Motivational Interviewing: How to use it in coaching


We all have an inner belligerent teenager who resists, rebels, and feels misunderstood.

If you’re a coach, you might be familiar with scenarios where a client’s inner-teen surfaced.

Maybe it was when a client…

… trained even harder despite you cautioning them to take time to recover.

… complained of heartburn, but when you suggested an acid-taming meal plan, they responded by going on a three-night spicy wings bender.

said they wanted to get better sleep, but gave you a hundred reasons why they couldn’t put their phone away before 1 am.

Before you consider using reverse psychology (“Never stretch, and drink eight ounces of Sriracha before bed every night…”), what if we told you there’s a framework that can dissolve these kinds of coaching tensions?

One that will help you understand:

  • Why clients’ actions sometimes contradict their intentions
  • Why people often rebel against good advice 
  • How to help clients clarify the changes they’re actually willing to make, and talk themselves into action 
  • How to collaborate better with clients, getting them better results and making your job easier and more enjoyable

This framework exists!

It’s called Motivational Interviewing—and once you get it, your client results can be mind-blowing.

What is Motivational Interviewing?

Developed by clinical psychologists William Miller, PhD, and Stephen Rollnick, PhD, Motivational Interviewing is a communication style that helps people:

✅ Explore goals

✅ Strengthen their own motivation and commitment

✅ Adopt new habits

✅ Quit unproductive habits

✅ Successfully change for the better

Motivational Interviewing: Benefits for the coach

Coaches who use Motivational Interviewing function kind of like tour guides for someone exploring a new country.

(In this case, that country is the Land of Fitness and Nutrition.)

Like a personal tour guide, you have expertise, insider’s knowledge, and ideas on the best things to do, but you don’t have a programmed route that you’ll force clients to stick to.

You might share some of your insights, but ultimately, your clients will decide where to go.

A good Motivational Interviewing coach will also be genuinely curious, respectful, and non-judgemental about a client’s preferences.

(“Oh, you’d rather spend the day picnicking on the Seine instead of visiting the Eiffel Tower? I totally get that.”)

You respect your client’s autonomy, and interact with them as an equal partner.

You often say, “What would you like to do next? I have some ideas, but I’d love to hear what you’re thinking first.”

As a result, even when they’re in foreign territory, clients end up feeling supported, but also free.

Motivational Interviewing: Benefits for the client

Motivational Interviewing works especially well when a person is:

  • Highly ambivalent, stuck between wanting to change, and wanting to stay the same (“I want to go to bed earlier, but I don’t want to give up my free time at night.”)
  • Not very confident about their ability to change (“I’ve never been athletic. I just don’t know if I’m the exercising ‘type.’”)
  • Uncertain about whether they even want to make a change (“Do I really want to eat more kale? Sounds gross.”)
  • Not convinced about the benefits of change (“Will meditating really lower my blood pressure?”)

Uhh.. that’s most clients, isn’t it?

Exactly.

How Motivational Interviewing works

The main purpose of Motivational Interviewing is to resolve ambivalence, or “stuckness” in a client.

This is achieved through empathy, rapport-building, and freedom to explore change options—including not changing at all.

Wait—not changing?!

When most coaches and practitioners hear this, they bristle. They feel it’s their job to help clients change and improve.

If a client isn’t progressing, many coaches will (naturally, understandably) try harder—convincing, encouraging, even lecturing a client about all the good, life-affirming reasons to change.

However…

“Helping harder” usually doesn’t work.

Sure, a few unicorn clients just need more prodding to make progress.

But many clients don’t respond to standard encouragement, rationalizing, and problem-solving. The harder you try to help them, the harder they push back, continuing their old habits.

Take this common coaching scenario:

A client comes to you because they want to eat healthier.

A former athlete, their weight has crept up because they replaced a busy training schedule with a desk job, and lots of snacking.

Their clothes no longer fit, and their doctor has warned them that they’re at high risk of developing prediabetes. They have two young kids, and their motivation is high to set a good example for them and be a healthy parent.

You’ve taught them about portions, protein, vegetables—all the nutrition basics.

And yet, a few sessions in, they haven’t changed a thing.

Of course, you ask them what’s up.

Client: I sit all day but feel so tired after work. I don’t have the energy to exercise; all I want to do when I get home is watch game highlights with a beer and some chips.

Coach: Okay, I can understand that. But your doctor told you it was important to start exercising, and stick to a better diet. She’s worried about your blood sugar, right?

