This motivational interviewing cheat sheet fits the whole method into about two pages: the spirit, the four processes, OARS with one-line examples, change talk, sustain talk and discord, the importance and confidence rulers, a planning checklist and the traps to avoid. It uses the terms of Miller and Rollnick's 2023 fourth edition, with the older name in brackets where one changed. That matters because most of the cheat sheets that rank for this search are PDF handouts built on the 2013 third edition. Print this page or save it as a PDF; the steps are just below.
This page is the condensed card. For 80 questions sorted by task, see our motivational interviewing questions. For each OARS skill done weakly and well, with practice drills, see OARS in motivational interviewing.
Every client in this article is invented. Any resemblance to a real person is a coincidence.
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The motivational interviewing cheat sheet
Fourth edition terms. Jordan, 29, is an invented client who uses cannabis to fall asleep.
The spirit of MI
- Partnership: your expertise plus theirs. "People are experts on themselves."
- Acceptance: respect, no judging. It "does not mean agreement or approval."
- Compassion: their well-being first. "MI is compassion in action."
- Empowerment (was evocation): "You have what you need, and together we will find it."
The four processes (tasks), which overlap
- Engaging, "Can we walk together?": build the relationship.
- Focusing, "Where are we going?": agree what to talk about.
- Evoking, "Why would you go there?": draw out their reasons.
- Planning, "How will you get there?": steps in their words. Stalls? Back to evoking.
OARS: aim for two reflections per question
- Open question:"What would you like your nights to look like?"
- Affirmation:"You've already worked out what the fog is costing you."
- Simple reflection:"You're tired of waking up foggy."
- Complex reflection:"You want sleep that doesn't cost you your mornings."
- Summary:"It helps you sleep, mornings are harder, the job matters. What did I miss?"
Change talk: DARN (preparatory) and CAT (mobilizing)
- Desire:"I want to wake up clear-headed."
- Ability:"I could skip it on work nights."
- Reasons:"I'd be sharper in morning meetings."
- Need:"I have to be on time at this job."
- Commitment:"I'm going to stop on weeknights."
- Activation:"I'm ready to try this week."
- Taking steps:"I didn't smoke on Tuesday."
- Respond with EARS:Elaborate ("In what way?"), Affirm, Reflect, Summarize.
Sustain talk and discord
- Sustain talk:their case for no change. "It's the only way I sleep."
- Discord:friction between you two. "You sound like my mom."
- Amplified reflection, said plainly:"Without it, you'd never sleep at all."
- Double-sided, change side last:"It helps you sleep, and you hate the fog at work."
- Autonomy, not argument:"It's your call what, if anything, you change."
- Repair discord:reflect it, shift focus, own your part ("I got ahead of you").
Importance and confidence rulers
- Ask importance, then confidence, 0 to 10.Not "How ready are you?"
- Follow up lower, then one up:"Why a 6 and not a 3?" "What would make it a 7?"
Planning checklist
- Readiness: more change talk, less sustain talk, "how" questions, small steps.
- Recap their change talk, then: "What do you think you'll do?" Sustain talk? Evoke more.
- Their goal and ideas first; your options only with permission (ask, offer, ask).
- First step: what, when, who helps, what might get in the way, and what then.
- How they'll know it's working; a confidence ruler; a summary of the plan.
Traps to avoid
- Expert trap:having the answers, the fixing reflex (was righting reflex), arguing.
- Question-and-answer trap:closed question after closed question.
- Labeling and blaming traps:"addict," "in denial," "resistant"; whose fault it is.
- Premature focus trap:your agenda first, or planning too soon.
- Also:neutral pros and cons, unasked-for advice, warnings, stacked questions.
- Risk disclosed:step out of MI and assess safety directly.
End of the sheet.
Where the sheet's content comes from
- Spirit and the four task questions:Miller and Rollnick's fourth edition, from its chapter 1 sample ("four interlocking elements of that underlying spirit: partnership, acceptance, compassion, and empowerment") and its table of contents, where chapters 4 to 7 are named with the four questions.
