Spotlight on Motivational Interviewing

Motivational Interviewing (MI) is a collaborative, person-centred communication approach that helps people explore and strengthen their own motivation for change. Rather than persuading, directing or telling people what they should do, Motivational Interviewing recognises that lasting behaviour change is most likely to occur when individuals identify their own reasons for changing and feel empowered to make decisions themselves.

Originally developed by psychologists William R. Miller and Stephen Rollnick for the treatment of substance use disorders, Motivational Interviewing is now widely used across healthcare, rehabilitation, disability services, occupational therapy, psychology, veterinary medicine and health coaching. It has become one of the most well-researched communication approaches for supporting behaviour change.

Within assistance animal practice, Motivational Interviewing is particularly valuable because handlers frequently need to adopt new behaviours, develop new routines and maintain long-term lifestyle changes. Examples include maintaining daily training, improving animal welfare practices, adhering to veterinary recommendations, implementing occupational therapy strategies, managing public access responsibilities and preparing for retirement of an assistance animal. Sustainable change cannot usually be achieved simply by providing more information. Instead, practitioners must help handlers develop their own confidence, motivation and commitment to change.

Motivational Interviewing aligns closely with the values of occupational therapy because it respects autonomy, supports shared decision-making and recognises the handler as an active partner rather than a passive recipient of professional advice.

The Spirit of Motivational Interviewing

Motivational Interviewing is more than a collection of communication techniques. It is founded upon a particular philosophy or spirit that guides every interaction.

Four key principles underpin this approach.

Partnership

The practitioner and handler work together as equals.

The professional brings clinical expertise.

The handler brings expertise regarding their own life, experiences, values and goals.

Neither perspective is more important than the other.

Acceptance

Practitioners demonstrate genuine respect for the individual’s autonomy, strengths and inherent worth.

Acceptance does not mean agreeing with every decision.

Rather, it involves recognising that meaningful change ultimately belongs to the individual.

Compassion

The practitioner’s primary motivation should always be the wellbeing of the handler and assistance animal.

Motivational Interviewing should never be used to manipulate people into making decisions that benefit the practitioner or organisation.

Evocation

Rather than telling people why they should change, practitioners help individuals identify their own reasons for change.

People are generally more persuaded by arguments they make themselves than by arguments presented by others.

Why Motivational Interviewing Works

Many professionals naturally respond to problems by offering advice.

For example:

“You need to practise public access every day.”

“You should check your dog’s paws every evening.”

“You really need to lose weight because it affects your dog’s mobility work.”

Although well intentioned, advice alone rarely changes behaviour.

People usually already know what they should do.

The challenge is maintaining motivation, overcoming barriers and developing confidence.

Motivational Interviewing recognises that behaviour change occurs when three elements come together:

• motivation;
• confidence; and
• opportunity.

The role of the practitioner is to facilitate these elements rather than simply provide instructions.

The OARS Communication Skills

One of the most widely recognised components of Motivational Interviewing is the OARS framework.

O — Open Questions

Open questions encourage discussion rather than brief yes-or-no answers.

Examples include:

• “What are your goals for working with your assistance dog?”
• “How do you feel your training has been progressing?”
• “What challenges have you experienced recently?”
• “What concerns you most about today’s assessment?”

Open questions encourage reflection and provide richer information than closed questions.

A — Affirmations

Affirmations acknowledge strengths, efforts and positive behaviours.

Examples include:

• “You’ve clearly invested a great deal of time in your dog’s training.”
• “I can see how committed you are to your dog’s welfare.”
• “You’ve overcome several challenges already.”

Affirmations should always be genuine and specific.

They are not compliments for their own sake but recognise existing strengths that support future change.

R — Reflective Listening

Reflection involves restating or paraphrasing what the person has communicated.

Examples include:

Handler:

“I’m exhausted trying to fit training around work.”

Practitioner:

“You’re committed to training, but finding enough time has become really difficult.”

Reflection demonstrates understanding while encouraging deeper exploration.

It also helps individuals hear their own thoughts more clearly.

S — Summaries

Summaries draw together important points discussed throughout the conversation.

For example:

“So today we’ve discussed your concerns about public access, the progress you’ve already made, the challenges of practising consistently and some ideas that might make training easier over the next few weeks.”

Summaries improve clarity, reinforce motivation and ensure shared understanding.