Client: Yeah, I know. I just feel like work is so crazy right now, and I really need time to decompress after work. It’s all I have before the kids get home, and then the house is nuts until they go to bed.

Coach: Hmm, well maybe you could just put a stationary bike in front of the TV and have seltzer instead of beer?

Client: But that doesn’t feel relaxing to me. What I’m saying is that I really need some time when no one needs me to do anything, and I can just treat myself. I never get to do that.

Coach: I get that. But you said that long term, you want to be healthy for your kids. And the best way to do that is to take better care of yourself now.

Can you see where this is going?

The coach is trying to help by suggesting solutions, and reminding the client of the importance of their choices.

The coach has a sincere desire to correct course when they see the client getting off track. (In Motivational Interviewing, this is called “the righting reflex.”)

Paradoxically, this causes the client to take the opposing position, to defend themself. 

Sadly, the coach ends up feeling frustrated because they don’t feel like they’re doing a good job helping. (Which is what they were hired to do… right?)

Meanwhile, the client feels misunderstood, and further invested in justifying their current habits.

You know your client wants to adopt better habits—they told you in your first session together.

But they also seem pulled to maintain their current comforts.

So how do you get this client to change? (Without making yourself the enemy?)

Follow these five steps and experience the magic of Motivational Interviewing.

Motivational Interviewing skills: 5 steps to better client conversations

When a client is 100 percent ready, able, and willing to take action RIGHT NOW, you won’t need much help.

(Heck, you might never meet a client like that. Why would they hire a coach?)

Motivational Interviewing is most needed—and effective—when you sense friction in your client sessions. Your client is expressing uncertainty, not following through on their intentions, or straight up resisting what you offer.

When that happens (and it will), follow these steps.

Motivational Interviewing Skill #1: Recognize that ambivalence is normal

Ever make a big decision?

Get married? Buy a house? Change careers?

Do you remember how part of you felt excited for the change, but another part of you felt grief or anxiety over the loss of your single life, your old (cheap) apartment, or your unstimulating-but-regular-paycheck job?

It’s the same way when clients contemplate lifestyle changes.

Part of them wants to be the type of person who eats salads every day, and the other part still wants to have a carefree attitude towards food, and yes, add fries to that.

This internal conflict between wanting to change and wanting to stay the same is called ambivalence.

And it’s totally normal.

Most clients won’t know how to name this tension either, and they certainly won’t assume it’s normal. They’ll probably just say: “I want to do this thing. But I’m not doing it. WHAT’S WRONG WITH ME??”

Ambivalence is such a normal part of change that both coach and client should bake it into their expectations.

(To bring awareness to—and sometimes even resolve—ambivalence, this exercise can be magic: 4 Crazy Questions Worksheet)

However, ambivalence is also a place where people can get stuck.

Usually, being stuck means maintaining the “old” way. Meaning: Your client isn’t getting any healthier.

In order to help a client move through these natural feelings of ambivalence, don’t push harder.

Instead…

Motivational Interviewing Skill #2: Assess your client’s readiness for change

Change is rarely a single event: You’re one way, then you’re suddenly “changed.”

Change is a process with multiple stages. And during some of those stages, it won’t “look” like anything’s happening.

The idea that change is a multi-step process with distinct phases is called the Transtheoretical Model of Change.

Image of transtheoretical model of change shows 6 stages of change, arranged in a cycle. Although people may enter or exit at any phase, typically people enter in the precontemplation phase, then move to contemplation, then preparation, then action, then potentially relapse, then ideally enter a maintenance phase.

Clients can enter or exit at any stage of the above model.

However, assessing where your client is in that process can help you coach them better—a person will have different needs depending on which phase they’re in. It’ll also help you avoid getting ahead of them and inadvertently scaring them away from change.

The transtheoretical model of change: 6 stages

Table describes the transtheoretical model of change, which has 6 stages of change: precontemplation, contemplation, preparation, action, maintenance, then potentially relapse.

Most programs and coaches assume clients are in the “action” stage already.

For example, giving a client a meal plan or a workout program after your first session assumes they’re already in the action stage. Which isn’t always true.

By understanding and preparing for various stages of readiness, you’ll be able to connect with—and help—way more clients.

Motivational Interviewing Skill #3: Understand your client’s motivations

Whatever your client’s doing that’s holding them back from better health—staying up late, getting too wound up at work, or stress-eating expensive cheese—they have a good reason for doing it.  