- The renamed terms:a note on the fourth edition on The Change Companies' page for its MI video series says the processes or tasks "remain the same," the fourth part of the spirit was broadened "from evocation to empowerment," and the righting reflex "is now termed the fixing reflex."
- Why "resistance" is gone:chapter 1 calls the term "an unhelpful way to think about helping relationships." SAMHSA's TIP 35 describes it as sustain talk arising out of counselor-client discord, and calls it "a two-way street."
- DARN-CAT, responses to sustain talk, the rulers, signs of readiness, key questions, the planning steps and the five named traps:TIP 35, chapters 3 and 6, which follow Miller and Rollnick's 2013 edition. Its ruler advice: follow up with a lower number, because a higher one is likely to evoke sustain talk, and "don't jump to a much higher number." It also suggests at least one reflection after each open question, "preferably two or three."
- "How ready are you?":MINT's Ten Strategies for Evoking Change Talk says it "tends to be confusing because it combines competing components of desire, ability, reasons and need." EARS comes from MINT's Responding to Change Talk handout.
- Neutral pros and cons:Miller and Rose found that with ambivalent people, a decisional balance "tends to decrease commitment to change," while evoking change talk promotes it (Miller and Rose, 2015).
- Our own wording:the discord repairs other than the shift in focus, and the risk line, are common MI teaching rather than quotes from these sources.
How to use this sheet
- Pick one section per session.Before you start, choose one line to practice, such as two reflections per question. A whole sheet in view pulls your attention off the client.
- Glance, don't read.It reminds you of skills you've trained in. It isn't a script.
- Review it after the session.Mark what you used, and one moment you missed, such as change talk you didn't reflect.
- Listen back, with consent.Ask the client for written consent to record, then count your questions and reflections in a stretch of the recording. A recording is protected health information, so keep it with the same protections as your notes.
- Take it to supervision.A sheet doesn't replace MI training with feedback on your own sessions. MINT keeps a trainer listing.
- Go deeper when you need to.The questions article has full question lists for each task; the OARS article has weak and strong versions of each skill and eight drills.
How to note MI in a progress note
A note should show what you did and how the client responded, and "used MI" shows neither. Record the process you were in, the strategies you used, any ruler numbers, a short quote of change talk and the next step in the client's words. Leave out "resistant" and "unmotivated." Write the sustain talk or discord you heard instead.
Lines you can copy and adapt, from Jordan's third session:
In a DAP note, these lines go in Data, and your reading of readiness ("importance high, confidence the gap") goes in Assessment. In a BIRP note, strategies go in Intervention, and the client's words and ratings go in Response. For a full MI session written as a note, see the DAP example in our OARS article, and for the formats themselves, the DAP notes examples, the BIRP note examples and the progress notes cheat sheet.
How this works in TranqBay
TranqBay is practice software for therapists in private practice. Here is where it meets an MI conversation:
- A section on how you work, on your practice website. In the website editor you can add one, such as a "My approach" section, and it's often among the first things a new client reads from you. Describing how you work in the spirit of MI (you work things out together, and the client chooses what to change) starts engaging before the first session.
- Online booking. Confirm each booking yourself or let clients book straight away, and ask new clients to start with a consultation if you like.
- Video sessions that are end-to-end encrypted. TranqBay is HIPAA-ready and provides a Business Associate Agreement that applies when you accept the Terms, with no separate document to sign.
- Forms before the session. The form library has ready-made templates you can send a client for a session, including the AUDIT-C, PHQ-9 and GAD-7, intake forms and consent forms. The client fills them in online and the answers wait with the session. TranqBay doesn't score them, so total them yourself or use our AUDIT-C scoring page. Going over the answers together is a natural place for ask, offer, ask.
- Session notes in BIRP, DAP, SOAP or GIRP format, or a blank note. The structured formats are part of the advanced note templates, which some plans include.
practice.tranqbay.health shows a therapist adding a "My approach" section to her website and the booking page a new client would use, so you can see where your way of working would sit before you set anything up.
