{"id":19018,"date":"2026-04-01T20:09:04","date_gmt":"2026-04-02T00:09:04","guid":{"rendered":"https:\/\/psymontreal.com\/?p=19018"},"modified":"2026-04-03T12:12:00","modified_gmt":"2026-04-03T16:12:00","slug":"stuck-motivational-interviewing-latest-edition","status":"publish","type":"post","link":"https:\/\/psymontreal.com\/en\/stuck-motivational-interviewing-latest-edition\/","title":{"rendered":"Why You Get Stuck in Motivational Interviewing and What the Latest Edition Reveals"},"content":{"rendered":"<p dir=\"ltr\"><strong>You use motivational interviewing in your practice.<br \/>You reflect.<br \/>You ask open questions.<\/strong><\/p>\n<p dir=\"ltr\"><strong>And yet\u2026<\/strong><\/p>\n<ul>\n<li><span><strong>Some conversations repeat themselves<\/strong><\/span><\/li>\n<li><span><strong>Ambivalence\u200b persists<\/strong><\/span><\/li>\n<li><span><strong>Change is slower than expected<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\">If this feels familiar, you are not alone.<\/p>\n<p dir=\"ltr\">In many cases, the issue is not a lack of knowledge.It is a question of how the skills are being used.<\/p>\n<p>The latest edition of Motivational Interviewing (Miller &amp; Rollnick, 4th edition) highlights several important evolutions in the approach. These help clarify five common difficulties that often explain why you may feel stuck, and how to move forward.<\/p>\n<h2>1. Responding to change talk\u2026 without cultivating it<\/h2>\n<p>In MI trainings, you often learn to use reflective listening. This is an important skill. A key element is learning to recognize and reflect specifically change talk. Because if you only respond to what is already present, the conversation may remain limited.<\/p>\n<p><strong>Example<\/strong><br \/><strong>Client:<br \/><\/strong>\u201cI know I should cut down\u2026 but I don\u2019t know.\u201d<br \/><strong>Reflection:<br \/><\/strong>\u201cYou\u2019re unsure about making a change.\u201d<\/p>\n<p><strong>This is accurate.<\/strong><\/p>\n<p><strong>\u200b<\/strong><strong>It keeps the conversation clear, but it does not move it forward.<\/strong><\/p>\n<p><strong>A more helpful direction<\/strong><br \/>\u201cWhat concerns you most about continuing this way?\u201d<br \/>Here, you begin to evoke additional change talk, rather than waiting for it to emerge.<\/p>\n<p><strong>Key point:<\/strong><br \/>Responding to change talk is useful. Cultivating it is essential.<\/p>\n<h2>2. Confronting sustain talk\u2026 instead of softening it<\/h2>\n<p>When clients express reasons to maintain the status quo or disadvantages of changing (sustain talk), it is natural to want to correct or challenge. In practice, this often creates tension and slows the conversation.<\/p>\n<p><strong>Example<\/strong><br \/><strong>Client:<br \/><\/strong>\u201cDrinking is the only thing that helps me relax.\u201d<br \/><strong>Common response:<\/strong><br \/>\u201cBut it\u2019s also causing problems.\u201d<\/p>\n<p><strong>This can increase friction.<\/strong><\/p>\n<p><strong>A more helpful direction<\/strong><br \/>\u201cGiven how much stress you\u2019re under, it makes sense that you would rely on something that helps in the moment.\u201d<br \/>This response does not endorse the behaviour. It reduces defensiveness and keeps the conversation open.<\/p>\n<p><strong>Key point:<\/strong><br \/>Sustain talk is not something to eliminate. It is something to work with skillfully.<\/p>\n<h2>3. Using skills correctly\u2026 but without direction<\/h2>\n<p>You may already be applying the core skills of motivational interviewing appropriately.<\/p>\n<p>You:<\/p>\n<ul>\n<li><span><strong>reflect<\/strong><\/span><\/li>\n<li><span><strong>ask open questions<\/strong><\/span><\/li>\n<li><span><strong>avoid directing the client<\/strong><\/span><\/li>\n<\/ul>\n<p>Yet, despite this, the conversation may not progress. A good conversation is not the same as a conversation that leads to change.