What Every Health Care Provider Should Know About Motivational Interviewing

As health care providers, we often find ourselves face-to-face with patients who seem resistant to change. Whether it’s someone struggling to quit smoking, reduce alcohol use, manage chronic illness, or begin counselling for substance abuse, the challenge is rarely about knowledge—it’s about motivation. That’s where motivational interviewing for healthcare steps in.

In our practice here in Victoria, BC, we’ve seen firsthand how a patient’s willingness to change can make all the difference. But coaxing out that readiness is more complex than simply offering advice or giving out pamphlets. We need to have conversations that actually mean something. Conversations that inspire action—on the patient’s terms. That’s the essence of motivational interviewing.

Let’s explore what motivational interviewing is, why it matters for health care providers in Victoria, and how you can build the motivational interviewing skills that truly support your clients.

 

What Is Motivational Interviewing?

 

Motivational interviewing (MI) is a collaborative, person-centred form of communication that helps individuals resolve ambivalence and move toward positive behavioural change. It’s not a lecture. It’s not persuasion. It’s a conversation—guided with intention, empathy, and respect.

 

It was initially developed to help individuals with substance use issues, but today, MI is used across a wide range of health care contexts—from chronic disease management to mental health and wellness.

We’ve been integrating motivational interviewing for addiction into our support sessions for years. It works because it respects where the person is at, and it builds on their internal drive to change—not ours.

 

Why It Matters in Today’s Health Care Settings

 

In Canadian health care, especially in communities like Victoria, we see many patients dealing with complex health concerns—addictions, mental health struggles, and chronic conditions all rolled into one. These patients often feel overwhelmed, judged, or misunderstood.

 

When we use MI, we create a space where:

• People feel heard, not talked down to

• Change comes from within, not from pressure

• Resistance is reduced

• Trust is built

We’ve found this particularly helpful when working with individuals navigating motivational interviewing for substance abuse. Sometimes, just being understood can be the turning point for someone who has been shut down or brushed off by the system too many times.

 

The Four Core Principles of Motivational Interviewing

 

MI is grounded in a few key principles. If you’re just getting started, here’s what we focus on:

Principle	Description
Express Empathy	Use reflective listening to show you understand their perspective
Develop Discrepancy	Help the patient see the gap between where they are and where they want to be
Roll with Resistance	Avoid arguing; explore resistance without pushing back
Support Self-Efficacy	Build the patient’s belief in their own ability to change

 

Let’s say someone comes in struggling with alcohol use. Instead of saying, “You need to stop drinking,” we might say, “It sounds like you’ve been thinking about cutting back, but you’re not sure how it’ll affect your social life. That’s a real concern.” This validates their feelings, while still moving the conversation forward.

 

Common Challenges Health Care Providers Face—and How MI Helps

 

If you’re working in health care in Victoria, these scenarios might sound familiar:

• Patients say they want to change but take no action

• People miss appointments or don’t follow medical advice

• Clients feel like they’re being judged or criticized

• Conversations feel like they’re going in circles

We’ve been there. But once we began incorporating MI strategies, we noticed shifts—not just in our patients, but in ourselves. We felt more effective. More connected. Less frustrated.

 

Here’s how MI helps address those pain points:

• It reduces the need to "convince" someone—they become the expert on their own change

• It cuts through defensiveness by aligning with the patient, not against them

• It fosters ongoing relationships based on trust and mutual respect

• It allows for honest dialogue, even when the topic is uncomfortable

Learning and Applying Motivational Interviewing Skills

 

No one becomes an expert in MI overnight. But the good news is, many of us already use some elements of it without even realizing. The key is to build on what we’re already doing.

 

Here are a few motivational interviewing skills we use often:

1. Open-Ended Questions

Instead of: “Do you want to quit smoking?”

Try: “What’s your experience been like trying to cut back on smoking?”

 

2. Affirmations

Recognize effort, not just outcomes.

