MI: Core skills

Core skills and strategies

The core skills are used throughout the processes of engaging, focusing, evoking and planning. However, certain skills may be more applicable to specific processes.

OARS

The four OARS skills are fundamental to MI practice. Even in a brief conversation, they can build collaboration and enhance motivation for change.

OARS is an acronym for:

  • Open-ended questions
  • Affirmations
  • Reflections
  • Summaries

Open-ended questions

Open-ended questions invite the person to elaborate further. Closed questions, on the other hand, generally limit the person's reply to "yes" or "no." In general, open-ended questions are preferred over closed ones because they are more effective at eliciting the client's thoughts, feelings, preferences and goals.

Affirmations

Statements of affirmation acknowledge a client's efforts, willingness to engage or ability to make a change. Using these statements periodically throughout the conversation can help build self-efficacy and communicate the counsellor's regard for the client and the work he or she is doing. statements of affirmation emphasize clients' strengths, particularly those that are important and relevant to that person.

Reflections

There are two types of reflective responses:

(1) simple reflections essentially repeat back to a client the explicit content of something he or she has said

(2) complex reflections include the client's unspoken (implicit) meaning, feelings, intentions or experiences. In general, complex reflections are more effective at continuing and deepening the conversation

Summaries

Summary statements bring together key points and content and offer these back to the client in order to help reflect on where the conversation has led. Summarizing can be used strategically—since an important objective in MI is to elicit change talk, practitioners who are skilled in the approach are able to offer selective summaries, emphasizing the different kinds of change talk they hear from clients. Miller and Rollnick (2010) call this offering "bouquets of change talk" (with sprigs of sustain talk)

Providing information

In Motivational Interviewing: Helping People Change (3rd edition), Miller and Rollnick added a fifth skill: Providing information.The key is to set the stage so that the client asksfo--or is receptive to--receiving information.

Example:

"Would you be interested in knowing what has worked for other people?"

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