Frequently asked questions about the motivational interviewing cheat sheet
What should a motivational interviewing cheat sheet include?
The spirit, the four processes, the core skills (OARS), the kinds of change talk and how to respond to them, how to respond to sustain talk and discord, the importance and confidence rulers, a planning checklist and the traps. The sheet above covers all eight.
Is there a motivational interviewing cheat sheet PDF?
This page works as one. Open your browser's print window, choose "Save as PDF," and set the page range to the sheet if that's all you want.
What are the four elements of the spirit of MI?
In the fourth edition: partnership, acceptance, compassion and empowerment. The third edition's fourth element was evocation, and the authors broadened it to empowerment, with more weight on the client's own strengths and autonomy.
Are they the four processes or the four tasks of MI?
They're the same four: engaging, focusing, evoking and planning. The third edition called them processes and the fourth edition calls them tasks.
What happened to the four principles of MI?
Express empathy, develop discrepancy, roll with resistance and support self-efficacy come from earlier versions of MI. TIP 35 explains that they were "folded into the four processes as reflective listening or strategic responses." Some older sheets also print RULE, a memory aid built around avoiding the righting reflex, understanding, listening and empowering. Its ideas overlap with the spirit and the expert trap on this sheet.
What is the difference between preparatory and mobilizing change talk?
Preparatory change talk (desire, ability, reasons and need) is about why a change might be worth it. Mobilizing change talk (commitment, activation and taking steps) shows the person moving toward doing it. When mobilizing talk grows and sustain talk fades, a recap summary and a key question show whether it's time to plan.
What is the difference between sustain talk and discord?
Sustain talk is about the behavior: the client's own reasons to keep things as they are. Discord is about the relationship: friction between the client and you. Meet both with reflections and respect for the client's choice rather than argument, and with discord, check your own part first, since pushing for change is a common cause.
Can I use this sheet in telehealth sessions?
Yes. Guilford lists delivering MI remotely among the fourth edition's new topics. Keep the printout beside your screen and off camera, and close any window with the sheet before you share your screen.
Does using a cheat sheet mean I'm practicing MI?
No. MINT describes MI as a way of being with people and says it "is not a way to 'get people to change' or a set of techniques to impose on the conversation" (Understanding Motivational Interviewing). The sheet reminds you of skills; training with feedback on your own sessions builds them.
Before your next session
Choose one section of the sheet for your next three sessions, and one line from it to practice. Afterward, mark what you used and what you missed.
If you also want your practice website, online booking, video sessions, client forms and session notes in one place, see the website designs, a section on how a therapist works and the booking page your clients would use. If you're deciding whether to join, this page explains how joining TranqBay works.
Sources
Books 2motivationalinterviewing.org 4Federal 1Research 1988 Lifeline 1
Books and publishers2
- 1Miller, W. R., and Rollnick, S. (2023). Motivational Interviewing: Helping People Change and Grow, 4th edition. Guilford Press. Table of contents and sample chapter 1 (PDF).guilford.comhttps://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781462552795
- 2The Change Companies. Motivational Interviewing video series, with a note on terminology changes in the fourth edition.shop.changecompanies.nethttps://shop.changecompanies.net/products/mid
motivationalinterviewing.org4
- 3Motivational Interviewing Network of Trainers (MINT). Understanding Motivational Interviewing.motivationalinterviewing.orghttps://motivationalinterviewing.org/understanding-motivational-interviewing
- 4MINT. Ten Strategies for Evoking Change Talk (PDF).motivationalinterviewing.orghttps://www.motivationalinterviewing.org/sites/default/files/Ten%20Strategies%20for%20Evoking%20Change%20Talk%20Sue%20EckMaahs.pdf
- 5MINT. Responding to Change Talk: EARS (PDF).motivationalinterviewing.orghttps://motivationalinterviewing.org/sites/default/files/EARS%20Practice%20Cheat%20Sheet%20Sue%20EckMaahs.pdf
- 6MINT. Trainer Listing.motivationalinterviewing.orghttps://motivationalinterviewing.org/trainer-listing