and tell me about rather than questions that can be answered with yes or no. For example: 'What concerns do you have about this?' or 'How did you first come to this view?' These questions invite self-reflection.
- Practice reflective listeningSummarize what you hear and reflect it back. This shows you are genuinely trying to understand, not just waiting for your turn to argue. Acknowledge the complexity and difficulty of the situation rather than dismissing their concerns.
- Affirm autonomy and abilityExplicitly state that the choice is theirs. Remind them you trust their judgment and intentions. When Arnaud told Marie-Helene that he respected her decision as someone who wanted the best for her kids, she said that sentence was worth all the gold in the world. It was the turning point.
- Help them identify their own discrepanciesThrough your questions and reflections, help the person notice gaps between their values and their current behavior. Do not point these out directly; let them discover the inconsistency. Self-discovered insights produce lasting change.
Marie-Helene Etienne-Rousseau was firmly anti-vaccination, having never vaccinated her three older children. When her premature baby Tobie needed protection, traditional doctors lectured her about vaccine benefits and warned about risks of refusal, making her feel attacked. Neonatologist Arnaud Gagneur used motivational interviewing instead. He told her he was worried about Tobie but accepted her decision. For over an hour, he asked open-ended questions about her reasoning and listened carefully. He affirmed her freedom to choose and trusted her intentions.
In the early 1980s, clinical psychologist Bill Miller was troubled by his field's approach to addiction, where therapists accused clients of being pathological liars in denial. Miller noticed that preaching and prosecuting backfired. He started asking questions and listening instead. His paper on the approach reached Stephen Rollnick, a young nurse trainee in addiction treatment. They met in Australia and realized they had discovered something much bigger than a treatment technique. Grant illustrates the power of this approach through Marie-Helene Etienne-Rousseau, an anti-vaccination mother in Quebec whose premature baby Tobie needed measles protection. Traditional doctors had attacked her position and made her defensive. A vaccine whisperer named Arnaud Gagneur used motivational interviewing instead, spending over an hour asking open-ended questions about her reasoning, listening carefully, and affirming her freedom to choose.