To dig into that reason, Motivational Interviewing coaches use OARS:

Open questions

Affirmations

Reflections

Summarizing

OARS represents a set of communication skills that build understanding and trust between the client and the coach.

Let’s go into how (and when) to use those now.

Open Questions

Generally, an open question is one that prompts a client to think, and yields more than a “yes” or “no” answer.

Open questions give you insight into a client’s feelings, experience, and expectations.

Examples:

  • What brings you in today?
  • How are your current habits affecting you right now?
  • What do you hope for yourself in the future?

Open questions are a great way to start off a session, or to explore a certain topic at any point in the session.

Good open questions also help the client realize why change matters, and how it might be possible.

Affirmations

Affirming means accentuating a client’s strengths, efforts, and past successes as a way to build hope and optimism.

Your affirmations can help clients see themselves differently: Perhaps as someone who’s wise and worthy of respect—and most importantly, someone who’s capable of change.

Affirming should be genuine; If you’re truly listening and understanding your client’s side of the story, you will see their positive aspects, such as their resilience or their creativity, and it’ll feel natural to call it out.

Affirmations sound like this:

  • Wow, you’ve worked really hard on this issue! I really admire your persistence.
  • It sounds like even though things didn’t turn out as you planned, your intention was good.
  • I know you’re disappointed that you couldn’t practice your new habit perfectly, but I see huge progress from where you started.

Affirmations can be used to build momentum when a client is making progress, but they’re equally important when a client is feeling defeated and could use some help reframing themselves or their actions.

Reflections

Clients don’t always communicate perfectly: They try to describe an experience and don’t always convey their full meaning.

Sure, you could press them to be more clear or elaborate further, but that can make some clients just feel like they’re doing a bad job of communicating, or that you just don’t understand.

Reflections are a way of guessing at a client’s deeper meaning.

They help you confirm you’ve understood what the client is really saying, and also gives you the opportunity to build on what the client might be trying to get at, by weaving in some of your own insights.

When done properly, reflecting can help a client feel deeply cared for, understood, and also enhance their own understanding of themselves and their situation.

Here are some examples of reflections:

Client: I feel nervous.

Coach: You’re feeling uneasy, maybe because you’ve never talked about these things before.

Client: I feel like I failed.

Coach: You feel disappointed that you slipped up this week, and this makes you wonder if you can really change in the long run.

Client: I’m so happy I went to the gym this week!

Coach: You’re happy you went to the gym and you must be feeling so proud of yourself! You’re getting a taste for what’s possible!

Believe it or not, it actually doesn’t matter so much if you occasionally get a client’s meaning wrong. Just take a guess, and your client will correct you if you’re wrong.

Check it out:

Client: This meal plan kind of freaks me out!

Coach: All those macros and calories can be overwhelming!

Client: Oh, that’s not it at all. I’m pretty comfortable with macros. It’s just that I have two daughters, and I’m worried about the message I’m sending them if they see me weighing all my food.

In correcting you, your client helps you understand what they mean anyway.

Getting it wrong can feel awkward, but it’s better than staying quiet and assuming you understand a client’s full meaning when they say something.

(Note: The above are all examples of complex reflections. If all that interpreting sounds risky, then try a simple reflection, where you just repeat or slightly rephrase what a client said. Although basic, even this strategy can help a client feel like you’re listening, and offers them a chance to elaborate.)

Summarizing

Summarizing is just stringing together reflections—and sometimes affirmations—based on several things a client has told you.

Like reflections, summaries help you confirm whether you’ve heard and interpreted a story correctly.

They also give clients a chance to reflect on everything they’ve told you so far, and possibly to see their story in a different way. Sometimes when we hear someone else tell our story back to us, it gives us new insights.

Here’s an example:

“So, you came here today because you’re worried about your health. You often feel sore and tired, and that worries you because you have young kids who need you to be healthy for a long time. You’ve had trouble sticking to nutrition programs in the past, so you don’t feel super confident that you can do it now. However, you’ve also continued to care about your health, and try to find solutions, which shows me how resilient you are.”

At the end of your summary, you can ask, “Did I miss anything?” or “Do you want to add anything else?”

Use summaries when you:

✅ Wrap up a certain topic

✅ Shift from one phase of a client session to the next

✅ Reach the end of a session

With the whole picture freshly laid out, you and your client can better come up with the most appropriate next steps.

