OARS Motivational Interviewing and Skills

Motivational Interviewing is a powerful tool for helping people make positive changes in their lives. At the heart of this approach is the OARS (Open-questioning, Affirming, Reflecting, and Summarizing) model. In this guide, we will give you an overview of what OARS is, how to use it in professional practice, and why it is so effective.

What is OARS Motivational Interviewing?

OARS Motivational Interviewing is a collaborative conversation-style technique that encourages individuals to explore and address ambivalence around behavior change. It was initially developed in the 1980s by William R. Miller and Stephen Rollnick. The technique is based on four main principles: open-ended questioning, affirmation, reflection, and summarization.

Open-ended questioning involves asking questions that are not leading or judgmental, creating a space for your client to think and reflect on their answers. Affirming shows the client that you value them and recognize the positive aspects of their life. Reflecting conveys understanding and allows your client to be heard without interruption. Finally, summarizing aids in consolidating the core points and allows for a review of the conversation.

Besides OARS, Motivational Interviewing utilizes the Stages of Change Model (Prochaska & DiClemente, 1983). According to this model, people go through different stages as they make changes in their lives. These stages are pre-contemplation, contemplation, preparation, action, maintenance, and relapse. A different set of thoughts, feelings, and behaviors characterizes each stage.

Why is OARS Motivational Interviewing Helpful?

Using the OARS Motivational Interviewing approach can be helpful in a variety of ways:

It helps to create a safe, non-judgmental space for the client

OARS Motivational Interviewing encourages clients to explore their values and decisions. It also helps your client become more aware of the pros and cons of behavior change.

It encourages the client to take responsibility for their own behavior change

Through this method, your client can gain valuable insights into their behaviors and motivations, which will help them to make more informed decisions.

It helps you establish trust and build a strong relationship

The OARS Motivational Interviewing approach is incredibly effective for building rapport with your client. It will help create a safe and supportive environment where they can express themselves freely.

It helps motivate the client

When clients feel understood and supported, they will be more motivated to take small steps toward their goals. They’ll be more likely to stay on track and keep trying until they reach their desired outcomes.

Overall, OARS is a powerful approach that can help clients in many ways. You can also use Motivational Interviewing Questions alongside OARS to deepen the connection between you and your client and help them reach their goals.

The Four Core Motivational Interviewing Skills

The four core MI skills are open questioning, affirming, reflecting, and summarizing (Miller, W. R., & Rollnick, S. 2013). These skills are fundamental to the Motivational Interviewing approach and are used to facilitate and enhance the client's motivation to change.

Open questioning

This involves asking questions that invite your client to elaborate on their experiences, thoughts, and feelings. This helps you understand the client's perspective and explore their ambivalence towards change. 

An example of an open question could be, "What brings you here today?" This question allows your client to elaborate on their reasons for seeking help and provides you with valuable information about your client's concerns.

Affirming

You can use this skill to acknowledge and validate your client's strengths, efforts, and successes. This helps build the client's self-esteem and confidence, which is essential for promoting change.

For example, if your client expresses concern about their ability to change, you could respond by saying, "It takes courage to seek help, and I appreciate the effort you are making to address your concerns."

Reflecting

It involves restating or paraphrasing what your client has said, which demonstrates empathy and helps them feel understood. This skill also allows your client clarify their thoughts and feelings and gain insight into their behavior.

For instance, if your client says, "I know I need to stop smoking, but it is hard," you might respond by reflecting, "It sounds like quitting smoking is something you are thinking about, but you are struggling with the process."

Summarizing

You can concisely summarize the session by pulling together the client's thoughts and feelings. This helps reinforce the client's motivation and commitment to change and provides a roadmap for the next session.

For example, at the end of a session, you might say, "So, we have talked about your concerns about quitting smoking, your desire to be healthy, and your challenges. Does that sound accurate?" This summary reinforces your client's motivation and commitment to change and provides a roadmap for the next session.

Other Motivational Interviewing Techniques include eliciting and responding to change talk, rolling with resistance, and supporting self-efficacy. These can help you work effectively with your clients and support them in making positive changes.

Benefits of OARS Motivational Interviewing

OARS Motivational Interviewing has many benefits for both you and your client. Some of these advantages are:

It improves engagement in treatment

OARS Motivational Interviewing can improve engagement in treatment by making individuals feel more comfortable and heard. A randomized controlled trial found that Motivational Interviewing, which includes the OARS technique, was associated with higher engagement in treatment for individuals with substance use disorders (Carroll et al., 2006).

It helps patients understand their conditions better

In a randomized controlled trial by Chien et al. (2015), adherence therapy that utilized OARS Motivational Interviewing effectively improved various aspects of treatment outcomes for individuals with schizophrenia spectrum disorders.

Compared to those who received usual care, participants who underwent this therapy reported significant improvements in comprehending their illness and treatment, psychosocial functioning, symptom severity, number of re-hospitalizations, and medication adherence. Moreover, the study boasted a low dropout rate, with only 3.5% of participants leaving the trial prematurely.

It helps you make more informed decisions

According to a two-stage pretest-posttest empirical study conducted on nurses working in Special Care Units, Motivational Interviewing, including OARS, can improve nurses' moral sensitivity.

Ghafari et al. (2020) found a significant difference in the mean score of moral sensitivity in nurses one month after the intervention compared to before. This suggests that Motivational Interviewing can help healthcare providers better understand moral challenges and make more ethical decisions, ultimately improving healthcare quality. 

OARS Motivational Interviewing App – How Can Carepatron can Help?

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References

Miller, W. R., & Rollnick, S. (2013). Motivational Interviewing: Helping people change (3rd ed.). Guilford Press.

Carroll, K. M., Ball, S. A., Nich, C., Martino, S., Frankforter, T. L., Farentinos, C., Kunkel, L. E., Mikulich-Gilbertson, S. K., Morgenstern, J., Obert, J. L., Polcin, D., Snead, N., & Woody, G. E.; National Institute on Drug Abuse Clinical Trials Network. (2006). Motivational Interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study. Drug and Alcohol Dependence, 81(3), 301-312. https://doi.org/10.1016/j.drugalcdep.2005.08.002 

Chien, W. T., Mui, J. H., Cheung, E. F., & Gray, R. (2015). Effects of Motivational Interviewing-based adherence therapy for schizophrenia spectrum disorders: A randomized controlled trial. Trials, 16, 270. https://doi.org/10.1186/s13063-015-0785-z

Ghafari, S., Shahrokhi, R., Mosavy, F., & Mohamadi Armandi, M. (2020). The effect of Motivational Interviewing on the moral sensitivity of nurses working in intensive care units. Journal of Intensive and Critical Care Nursing, 3(2), 1-6.

Prochaska, J., & DiClemente, C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.