Motivational interviewing is, by definition, arranging conversations so that people talk themselves into change based on their own values and beliefs. The key words in this MI description are “arranging conversations.” As interviewers, we arrange conversations by asking open-ended or powerful (full of impact) questions and then listening intently for what our interviewee says and how they speak (voice inflection, hand gestures, facial expressions etc). We propose that the most fundamental question we can ask in every interview is some variation of, “what’s important about _________ ?” where the blank is whatever the interviewee has identified as their focus. The question is the most basic, elegant, and power-full way to get at client values just because you are trying to get them to talk about importance = value. The beauty of the question, if genuinely asked, is that it can be repeated in a chain of questions that keep drilling down on your client’s values and beliefs. What-style questions can be layered to enable clients verbally to walk around themselves in service of ferreting out their value/s attached to a desired behaviour change:
What, as a question-starter, opens up a conversation and lets people ‘see’ inside themselves out loud. ‘What’ is an invitation whereas why and how challenge people, perhaps encouraging them to justify or analyze themselves. We as a society have literally been schooled to use the question why in an institutional, educational system that enshrines the scientific method and with good reason when we want valid evidence re the efficacy of a new drug, for example. However, when it comes to human behaviour change, it might be that ‘what’ serves people much more than why. Why is convergent, it narrows focus; what is divergent, it has the potential to expand our focus. Almost any ‘why’ question can be turned into, ‘in what way’ as a bridge to becoming accustomed to using what-questions in an effective manner. Consider these what-questions and their potential impact on clients (in no order of use, each question is of singular value, depending upon interviewee responses):
What is important in your life?
What’s most important in your life right now?
What assumption/s are you making?
What do you need?
What do you want?
What encourages or inspires you?
What motivates you?
What are you willing to change?
What will help you prepare to change?
What would being ready for this change look like?
What’s possible from here?
What would your life be like if you were to make this change?
What would have happened if our convesation ended up invaluable to you today?
Each of these what-questions can be followed up with ‘what’s important about____________?’ What then, in our view, is the most fundamental, potent question-starter we can use in motivational interviewing. What takes us to possibility/ies, windows into and perhaps levers for change talk. Well used, it is the most “open” of open-ended questions proscribed in the MI O-A-R-S + advising (using Elicit~Provide~Elicit) skill set. What’s important? What’s important!
“Would you tell me, please, which way I ought to go from here?”
“That depends a good deal on where you want to get to.”
“I don’t much care where –”
“Then it doesn’t matter which way you go.”
~ Lewis Carroll, Alice in Wonderland