Motivational interviewing (MI) is a person-centered, goal-oriented approach designed to enhance individuals’ motivation for change by helping them explore and resolve ambivalence. Originally developed in the 1980s to support addiction treatment, MI has since expanded into healthcare, mental health, social work, and coaching as an evidence-based method to empower individuals toward positive behavioral change.

The Camden Coalition uses motivational interviewing techniques to support individuals with complex health and social needs. By integrating MI into patient care, the Camden Coalition helps individuals navigate barriers to healthcare and social support, ultimately leading to improved health outcomes.

Defining motivational interviewing

To define motivational interviewing, it is essential to recognize its foundation in collaboration, compassion, and patient empowerment. MI is not directive in the traditional sense but instead encourages individuals to discover their own motivations for change rather than being told what to do. The approach is based on four core processes:

• Engaging: Building a trusting relationship between the practitioner and the client.
• Focusing: Identifying a specific behavior or issue the client wants to address.
• Evoking: Encouraging change talk, a key part of motivational interviewing strategies that helps the client articulate reasons for change.
• Planning: Developing an actionable plan to support change efforts​.

PACE principles in motivational interviewing

The PACE (partnership, acceptance, compassion, and evocation) principles are the foundation of motivational interviewing techniques, guiding practitioners to foster meaningful, patient-centered conversations that encourage change.

• Partnership: Motivational interviewing is a collaborative process, recognizing that individuals are the experts in their own lives. In complex care, practitioners build authentic healing relationships, ensuring that change efforts feel mutually empowering rather than directive.
• Acceptance: Practitioners take a non-judgmental approach, respecting a person’s autonomy while affirming their strengths and experiences. Expressing empathy and recognizing a person’s right to choose whether or not to change are essential to this process.
• Compassion: Prioritizing a person’s well-being is central to MI. Practitioners act in the best interest of the individual, offering support that is selfless and rooted in genuine care.
• Evocation: Rather than prescribing solutions, MI draws out an individual’s own motivations, priorities, and strengths. People already possess the inner resources for change, and MI helps uncover those intrinsic motivators to foster sustainable transformation.

By applying the PACE principles, practitioners using motivational interviewing skills create an environment where individuals feel empowered to make informed, meaningful changes in their lives.

OARS in motivational interviewing

OARS is an acronym describing the key skills used in motivational interviewing. It stands for:

• Open-ended questions: Encouraging clients to explore their thoughts and motivations.
• Affirmations: Recognizing the client’s strengths and efforts
• Reflections: Repeating or paraphrasing what the client has said to show understanding
• Summaries: Reviewing key points in the conversation to reinforce motivation and clarify next steps​

These motivational interviewing skills help guide clients through the stages of change, a psychological model that describes how individuals move from ambivalence to action.

Stages of change in motivational interviewing

The motivational interviewing stages are based on the Transtheoretical Model of Change:

• Precontemplation: The individual is not yet considering change

• Contemplation: Awareness of the problem grows, but ambivalence remains

• Preparation: The individual commits to making a change

• Action: The individual actively works toward change

• Maintenance: Sustaining the change over time​

By understanding where a person is in the stages of change in motivational interviewing, practitioners can tailor their approach to facilitate meaningful progress.

The role of change talk in motivational interviewing

Change talk in motivational interviewing refers to statements made by the client that indicate a desire, ability, reason, or need for change. Encouraging change talk increases the likelihood that a person will take action.

Examples of change talk: 

• Desire: “I want to exercise more.”
• Ability: “I think I could make small changes.”
• Reason: “I know it would help my heart health.”
• Need: “I have to start eating better.”

By using motivational interviewing questions that elicit change talk, practitioners help clients strengthen their commitment to change​.

Motivational interviewing training and implementation

Effective MI requires motivational interviewing training, which equips professionals with the skills needed to implement MI techniques in various settings. Training typically includes:

• Workshops and online courses
• Role-playing motivational interviewing activities
• Supervised practice sessions

The Camden Coalition Learning Center offers extensive training opportunities for professionals looking to enhance their MI skills in complex care settings​.

How the Camden Coalition uses motivational interviewing

• The Camden Coalition integrates MI into complex care management to support individuals facing barriers to healthcare, housing, and social services. Our work highlights the importance of motivational interviewing in complex care, particularly in supporting individuals experiencing health-related social needs and medical complexity.

Through motivational interviewing, Camden Coalition builds authentic healing relationships, empowering clients to make sustainable changes.

Motivational interviewing is a proven method for guiding individuals toward positive change through empathetic and collaborative conversations. By leveraging motivational interviewing techniques, professionals can support individuals in overcoming ambivalence and taking action toward healthier behaviors.

For those wondering how to do motivational interviewing or interested in motivational interviewing training, visit the Camden Coalition Learning Center.  The Complex Care Certificate and Skills Lab both cover motivational interviewing principles and best practices.

The Camden Coalition is a multidisciplinary, community-based nonprofit working to improve care for people with complex health and social needs in the city of Camden, across New Jersey, and around the country. We develop and test care management models and redesign systems in partnership with consumers, community members, health systems, community-based organizations, government agencies, payers, and more, with the goal of achieving person-centered, equitable care.

As one of New Jersey’s four Regional Health Hubs, the Camden Coalition works with regional partners, New Jersey’s Medicaid office, and other state agencies to expand data-sharing and collaboration between organizations so that patients across South Jersey experience seamless, whole-person care. You can visit the Camden Coalition Learning Center to register for on-demand, curated courses that provide skills and resources to develop and grow complex care programs.

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