What We’ve Said

What we’ve said about Motivational interviewing

8 points from 7 episodes, newest first

Also searched as MI

In short

The core of motivational interviewing is Rogerian reflection: you pull information and values out rather than hand information over, so patients notice discrepancies in themselves. Read properly, it is a mutual process of discovering what matters to the patient, and it is the closest literature we have to building an alliance.

What it really is

  1. The actual core of motivational interviewing is containment, the Rogerian-type mirroring, which lets patients notice discrepancies within themselves that they would not see without those reflections.

    “The actual core of motivational interviewing is the ability to do this technical containment, the Rogerian-type mirroring, and in it, allowing patients to actually notice areas of discrepancy within themselves that would not otherwise be noticed without these kinds of reflections”
    55:26Psychodynamic Technique and Therapeutic Intervention: ContainmentApr 2026

  2. You are getting information, not giving it: pulling information and values out. Ambivalence in treatment often comes from a lack of clarity about the underlying conflicts.

    “you try to get information you're not giving information you're pulling information and values out and i think that a lot of the time ambivalent behavior and treatment comes from a lack of clarity into the underlying conflicts”
    1:04:48Handling Difficult Situations in Psychiatry: ADHD Evaluations, Benzo Requests, Disability Claims, and Involuntary AdmissionsOct 2025

  3. It is a process where you and the patient mutually discover what is important to them, what they want, and what they do or do not see as a problem.

    “what you are doing is that you're engaging the patient in the process where you mutually discover the what is important to the patient, what they want, and what they see is or is not a problem”
    32:21Probably The Most Important Topic in Psychiatry: Therapeutic Alliance and FrameJan 2025

How we use it

  1. When you notice discrepancies in the narrative, or between the patient's behaviors, thoughts, feelings and values, point them out.

    “When you notice discrepancies in the narrative, or between the patient's behaviors, thoughts, feelings, or values of things that you know the patient have, it's important to confront it”
    35:37Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026

  2. When a patient will not accept a medically necessary treatment, your job is to keep counseling them toward it, and that does not mean simply repeating that they need it.

    “When the patient won't accept the medically necessary treatment, your job as a clinician is to continue to counsel them on accepting the medically necessary treatment. And I don't mean just simply telling them over and over that's what they need to do”
    50:27PTSD Medications: Integrating Pharmacotherapy, Therapy, and the Treatment Frame | Episode 22Apr 2025

  3. With anxiety there is usually some resistance: the anxiety serves a purpose, often a hidden belief that it is protecting them.

    “Usually, there's some sort of resistance and that their anxiety is serving some sort of purpose, like a subconscious belief that their anxiety is protecting them in some way”
    35:36Understanding Anxiety, GAD, and Treatments of AnxietyJun 2025

  4. Explaining is taking power over the relationship. Flip it so the power sits with the person who has to make the physiologic and behavior changes: start by understanding what is important to them, then remind them that they said it is important.

    “explaining is taking power over this relationship. I want to flip that around so that the power is in the hands of the person who has to, because of their bipolarity, make the physiologic changes, make the behavior changes”
    46:15How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode
    Also said in 1 more episode
    “Helping people understand things begins with what is important to them, understanding what's important to them, and then reminding them that they said that, that's important to them”
    45:47How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode

  5. If you need to stay up till two and have a few beers with your friends, know that it comes at a cost, and whether the cost is worth it is ultimately your decision.

    “Listen, if you need to stay up till two and have a few beers with your friends, just know that it's coming at a cost. And it's ultimately your decision of is the cost worth it”
    1:09:12How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026

From these episodes

Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.

Educational content only. Everything here is what was said on the Psychofarm podcast, for clinicians. It is not medical advice and not a substitute for clinical judgment, current labeling or guidelines. An episode reflects what we thought when we recorded it, so check anything before you rely on it.