<\/p>\n<p><strong>Example<\/strong><br \/><strong>Client:<br \/><\/strong>\u201cI\u2019m torn. Part of me wants to change, part of me doesn\u2019t.\u201d<br \/><strong>Reflection:<br \/><\/strong>\u201cYou\u2019re feeling conflicted.\u201d<\/p>\n<p><strong>This is correct. But it maintains the current state.<\/strong><\/p>\n<p><strong>A more helpful direction<\/strong><br \/>\u201cA part of you is starting to question whether this can continue.\u201d<br \/>This reflection gently highlights movement toward change.<\/p>\n<p><strong>Key point<\/strong><br \/>Accuracy is not enough. Interventions need to be purposeful and directional, guiding the conversation toward more change talk, not just reflecting it.<\/p>\n<h2>4. Underusing affirmations<\/h2>\n<p>Affirmations are a core component of motivational interviewing. However, in practice, they are often:<\/p>\n<ul>\n<li><span><strong>brief<\/strong><\/span><\/li>\n<li><span><strong>generic<\/strong><\/span><\/li>\n<li><span><strong>or overlooked<\/strong><\/span><\/li>\n<\/ul>\n<p>The latest edition further clarifies their role, including the distinction between more basic and more developed forms.<\/p>\n<p><strong>Example<\/strong><br \/><strong>Client:<br \/><\/strong>\u201cI almost didn\u2019t come today.\u201d<br \/><strong>Common response:<br \/><\/strong>\u201cI\u2019m glad you came.\u201d<\/p>\n<p><strong>This is supportive, but limited.<\/strong><\/p>\n<p><strong>A more helpful direction<\/strong><br \/>\u201cEven with everything going on, you still showed up. That says a lot about your commitment.\u201d<br \/>This highlights effort, persistence, and values.<\/p>\n<p>A simple affirmation acknowledges behaviour. A more developed affirmation highlights effort or values.<\/p>\n<p><strong>Key point<\/strong><br \/>Effective affirmations strengthen:<\/p>\n<ul>\n<li><span><strong>confidence<\/strong><\/span><\/li>\n<li><span><strong>engagement<\/strong><\/span><\/li>\n<li><span><strong>readiness for change<\/strong><\/span><\/li>\n<\/ul>\n<p>They are not an accessory. They are part of the process.<\/p>\n<h2>5. Applying techniques\u2026 instead of embodying the approach<\/h2>\n<p>Motivational interviewing is often taught through techniques:<\/p>\n<ul>\n<li><span><strong>reflections<\/strong><\/span><\/li>\n<li><span><strong>questions<\/strong><\/span><\/li>\n<li><span><strong>summaries<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\">These are essential.<\/p>\n<p dir=\"ltr\">At the same time, the latest edition reinforces that motivational interviewing is fundamentally a relational style, grounded in:<\/p>\n<ul>\n<li><span><strong>collaboration<\/strong><\/span><\/li>\n<li><span><strong>autonomy<\/strong><\/span><\/li>\n<li><span><strong>authenticity<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\">It is possible to sound technically correct, but still feel distant in the conversation.<\/p>\n<p dir=\"ltr\">Consider the difference:<\/p>\n<p dir=\"ltr\"><strong>\u201cWhat would you like to change?\u201d<\/strong><\/p>\n<p dir=\"ltr\">The same question can be asked:<\/p>\n<ul>\n<li><span><strong>in a procedural way<\/strong><\/span><\/li>\n<li><span><strong>or with genuine curiosity<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\">Clients perceive this difference immediately.<\/p>\n<p dir=\"ltr\">When the approach becomes mechanical:<\/p>\n<ul>\n<li><span><strong>collaboration increases<\/strong><\/span><\/li>\n<li><span><strong>change becomes more likely<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\"><strong>Key point<\/strong><\/p>\n<p dir=\"ltr\">Motivational interviewing is not only what you say.It is how you are with the client.<\/p>\n<h2>In summary<\/h2>\n<p dir=\"ltr\">These five difficulties are not separate problems.<\/p>\n<p dir=\"ltr\">They reflect a single pattern:<\/p>\n<ul>\n<li><span><strong>Using motivational interviewing as a set of techniques, rather than as a way of guiding conversations toward change.<\/strong><\/span><\/li>\n<li><span><strong>Participating in trainings provides a strong foundation.