Motivational Interviewing

What is motivational interviewing?

Motivational interviewing (MI) is a conversational approach used by counselors to help people address ambivalence and find motivation to make changes in their lives. It involves exploring a person’s mixed feelings, which hold them back from taking important actions. A key aspect of MI is that the interviewer does not attempt to convince the interviewee to change, because that often leads people to feel the need to defend themselves and to become more resistant to the idea of change. Rather, through an empathetic and non-judgmental exploration of the person’s feelings about change, the interviewer guides them to discover their own motivation to change.

A concept at the center of MI is differentiating between change talk and sustain talk. Change talk can include the following types of statements: the desire to change, the ability to change, reasons to change, the need to change, commitment (“I promise”), activation (“I’m ready”), and taking steps (actions completed). In contrast, sustain talk includes statements of resistance to change. The more a person uses change talk, the more likely they are to make those changes.

The core skills of MI are open-ended questions, affirming, reflective listening, and summarizing (OARS):

  • Open-ended questions encourage the interviewee to tell their story and voice their feelings and motivations. Example: “Tell me about…”
  • Affirming puts a positive focus on the interviewee’s ideas and actions. Example: “You came up with some great ideas and have taken steps to start making changes.”
  • Reflective listening: The interviewer reflects the interviewee’s statement through any one of the following response types: repeating, rephrasing, highlighting the feeling or meaning, resolving ambivalence by reinforcing change talk, or amplifying sustain talk in order to evoke change talk. This can be as simple as repeating exactly what was said, or it can sound more like restating in different words, with a different emphasis.
  • Summarizing: The interviewer summarizes a larger portion of the conversation into a single statement. This can be used to encourage reflection, make connections, wrap up, or shift gears in a conversation.

Using the four core skills, the interviewer guides conversation through the four processes of MI: engaging, focusing, evoking, and planning.

  1. Engaging is the process of establishing a positive, trusting relationship.
  2. Focusing is the process of developing an agenda for the rest of the conversation, or a specific behavior that will be addressed.
  3. Evoking is the central process of MI. It is the process of uncovering the client’s motivations for change and working through ambivalence.
  4. Planning is the process of developing a change plan and strengthening commitment to the plan.

Motivational interviewing in the climate crisis

Motivational interviewing is based on Carl Rogers’ theory of unconditional positive regard, which is a counseling technique of showing support and acceptance to clients, regardless of their behavior. Clinical psychologists Stephen Rollnick and William Miller developed MI in the 1980s as a way of helping clients with substance use disorders, but it is also effective at reducing other types of health-risk behaviors (ie., smoking, overeating, unsafe sex) and at promoting a wide variety of healthy behaviors (such as medication adherence, sleep hygiene, and physical activity). Miller and Rollnick first published their book in 1991, with the updated 4th edition published in 2023.

While MI has traditionally been used by helping professionals like therapists and nurses, it is gaining recognition as a useful tool in other fields, such as management and activism. Today, there are many advocates for the use of MI in climate activism.  For example, Dave Christian, Ph.D., from Citizen’s Climate Lobby (CCL), finds success through motivational interviewing when meeting directly with lawmakers. Renee Lertzman, a climate psychologist, uses the MI concept of working through ambivalence to help leaders address climate change. Other research shows how MI can be used in climate communication or in promoting climate-friendly behaviours in the workplace.

How does motivational interviewing affect our mental health?

Counselors use MI to help improve the mental health of their clients by helping them to stop feeling stuck and to make behavioral changes that improve their overall wellbeing. Because MI focuses on behavioral change, it does not directly treat mental health issues such as anxiety and depression, but the use of MI is associated with lower levels of stress and depression. MI can also help address climate-based depression and anxiety by helping us to take pro-environmental actions, which can buffer those negative emotions.

Unequal impacts

Research findings

  • A large body of research supports MI as an effective way to increase positive behaviors across a variety of personal health issues. There is limited research focusing specifically on applications of MI to climate change.
    • MI is an especially impactful counseling style because it can help lead to behavior change in a relatively short amount of time, when compared to other types of counseling.
    • MI is more effective when used one-on-one than in groups.
  • Klonek and colleagues’ study demonstrates how activists can use MI to communicate more effectively by reducing the extent to which they are perceived as threatening by their listeners.
  • Costanza and colleagues compare our collective dependence on unsustainable climate practices with a substance use disorder, and note that MI could be just as effective at addressing the climate crisis as it is at addressing substance use.
  • Endrejat and colleagues assert that MI can be used at an organizational scale to increase employees’ climate-friendly behaviors.

