Ignite Behavior Change With Motivational Interviewing

Last Updated April 12, 2024 (originally published August 24, 2017) 

As a health and exercise professional, it’s easy to feel like your clients’ health behaviors are your responsibility. While you can guide and encourage your clients, lasting behavior change ultimately has to come from within an individual. 

Psychologists William R. Miller and Stephen Rollnick developed MI as a client-centered coaching style to encourage healthy behavior change. First used in treating those with alcoholism, MI is characterized by its non-directive, collaborative and exploratory approach. 

According to the self-determination theory of human motivation, individuals are compelled to engage in behaviors when they have high feelings of competency, autonomy and relatedness to others. MI supports this by putting clients in control of their own behavior change. 

Whether you are helping clients adopt healthier eating habits, stress-reduction strategies or regular physical activity, use the following MI strategies to enhance client autonomy and success. 

Open-ended Questions 

Let clients explore their underlying thoughts, feelings, fears and goals through open-ended questions. These questions require clients to answer with more than a “yes” or “no.” Here is an example of an open-ended question: “So, you’d like to lose 20 pounds in the next five months. What would this weight loss mean for you?” 

Open-ended questions can also be used in the face of client ambivalence. For example, if a client says they’ve always hated exercise, you might ask, “What experiences have led you to feel so negatively about exercise?” Rather than telling the client their feelings are wrong by expressing how wonderful you think exercise is, this question allows the client to explore the reasons underlying their dislike of physical activity. 

Non-judgment 

Approaching clients with an accepting and non-judgmental attitude creates a safe space for behavior change to occur. If clients fear being judged by their health coach or exercise professional, they are less likely to be honest about their thoughts, feelings and behaviors, and more likely to commit to things just to please you. You can explicitly create a non-judgmental environment by stating something like, “There are no failures here, only learning opportunities. Nothing you do is inherently bad (even binging on a carton of ice cream) and will only teach us more about what factors might lead you to engage in an unhealthy behavior (such as overeating). 

Reflect and Affirm 

Let clients know that they are being heard by reflecting their thoughts and feelings back to them. This helps clear up any potential confusion and lets clients know that you are trying to understand and value how they feel. For example, if a client who dislikes exercise goes into a story about embarrassing experiences they had in high school gym class, you could say, “It sounds like your past experiences have really affected the way you feel about exercising. Does this sound true?” This will both clarify your understanding of the client’s feelings and help them recognize thoughts and feelings they have but may not have paid attention to. 

It can be tempting to dictate health behaviors to your clients. While you may be an expert in fitness or nutrition, you are not an expert in your client’s feelings, lifestyle, needs or goals. Rather than telling clients what to do, help them explore viable healthy behaviors, understand the benefits of these behaviors, and recognize and overcome barriers getting in the way. 

Ensure any goal a client sets is both relevant and achievable. Telling a client to jog for 30 minutes five days a week may be in line with national guidelines, but if it isn’t meaningful to the client and doesn’t fit in the context of their life, it’s useless. Present clients with options that meet them where they are. An easy way to gauge the potential efficacy of a behavior is to ask the client. For example, if you and the client work together to come up with a specific goal around eating vegetables, you might ask, “How important is it to you that you eat at least two servings of vegetables at two meals each day?” and “How confident are you that you will stick with this goal every day for the next week?” This way, you and the client can collaborate to create goals that are meaningful to them and more likely to be achieved. 

Final Thoughts 

As a health coach or exercise professional, your ultimate goal is to create healthier, happier and more vibrant individuals and communities. Motivational interviewing is an excellent strategy to help you empower clients to develop intrinsic motivation and create meaningful healthy behaviors that last a lifetime. 

If you’re interested in learning more about how to incorporate behavior-change principles into your work with clients, become an ACE Behavior Change Specialist (worth 2.5 ACE CECs). In this course, you’ll learn about common obstacles to achieving healthy behavior change and strategies to empower clients to overcome those obstacles and find their own path to a more fulfilling lifestyle.  

Or, take your expertise a step further by earning the ACE Health Coach Certification and become part of a growing profession with a variety of rewarding career paths.