Change Talk

Perhaps the most distinctive feature of Motivational Interviewing is encouraging change talk.

Change talk refers to statements made by the individual that support movement towards positive change.

Examples include:

• “I really want my dog to be successful.”
• “I know I need to practise more consistently.”
• “I’d feel much more confident if we worked on public transport.”
• “My dog’s welfare has to come first.”

Research consistently demonstrates that the more people verbalise their own reasons for change, the more likely they are to implement that change.

Practitioners therefore listen carefully for change talk and encourage further discussion.

For example:

“You mentioned that your dog’s welfare is your highest priority. Tell me more about that.”

Rather than introducing new arguments, the practitioner helps the handler expand upon their own motivations.

Sustain Talk

Not all conversations focus on change.

Individuals often express reasons for maintaining current behaviour, known as sustain talk.

Examples include:

• “I don’t have enough time.”
• “We’ve always done it this way.”
• “The training seems too difficult.”
• “Nothing has worked before.”

Sustain talk should not be viewed as resistance or non-compliance.

Instead, it reflects normal ambivalence.

Rather than arguing against sustain talk, practitioners acknowledge it respectfully while gently exploring the person’s own motivations.

Rolling With Resistance

One of the central principles of Motivational Interviewing is rolling with resistance.

When individuals argue, become defensive or reject advice, the practitioner avoids confrontation.

Instead of attempting to “win” the discussion, they remain curious.

For example:

Handler:

“I don’t think retirement is necessary.”

Rather than responding:

“You’re wrong. The dog definitely needs retirement.”

A Motivational Interviewing response might be:

“It sounds like retirement feels like a very difficult decision. Can you tell me what concerns you most about it?”

This approach maintains rapport while encouraging further discussion.

It does not mean avoiding difficult decisions.

It means approaching disagreement respectfully rather than argumentatively.

Supporting Self-Efficacy

People are more likely to change when they believe they are capable of succeeding.

This belief is known as self-efficacy.

Practitioners support self-efficacy by highlighting previous successes, acknowledging strengths and helping individuals develop achievable goals.

Examples include:

• recognising progress already made;
• breaking large goals into smaller steps;
• celebrating improvements;
• encouraging problem-solving;
• reinforcing confidence.

Supporting self-efficacy is particularly important when handlers experience setbacks during training.

When Motivational Interviewing Is Useful

Motivational Interviewing is valuable whenever behaviour change is required.

Examples include:

• increasing consistency of handler training;
• improving daily welfare routines;
• introducing new occupational strategies;
• discussing retirement of an assistance animal;
• improving adherence to veterinary recommendations;
• encouraging participation in refresher training;
• supporting health behaviour change;
• managing lifestyle adjustments;
• preparing for organisational change.

It is particularly effective when individuals feel uncertain, ambivalent or resistant.

Limitations of Motivational Interviewing

Motivational Interviewing is not appropriate for every situation.

It should not replace:

• emergency decision-making;
• safeguarding responsibilities;
• mandatory reporting;
• legal compliance;
• immediate public safety interventions;
• urgent animal welfare actions.

Where immediate action is necessary, practitioners must fulfil their professional responsibilities regardless of an individual’s readiness to change.

Motivational Interviewing supports behaviour change but does not replace professional accountability.

Applying Motivational Interviewing in Assistance Animal Practice

Imagine a handler who has become inconsistent with public access training.

A directive approach may involve repeated reminders about organisational requirements.

A Motivational Interviewing approach instead explores:

• What matters most to the handler?
• What barriers exist?
• What successes have already occurred?
• What motivates them to continue?
• What changes feel realistic?
• What support would increase confidence?

Rather than persuading the handler, the practitioner helps them identify their own solutions and commitment to action.

This collaborative process often produces more sustainable behaviour change than advice alone.

Key Message

Motivational Interviewing is not about convincing people to agree with the practitioner.

It is about creating conversations in which individuals discover their own motivation, confidence and capacity for change.

By listening more than talking, asking rather than telling, and collaborating rather than directing, occupational therapists help handlers become active participants in their own learning and development.

Ultimately, Motivational Interviewing reflects one of the core principles of occupational therapy: people are far more likely to achieve meaningful, lasting change when they are supported to identify their own goals, make their own decisions and develop confidence in their own abilities. This makes Motivational Interviewing a powerful communication approach for strengthening handler engagement, promoting animal welfare and supporting successful long-term assistance animal partnerships.