Motivational Interviewing Skill #4: Roll with any resistance that comes up

Resistance happens when the client appears to move away from change, and towards maintaining their old habits.

Resistance might sound like this:

“But I make all my meals at home! I don’t understand how my diet could be unhealthy!”

Or:

“I’m just not a gym person.”

Resistance isn’t about the client being “difficult.”

Resistance happens when the client feels some (normal) ambivalence about change, and the coach has moved too far ahead in the change process.

It’s often the coach who creates resistance. If a client’s pushing back, it means you’ve given them something to push against.

[Swallows jagged pill]

So when you experience resistance, you might ask yourself:

“What did I say to generate push-back?”

Maybe you—with totally good intentions—suggested the client change too much too fast. And they’re now feeling insecure, and overwhelmed.

This causes your client to dig in their heels, creating a feeling of friction if you continue to push forward.

A more effective way to deal with resistance is to step back, remind yourself that ambivalence and resistance are normal, and then use reflections to help understand and move through your client’s resistance.

Here’s what that might sound like:

Client: “I don’t see why my diet’s such a big problem.”

Coach: “You feel like you’re not really seeing the benefit of changing your eating habits.”

Client: “No. I mean, my doctor seems to think there’s a problem, but I don’t.”

Coach: “You’re not really sure your doctor is right about this.”

Client: “Well, I’m sure she knows something. She’s a doctor after all. I just don’t feel like I’m sick or anything.”

Coach: “Your doctor might know what they’re talking about, you just don’t feel you’ve experienced any negative consequences of your diet.”

Client: “Well, I guess I get heartburn a fair bit. And I don’t have the energy I used to.”

Coach: “Your heartburn’s bothering you, and it would be great to feel more energetic again.”

Client: “Yeah. Those things bug me a lot actually. Sigh. I guess I know if I eat better, I’ll probably feel better.”

Without trying to convince them of your position, you’ve just walked the client gently towards change.

Your client initially felt defensive and a little oppositional, but with some good reflections, they felt understood and free to explore their options.

Now, you’re in a much better position to ask the client if they’re okay with you sharing some things about how nutrition might improve their specific health issues.

And your client might actually feel ready to listen.

Motivational Interviewing Skill #5: Support your client’s ongoing ability to change

Many clients who come to you will have tried to change on their own—or even with the help of another practitioner—without success.

They might also be used to people telling them their habits are “bad” and pushing them to change.

In other words, many clients will come to you filled with self-doubt, mistrustful of their own instincts and wisdom.

This can negatively impact their long term progress.

Here’s what we know—from coaching over 100,000 clients—what does help people make meaningful and sustainable progress.

People are more successful when:

  • They find their own motivation to change. People are more persuaded by what they themselves say than what someone else tells them to do.
  • They see challenges as opportunities to get stronger, rather than give up. Affirmations that highlight a client’s efforts (rather than just results) can strengthen their belief in their ability to learn, grow, and adapt.
  • They’re self-compassionate. When a client works with a coach who accepts them as they are, sees the best in them, and believes in their potential, it’s transformative. Clients who internalize this compassion and positive regard are more likely to adopt healthier habits, and have better mental health outcomes.

By adopting the spirit of Motivational Interviewing in your coaching, you’ll naturally promote all of these outcomes in your clients.

(Read more about how to talk to clients in a collaborative, compassionate way: Effective coach talk: What to say to clients and why it matters)

Don’t expect your coaching to change all at once, though.

This was just a little sample of what Motivational Interviewing has to offer.

Even so, you might be feeling overwhelmed about everything we just covered.

Or maybe you’re super excited to put it into practice!

(Or maybe it’s both. Remember: Ambivalence is normal.)

Either way, know that Motivational Interviewing takes consistent practice on the part of the practitioner to really “get.”

Motivational Interviewing is a kind of language. And just like learning a new language, Motivational Interviewing takes time to master—and can feel REALLY awkward at first.

Just like you give your clients time and space to change, allow yourself to build your Motivational Interviewing proficiency over time.

(If you want to dig into it further, plus be mentored by one of our Super Coaches, check out the Precision Nutrition Level 2 Master Health Coaching Certification. Motivational Interviewing principles are built into our coaching methods—we call it “client-centered coaching.”)

When you get the hang of Motivational Interviewing, coaching will feel different.

Your clients will get better results because they feel more autonomous, respected, and appropriately supported. And that’s very rewarding to witness.