“You’ve already started cutting down—that takes real commitment.”

 

3. Reflective Listening

Mirror back what you hear to show understanding.

“It sounds like you’re worried about how stopping might affect your stress levels.”

 

4. Summarizing

Bring the pieces together to highlight motivation.

“So you’re feeling unsure about change, but you’ve also noticed some health concerns that are bothering you.”

 

Where MI Makes the Biggest Difference

 

We’ve applied motivational interviewing across a wide range of settings here in Victoria, from primary care clinics to mental health support. But the most profound results have come when we’ve used MI for:

• Addiction and recovery support

• Substance abuse counselling

• Chronic illness self-management

• Mental health interventions

• Youth and family counselling

One client, struggling with opioid use, told us, “This is the first time I’ve felt like someone actually sees me—not just my addiction.” That kind of feedback reminds us why this approach is worth learning.

 

How to Start Incorporating MI Into Your Practice

 

Getting started doesn’t require a complete overhaul of how you work. It begins with a shift in mindset. Instead of telling people what to do, we start inviting them to tell us what matters to them.

Practical steps:

• Start slow—focus on one or two patients where MI might be helpful

• Practice using open-ended questions and reflective listening

• Avoid giving advice unless it’s asked for

• Pay attention to “change talk”—the things people say that hint at a desire or reason to change

• Attend a workshop or training on MI skills, if possible

In our team’s experience, small changes in our communication approach led to big improvements in how patients responded.

 

The Long-Term Value of Motivational Interviewing

 

As providers, we’re under pressure to meet benchmarks, manage caseloads, and support increasingly complex client needs. MI isn’t a silver bullet, but it’s a tool that helps us be more effective, efficient, and compassionate.

 

We’ve noticed the long-term benefits:

• Stronger therapeutic relationships

• Reduced burnout among staff

• Improved patient outcomes

• More meaningful conversations

And in communities like Victoria, BC, where access to care is limited for some and stigma remains a real barrier for others, the ability to meet people where they are—without judgment—matters more than ever.

 

Final Thoughts

 

Motivational interviewing asks us to let go of control and lean into connection. We’ve found that people don’t resist change—they resist being changed. And when we show up ready to listen rather than fix, everything shifts.

Whether you're addressing motivational interviewing for addiction, helping a young adult navigate anxiety, or working through behavior change with someone managing diabetes—these skills apply. They’re flexible. They’re powerful. And they’re human.

 

If you’re a health care provider in Victoria, BC, and you’re ready to have better conversations with your clients—ones that create real, lasting change—motivational interviewing can help get you there.

Paul Burke is here to support you on that path. Let’s build healthier conversations, one client at a time.

 

FAQs

1. What is motivational interviewing in health care?

Motivational interviewing in health care is a client-focused communication method that helps individuals explore and resolve ambivalence about behaviour change. It’s widely used across Canadian health settings, including addiction support, chronic disease management, and mental health care.

 

2. How does motivational interviewing help with addiction treatment?

Motivational interviewing for addiction allows individuals to explore their own reasons for change in a non-judgmental space. It supports them in identifying internal motivations, which leads to more meaningful and lasting recovery outcomes.

 

3. Is motivational interviewing effective for substance abuse?

Yes, motivational interviewing for substance abuse has been shown to improve engagement, reduce resistance, and support long-term change. In Victoria, BC, we’ve seen great results using this approach in both clinical and community-based settings.

 

4. What are the key skills needed for motivational interviewing?

Core motivational interviewing skills include open-ended questioning, reflective listening, affirming client strengths, summarizing conversations, and recognizing change talk. These skills help build trust and promote autonomy.

 

5. Can motivational interviewing be used outside of addiction counselling?

Absolutely. While commonly used in addiction and substance abuse settings, motivational interviewing is also effective for chronic disease self-management, mental health care, and general lifestyle changes like smoking cessation or diet improvement.