Motivational Interviewing was originally developed as an alternative to traditional 1:1 counseling methods, and it evolved without much concern for session length. Many of us who currently use MI, however, do work with time constraints (typically 5, 15, or 25-minute consultations). How does the free flow of MI fit into the real, time-constrained world of professional counseling?

Our challenge is to skillfully use the relational and technical elements of MI in brief conversations – those elements that both promote the spirit of MI and also help guide the client toward behavior change. The components of MI that build your relationship with your client include the three “E’s": Empathy, Elicitation, and Empowerment.

Even the briefest MI intervention promotes a positive relationship when you collaborate, promote your client’s self-advocacy, and demonstrate a keen interest in your client’s point of view. Techniques you can use to achieve these goals include: asking permission before providing advice or information, offering your client a menu of options for change, and using reflective listening to demonstrate understanding.

MI’s technical components consist of interview strategies used to elicit and reinforce change talk – the things your client says that signal an interest in and commitment to behavioral change. Toward this end, brief MI interventions often employ the importance/confidence scaling technique, which both assesses readiness to change and helps set the agenda for brief advice-giving.

For example, here’s is a punch list for a brief discussion of teen smoking:

1. Set the Stage
a. Explain the purpose of the brief conversation.
b. Ask permission to proceed.

2. Build Rapport
a. “Tell me about yourself and your smoking.”
b. Listen well for 3-5 minutes.

3. Scale Importance
a. “How important is it for you right now to quit smoking?"(scale from 0 - 10)
b. “Why is it so important?”
c. “What would have to happen to make it even more important?”

4. Inform
a. Provide a small dose of pertinent information.
b. Avoid jargon.

5. Action Planning
a. Offer a menu of options.
b. Small first steps are most effective.

6. Scale Confidence
a. “How confident are you that you can succeed with our plan?”
b. “What would have to happen to raise your confidence?”

7. Summarize and Affirm
a. Support self-efficacy.
b. Set a follow-up date.