What is motivational interviewing? The 4 principles you need to know

By Rita Berríos R.

The practice of motivational interviewing plays an important role in a person’s thinking process toward change, making it an attractive technique for clinicians who want to support their client’s hearing loss journey from a person-centered perspective.

What is motivational interviewing?

A quick online search will tell you that motivational interviewing is a counseling approach used in the counseling of people with addiction.

However, it has also proven effective in different scenarios. For example, in hearing care when a client is ambivalent about taking action on their hearing loss.

William R. Miller and Stephen Rollnick, the two clinical psychologists who developed this communication technique in the 1980s, define motivational interviewing as:

“[…] a collaborative, goal-oriented style of communication with particular attention to the language of change.

It is designed to strengthen personal motivation for — and commitment to — a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.”

In other words, motivational interviewing is a communication style intended to maintain the focus of the conversation — the interview — on the patient’s personal motivations to identify what reasons can be used during a conversation/appointment for them to embrace behavioral changes. 

The 4 principles of motivational interviewing

In Ida’s University Course module Client Perspective - Motivational Interviewing created in collaboration with Dr. Deborah von Hapsburg, clinicians are invited to dig deeper into this communication technique by looking into the goals, foundations, roles, and more.

Von Hapsburg also introduces RULE, the four principles of motivational interviewing. The acronym helps bring focus back to the guidelines when interviewing clients.

R – Resist the righting reflex

U – Understand your client’s motivation

L – Listen to your patient with empathy and avoid argumentation

E – Empower your patient’s self-efficacy

How to practice motivational interviewing

The role of the clinician during a motivational interview becomes that of an informer, mediator, and supporter – this means that throughout a conversation with a client, a clinician will:

  • Present a new language or new terms within a context that helps their client to better understand the benefits of changing their view on a treatment or a possible solution to their health diagnoses. In the case of hearing loss, motivational interviewing can be used to increase adherence to audiologic recommendations
  • Start the dialogue and guide the client through their thoughts while allowing freedom for them to learn more about their own thoughts
  • Support and empower clients through their struggles and successes


Resources to help you conduct motivational interviews in the clinic

If you are interested in practicing motivational interviewing in your appointments, check out our Motivation Tools and the Learning Hall course Applying PCC in the Appointment (login required) to help you get started!