How can you navigate power dynamics in Motivational Interviewing?

1 Recognize your power

As an interviewer, you have more power than your client in many ways. You have more knowledge, skills, authority, and influence over the outcome of the session. You also have more control over the time, location, agenda, and format of the interview. Recognizing your power is the first step to avoid abusing it or imposing it on your client. You can acknowledge your power by being transparent about your role, purpose, and expectations, and by inviting your client to share their perspective, preferences, and goals.

2 Respect your client's autonomy

One of the core principles of MI is to respect your client's autonomy and self-determination. This means that you do not tell your client what to do, how to do it, or why to do it. Instead, you elicit their own reasons and motivations for change, and support their choice and confidence. You can respect your client's autonomy by using open-ended questions, reflective listening, affirmations, and summaries, and by avoiding arguments, confrontation, persuasion, or advice-giving.

3 Embrace your client's ambivalence

Another core principle of MI is to embrace your client's ambivalence and help them resolve it in a direction that is consistent with their values and interests. Ambivalence is a natural and normal part of the change process, and it does not mean that your client is resistant, unmotivated, or irrational. You can embrace your client's ambivalence by expressing empathy, curiosity, and acceptance, and by using the decisional balance, readiness ruler, or change plan worksheet to explore the pros and cons of change and the discrepancy between their current and desired situation.

4 Collaborate with your client

MI is a collaborative approach that requires a partnership between you and your client. You are not the expert on your client's life, nor are you the judge of their behavior. You are the facilitator of their change process, and you work with them to identify and enhance their intrinsic motivation. You can collaborate with your client by using the OARS skills (open-ended questions, affirmations, reflections, and summaries), by asking for permission before offering information or feedback, and by negotiating and agreeing on the goals and strategies for change.

5 Empower your client

MI is an empowering approach that aims to increase your client's confidence and competence in making and sustaining change. You do not impose your agenda or solutions on your client, nor do you take credit or responsibility for their success or failure. You acknowledge and reinforce your client's strengths, resources, and achievements, and you help them overcome their barriers and challenges. You can empower your client by using scaling questions, confidence rulers, action plans, and change talk, and by providing positive feedback, encouragement, and support.

6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?