Using motivational interviewing to address climate change and its mental health impacts

There are two ways for MI to play a role in addressing the climate crisis. First, climate advocates can learn MI and incorporate it into their advocacy, just as Dr. Christian is doing in his lobbying work. Second, mental health clinicians can use MI to help individual clients make changes in their lives, which can both reduce their environmental impacts and help them feel a greater sense of control and empowerment about their place in the climate crisis. For those looking to add MI to their skillset, suggested resources include Miller and Rollnick’s book, the Motivational Interviewing Network of Trainers, and Enviromentum, which offers MI training designed for climate activists.

What else might we need to know about motivational interviewing?

The ability to successfully implement MI depends on the interviewer’s level of proficiency with MI skills. These skills are counterintuitive and require practice. MI training courses exist, but there is limited data to support their efficacy, and more research is needed to establish best practices for teaching and learning MI.

Finally, while MI is an effective way to guide people towards change, it depends on them discovering their own motivation to do so. MI is not a way to make people change before they are ready to change. MI is rooted in the democratic ideal of autonomy, and it can be used to help guide people towards good decisions, but it can’t be used to control or make decisions for others.

Further reading


Motivational interviewing: Helping People Change and Grow by Miller & Rollnick, published in 2023 by Guilford Press.

Treatment Improvement Protocol (TIP) Series, No. 35, Chapter 3, published in 2019 by the Substance Abuse and Mental Health Services Administration (United States).

Articles and Online Sources

Behaviour Change, published in Ecopsychepedia on May 22, 2023, by Paula Richter, Frida Hylander, Kata Nylén, Kali Andersson.

Citizens’ Climate Lobby 2023 Fall Conference: Motivational Interviewing For Climate Advocacy: A Deeper Dive published on YouTube on November 6, 2023, by John Sabin and Citizens’ Climate Lobby

Climate advocates can up their game with Motivational Interviewing, published by Citizens’ Climate Lobby on April 19, 2017, by Dave Christian, Ph.D.

Renee Lertzman: Approach, published 2024, by Renee Lertzman, Ph.D.

A talking cure for climate-based depression? It worked for Renee Lertzman, published in Grist on February 18, 2016, by Heather Smith.

The trick to helping people process their climate-related dilemmas, published in Gen Dread on October 9, 2020, by Britt Wray.


Lifting the Burden in Motivational Interviewing, a short animated film featuring MI founder William Miller.

Motivational Interviewing Training Resources

Enviromentum provides MI training for environmental activists and organizations.

Motivational Interviewing Network of Trainers promotes MI practice and training around the world.

Selected Research/Scientific Papers

Bahafzallah, L., Hayden, K. A., Bouchal, S. R., Singh, P., & King‐Shier, K. (2019). Motivational interviewing in ethnic populations. Journal of Immigrant and Minority Health, 22(4), 816–851.

Costanza, R., Atkins, P. W., Bolton, M., Cork, S., Grigg, N. J., Kasser, T., & Kubiszewski, I. (2017). Societal addiction therapy: From motivational interviewing to community engaged scenario planning. Current Opinion in Environmental Sustainability, 26–27, 47–53.

Endrejat, P. C., Baumgarten, F., & Kauffeld, S. (2017). When Theory Meets Practice: Combining Lewin’s Ideas about Change with Motivational Interviewing to Increase Energy-Saving Behaviours Within Organizations. Journal of Change Management17(2), 101–120.

Klonek, F. E., Güntner, A. V., Lehmann‐Willenbrock, N., & Kauffeld, S. (2015). Using Motivational Interviewing to reduce threats in conversations about environmental behavior. Frontiers in Psychology, 6.

Kramer Schmidt, L., Andersen, K., & Søgaard Nielsen, A. (2022). Differences in the delivery of motivational interviewing across three countries. Journal of ethnicity in substance abuse, 21(3), 823–844.

Lundahl, B., & Burke, B. L. (2009). The effectiveness and applicability of motivational interviewing: a practice‐friendly review of four meta‐analyses. Journal of Clinical Psychology, 65(11), 1232–1245.

Lundahl, B., Kunz, C., Brownell, C., Tollefson, D. R., & Burke, B. L. (2010). A Meta-Analysis of Motivational Interviewing: Twenty-Five Years of Empirical Studies. Research on Social Work Practice, 20(2), 137–160.

Senay, E., Sarfaty, M., & Rice, M. B. (2021). Strategies for Clinical Discussions About Climate Change. Annals of internal medicine174(3), 417–418.

Tagkaloglou, S., & Kasser, T. (2018). Increasing collaborative, pro-environmental activism: The roles of Motivational Interviewing, self-determined motivation, and self-efficacy. Journal of Environmental Psychology, 58, 86–92.

Author and version info

Published: May 25, 2024

Author: Esme West, BSN, RN

Editor: Colleen Rollins, PhD