What are the most effective motivational interviewing strategies for LGBTQ+ communities?

1 Affirm identity and diversity

One of the core principles of MI is to express empathy and acceptance of the client's perspective and experience. This is especially important for LGBTQ+ clients, who may have faced stigma, discrimination, or rejection because of their identity or orientation. Affirming their identity and diversity means acknowledging and respecting their self-definition, preferences, and goals, without imposing any labels or assumptions. For example, you can use the client's preferred name and pronouns, ask open-ended questions about their identity and community, and validate their feelings and concerns.

2 Explore ambivalence and discrepancy

Another key principle of MI is to help the client resolve ambivalence and discrepancy, which are common sources of resistance to change. Ambivalence means having mixed or conflicting feelings about something, while discrepancy means having a gap between one's current behavior and one's desired outcome. For LGBTQ+ clients, ambivalence and discrepancy may be related to their identity, relationships, health, or well-being. For example, a client may want to come out to their family, but fear their reaction. Or a client may want to quit smoking, but find it hard to cope with stress. To explore ambivalence and discrepancy, you can use reflective listening, decisional balance, and scaling questions. For example, you can reflect back the pros and cons of change, ask the client to rate their readiness and confidence, and elicit their reasons and motivations for change.

3 Support self-efficacy and autonomy

A third essential principle of MI is to support the client's self-efficacy and autonomy, which are crucial for initiating and sustaining change. Self-efficacy means the client's belief in their ability to change, while autonomy means the client's sense of control and choice over their behavior. For LGBTQ+ clients, self-efficacy and autonomy may be influenced by their identity, context, and resources. For example, a client may feel empowered by their identity, but constrained by their environment. Or a client may have access to supportive services, but lack confidence in their skills. To support self-efficacy and autonomy , you can use affirmations, summaries, and change talk. For example, you can praise the client's strengths and achievements, summarize their progress and challenges, and reinforce their statements that express desire, ability, reason, need, or commitment to change.

4 Address specific needs and goals

A fourth important principle of MI is to address the client's specific needs and goals, which are the basis for developing a personalized plan for change. The needs and goals of LGBTQ+ clients may vary depending on their identity, orientation, stage of life, and situation. For example, a client may need information, counseling, or referrals for issues related to their sexual health, mental health, or legal rights. Or a client may have goals related to their identity, expression, or relationships. To address specific needs and goals, you can use information exchange, goal setting, and action planning. For example, you can provide relevant and accurate information, help the client set SMART (specific, measurable, achievable, relevant, and time-bound) goals, and assist the client in developing a realistic and feasible action plan.

5 Cultivate cultural competence and humility

A fifth and final principle of MI is to cultivate cultural competence and humility, which are essential for building rapport and trust with the client. Cultural competence means having the knowledge, skills, and attitudes to work effectively with diverse clients, while cultural humility means having the awareness, openness, and curiosity to learn from and respect the client's culture. For LGBTQ+ clients, cultural competence and humility mean recognizing and appreciating the diversity and complexity of their identities, experiences, and needs, without stereotyping or judging. To cultivate cultural competence and humility, you can use self-reflection, feedback, and consultation. For example, you can examine your own biases and assumptions, seek feedback from the client and other sources, and consult with experts or peers who have experience working with LGBTQ+ communities.

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?