Those principles guide the overall approach, but what does each MI technique actually sound like in a session? Most of it comes down to four core skills, known as OARS. Open-ended questions, affirmations, reflections, and summaries are the main interventions therapists use in motivational interviewing.
For example, imagine you’ve been wanting to exercise more but can’t seem to make it stick. Here’s how each skill might come up in a conversation with your therapist, plus some motivational interviewing interventions:
Open-ended questions: Your therapist asks questions that get you thinking and talking, instead of ones you can answer with a simple yes or no.
Example: “What would be different if you exercised regularly?”
Affirmations: Your therapist points out your strengths, efforts, and past wins to build your confidence.
Example: “You stuck with a running routine for months last year. That took real commitment.”
Reflections: Your therapist repeats or rephrases what you’ve said, sometimes with a guess at the deeper meaning. This shows they understand and also helps you hear your own thoughts more clearly.
Example: “It sounds like you miss how energized you felt back then.”
Summaries: Your therapist pulls together the key points you’ve shared so you’re both on the same page.
Example: “So you want more energy, you’ve done this before, and finding the time is the biggest hurdle right now.”
Your therapist will also listen closely for something called “change talk” (statements in favor of making a change, like “I want to feel stronger”) versus “sustain talk” (reasons for keeping things as they are). When they hear change talk, they’ll encourage you to say more. If they have information or advice to share, they’ll usually ask what you already know and whether you want their input first.
There’s also something called the EPE (elicit–provide–elicit) framework. It’s a technique used by therapists in MI to share information, advice, or feedback in a consistent way — without triggering defensiveness in their clients.