<\/strong><\/span><\/li>\n<li><span><strong>Developing mastery requires going further.<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\"><strong>Practice, with intentional use of these skills, is key.<\/strong><\/p>\n<h2>Conclusion<\/h2>\n<p dir=\"ltr\">If your conversations feel repetitive or stalled, the solution is not to learn more tools.<\/p>\n<p dir=\"ltr\">It is to use the ones you already know:<\/p>\n<ul>\n<li><span><strong>more intentionally<\/strong><\/span><\/li>\n<li><span><strong>more directionally<\/strong><\/span><\/li>\n<li><span><strong>more skillfully<\/strong><\/span><\/li>\n<\/ul>\n<p dir=\"ltr\">The difference is not subtle. It is what separates conversations that explore change from conversations that produce it.<\/p>\n<p>As the well-known martial arts saying goes:<\/p>\n<p dir=\"ltr\"><strong>\u201cFear not the man who has practiced 10,000 kicks once, but the man who has practiced one kick 10,000 times.\u201d<\/strong><\/p>\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Feeling stuck in your Motivational Interviewing sessions? The transition from &#8220;resistance&#8221; to &#8220;partnership&#8221; is a core focus of the newly released 4th edition by Miller &#038; Rollnick. Discover why clinical bottlenecks happen and how the latest updates provide a clearer pathway to evoke change and deepen the therapeutic alliance.<\/p>\n","protected":false},"author":1,"featured_media":19016,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"wds_primary_category":36,"footnotes":""},"categories":[36],"tags":[],"class_list":["post-19018","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthcare-professionnals"],"acf":[],"uagb_featured_image_src":{"full":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi.jpg",835,557,false],"thumbnail":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-150x150.jpg",150,150,true],"medium":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-300x200.jpg",300,200,true],"medium_large":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-768x512.jpg",768,512,true],"large":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi.jpg",835,557,false],"1536x1536":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi.jpg",835,557,false],"2048x2048":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi.jpg",835,557,false],"_nx_notification_thumb_100_100":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-100x100.jpg",100,100,true],"_nx_notification_thumb_200_200":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-200x200.jpg",200,200,true],"_nx_notification_thumb_300_300":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-300x300.jpg",300,300,true],"_nx_notification_thumb_400_400":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-400x400.jpg",400,400,true],"_nx_notification_thumb_500_500":["https:\/\/psymontreal.com\/wp-content\/uploads\/2026\/04\/stuck-mi-500x500.jpg",500,500,true]},"uagb_author_info":{"display_name":"PsyMontr\u00e9al","author_link":"https:\/\/psymontreal.com\/en\/author\/a5-pm-31\/"},"uagb_comment_info":0,"uagb_excerpt":"Feeling stuck in your Motivational Interviewing sessions? The transition from \"resistance\" to \"partnership\" is a core focus of the newly released 4th edition by Miller & Rollnick. Discover why clinical bottlenecks happen and how the latest updates provide a clearer pathway to evoke change and deepen the therapeutic alliance.","_links":{"self":[{"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/posts\/19018","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/comments?post=19018"}],"version-history":[{"count":0,"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/posts\/19018\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/media\/19016"}],"wp:attachment":[{"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/media?parent=19018"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/categories?post=19018"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/psymontreal.com\/en\/wp-json\/wp\/v2\/tags?post=19018"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}