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What Are the Core Techniques of Motivational Interviewing?

Rhonda Mattingly Williams, Ed.D, CCC-SLP, Pam Smithy, MS, OTR/L

April 15, 2026

Question

What are the core techniques of motivational interviewing?

Answer

First, we use open‑ended questions to encourage dialogue. We talk about this with our students across every discipline. If we ask a yes‑or‑no question, we are going to get a yes‑or‑no answer, which gives us only a tiny bit of information. Open‑ended questions invite the person to talk to us. For example, if a parent has mentioned that mornings are tough getting their child to daycare, I am not going to ask, "Do you have trouble in the morning?" or "Do you have trouble with feeding in the morning?" They have already told me that. Instead, I might ask, "Can you tell me more about what the mornings are like? What are you going through when you are trying to get your child ready?"

Second, we use reflective listening to show understanding. That might sound like, "It sounds like you really want your child to be more independent, but it is hard when time is short, and you need to get out the door." I am not judging; I am letting them know that I hear them and appreciate their perspective.

Third, we offer affirmation through compliments or validation. For instance, "You have been really patient working with your child's routine. That kind of patience builds new skills and helps develop the outcomes you want to see." This is not generic praise, such as "Oh, you are doing a great job." It is specific and tied to what the parent has actually said or done.

Fourth, we use summaries to reinforce key points. For example, "Today we talked about how you would like your child to dress themselves independently. Mornings can be tough, and you're under a lot of pressure. You are open to trying some strategies, and you want to make sure that helping your child dress faster is something you can actually do." Summarizing reinforces what has been discussed and shows that we were listening.

Finally, we elicit change talk. As you may recall from earlier slides, we discussed how people can spiral into negativity when they are beaten down and exhausted. We want to promote commitment to action. That might sound like, "You mentioned that you want your child to start feeding themselves more often. What small step can we take together this week that is going to help make that better?" This is where motivational interviewing really comes in. We are trying to understand what will truly drive that parent and how we can support them in making positive changes.

This Ask the Expert is an edited excerpt from the course, Using Adult Learning Theory to Enhance Coaching Practice and Parental Self-Efficacy, presented by Rhonda Mattingly Williams, Ed.D, CCC-SLP, and Pam Smithy, MS, OTR/L.

 


rhonda mattingly williams

Rhonda Mattingly Williams, Ed.D, CCC-SLP

Rhonda Mattingly Williams, EdD, CCC-SLP, is a professor in the Department of Otolaryngology, H/N Surgery, and Communicative Disorders at the University of Louisville. She teaches courses in early language evaluation and intervention, pediatric feeding and swallowing, cognitive-communicative disorders, and professional issues.

Dr. Williams has been practicing for over 35 years and currently provides clinical services to neonates, adolescents, and adults with a variety of disorders, including aphasia, cognitive impairment, voice dysfunction, slow feeding of the newborn, and dysphagia within the University of Louisville Healthcare System. She is active in research, publishes in scholarly journals, maintains membership in several professional organizations, and provides interdisciplinary continuing education to professionals across the globe.

 


pam smithy

Pam Smithy, MS, OTR/L

Pam Smithy, MS, OTR/L, serves as a Professor and Program Director of the Occupational Therapy Assistant Program at Jefferson Community and Technical College. She teaches a diverse range of courses, including pediatrics, physical disabilities, mental health, community practice, and professional transitions/management.

With over 37 years of occupational therapy practice and 28 years as a private practice owner, Pam has extensive experience collaborating with speech-language pathologists, physical therapists, and occupational therapy assistants to deliver comprehensive, interdisciplinary care. She remains actively involved in the Kentucky Occupational Therapy Association. She is a member of several other professional organizations, reflecting her ongoing commitment to advancing the profession and fostering collaboration across disciplines.


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