But you’ll also feel better: You’ll experience less frustration and conflict in client sessions, coaching will feel easier with less pressure to “produce results,” and you’ll feel more connected to the people you serve.

Motivational Interviewing is one of the most effective tools you can use to help your clients change for the better.

And it’ll change you too.

References

Click here to view the information sources referenced in this article.


Miller WR, Rollnick S. Motivational Interviewing. Preparing people for change. 3rd edn. New York: The Guilford Press, 2013.


In our elite mentorship program, you’ll learn the secrets of behavior change psychology—and join the world’s top 1% of coaches.

“I skyrocketed my coaching skills and confidence…My impostor syndrome is gone!– Katya Mohsen, PN Certified Master Health Coach

If you’re ready to level up your coaching skills and feel confident you can guide any client to a lasting health transformation, we’ve got some big news for you:

On April 4th, 2023, we’re opening registration for the next cohort of the PN Master Health Coaching Certification, the industry’s most respected practice-based mentorship.

“You cannot be a health or fitness coach without having the tools and techniques that this program brings. It’s a whole different level.”– Katya Mohsen, Lisa Bernier, PN Certified Master Health Coach

Inside the Master Health Coaching Certification, you’ll learn a skill set and be able to earn a credential that will distinguish you as an elite coach:

The ability to use behavior change psychology to help any client achieve sustainable, meaningful change. And the credential of being a Board Certified Health and Wellness Coach.

“This program does an absolutely phenomenal job of addressing how to affect behavior change…something that’s sorely missing in most people’s practices.”– Jeb Stuart Johnson, Founder of Food On The Mind, PN Certified Master Health Coach

It’s the only program in the world where you’ll learn the secrets of behavior change psychology through live mentorship.

Because, while knowing the science of nutrition and fitness is important, it’s not enough. In order to actually create change, you need a deep understanding of behavior change psychology.

We’ve applied this understanding with our coaching programs to help over 100,000 clients achieve lasting health transformations—something nobody else can say.

And now, we’re ready to share our hard-earned wisdom with you.

“This program taught me how to be a better coach and retain clients longer. Before, I had clients staying for a month. Now, it’s six, nine months, even a year.”– Jeff Grogan, PN Certified Master Health Coach

Through real-world coaching scenarios, hands-on assignments, and mentoring sessions with PN’s industry-leading Master Health Coaches, you’ll learn how to prioritize a client’s challenges, help them remove obstacles holding them back, and how to create unique, actionable coaching plans for every client, addressing their:

  • Sleep
  • Stress management
  • Mental health
  • Emotional wellbeing
  • Recovery
  • Diet
  • Exercise

This mentorship program is where the world’s best coaches come to take the next steps in their careers.

At the end of your 20-week program, you’ll be a Master Health Coach—confident in your ability to guide any client towards a meaningful, lasting health transformation.

“I now have more knowledge, more confidence and more skill. My clients stay longer and experience better results.– Jonny Landels, Founder of Next Step Nutrition, PN Certified Master Health Coach

After joining, you’ll:

  • Help any client achieve sustainable, meaningful change by leveraging behavior-change psychology.
  • Eliminate impostor syndrome and feel more confident in your skills than ever before by integrating proven methods used by the world’s top health and well-being coaches into your coaching practice.
  • Become an authority in the health and well-being space. As you learn from PN’s industry-leading coaches and network with some of the sharpest minds in the industry, you’ll build the confidence to share your expertise with anyone, anytime.
  • Make more money and achieve financial freedom. Whether you decide to take on the full-time role of “health coach”, or you want to expand on your current work as a health and well-being professional, health coaching is a great way to help more people.

Early Bird registration for our next PN Master Health Coaching Certification kicks off on April 4th, 2023.

If you’re interested, or just want more information, you should strongly consider signing up for the free waitlist below.

After joining the free Waitlist, you’ll save up to 44%, get exclusive perks, and early access.

  • Pay less than everyone else. We’re offering a discount of up to 44% off the general price when you sign up for the waitlist
  • Sign up 10 days before the general public. We only open the PN Master Health Coaching Certification a few times per year. Due to high demand, we expect it to sell out fast. But when you sign up for the waitlist, we’ll give you the opportunity to register 10 days before anyone else.
  • Get access to an exclusive bonus seminar with PN Co-founder Dr. John Berardi and PN CEO Timothy Jones: “Coaching After the Pandemic: How Health and Fitness Coaches Can Navigate the Industry in 2023 and Beyond.



Source link