Talking to Change: MI Practice Companion In this episode of Talking to Change, Glenn Hinds and Sebastian Kaplan welcome Kristin Dempsey and Ali Hall to explore how mental health practitioners can strengthen their Motivational Interviewing skills through experiential learning, deliberate practice and feedback. Drawing on their book Advancing Motivational Interviewing: An Experiential Skills Guide for Mental Health Providers, the conversation considers an important question for anyone developing MI: how do we move from understanding Motivational Interviewing to using it skilfully in real conversations? This Practice Companion draws out the practical learning from the conversation. It explores the assessment trap, using MI when time is limited, responding to wider systemic influences, and creating meaningful opportunities for deliberate practice. It also connects these ideas with related resources in the Motivational Interviewing Knowledge Centre for practitioners who want to develop their skills further. Listen to the full conversation This Practice Companion highlights selected ideas and practice implications from the episode. Listen to the full conversation with Kristin Dempsey and Ali Hall for the complete discussion, examples and reflections. Listen to Episode 96: Enhancing MI Skills for Mental Health Providers Kristin Dempsey is a psychotherapist, trainer, and counselor educator in the San Francisco Bay Area. She has over 30 years’ experience working with individuals, youth, and families with challenging behavioral issues that impact their lives such as substance use disorders, co-occurring mental health and substance use disorders, trauma symptoms, and unresolved grief. Kristin believes that each individual has unlimited ability to change and grow, and she enjoys exploring the complexities of complex challenges and how to approach them with compassion and curiosity. Kristin has taught many classes in the counselor education curriculum, and she is currently focused on practitioner skill development, substance use disorder treatment, and effective practices in community mental health. Kristin is a member of the Motivational Interviewing Network of Trainers (MINT), and she currently teaches MI to behavioral health and other allied human services professionals. She is an adjunct professor at the Wright Institute’s Counseling Psychology Program and lecturing faculty at San Francisco State University. Kristin is the author of The Harm Reduction Workbook for Addiction (New Harbinger, 2024), co-author of Advancing Motivational Interviewing: An Experiential Skills Guide for Mental Health Professionals (PESI, April 2026), and a writer for The Mental Health and Substance Use Recovery Workbook (New Harbinger, May 2027). Ali Hall is a member of the Motivational Interviewing Network of Trainers (MINT), a MINT Certified Trainer, and an independent consultant and trainer. Ali has designed and facilitated thousands of MI workshops for a wide variety of providers, including those who serve within criminal justice systems, behavioral health, substance use recovery, mental health, health care, children/family services and wraparound, and has served multiple Training for New Trainers events. Ali regularly provides skill development coaching for interdisciplinary provider teams. Ali is the co-developer of the Motivational Interviewing Competency Assessment (MICA), a coding and coaching tool for MI skill improvement, co-author of the book Motivational Interviewing for Mental Health Clinicians: A Toolkit for Skill Development (2021), developer of the Cultivating Hope activity deck (2025) and co-author of Advancing Motivational Interviewing: An Experiential Skills Guide for Mental Health Providers (2026). From knowing MI to practising MI One of the central themes in this conversation is the difference between knowing about Motivational Interviewing and being able to use it skilfully in practice. Reading about MI, attending training and understanding its principles all matter, but they do not automatically translate into fluent practice. Developing MI proficiency requires opportunities to practise specific skills, notice what happens in the interaction, receive useful feedback and try again. Dempsey and Hall’s emphasis on experiential learning therefore connects closely with deliberate practice: identifying an aspect of our MI practice that we want to improve and working on it purposefully rather than simply accumulating more experience. This matters because experience alone does not guarantee improvement. Deliberate practice involves identifying a specific aspect of performance, practising with intention, using feedback to understand what is happening, and repeating the process. For MI practitioners, that might mean focusing on the depth of reflections, recognising opportunities to evoke change talk, reducing questions that inadvertently direct the conversation, or reviewing recorded practice with a coach or coding tool. Explore further: Deliberate Practice in Motivational Interviewing The assessment trap: when gathering information gets in the way Mental health practitioners often need to gather substantial amounts of information. Assessment, risk, diagnosis, safeguarding and organisational requirements can all create pressure to ask questions. The difficulty arises when the conversation becomes a sequence of practitioner-led questions and client answers. In Motivational Interviewing, this is sometimes described as the assessment trap. The problem is not assessment itself. It is what can happen to the quality of the conversation when information gathering takes precedence over engagement, listening and understanding what matters to the person. A useful practice question is: Am I asking this question because I genuinely need the information now, or because asking questions has become the way I am organising the conversation? MI does not require practitioners to abandon necessary assessment. Instead, we can pay attention to how we conduct it. Reflections, summaries and open questions can help an assessment feel more like a collaborative conversation and less like an interview conducted on the person. One practical response is to become more intentional about the balance between questions and reflections. When someone gives us information, we do not always need another question. A reflection can communicate understanding, invite the person to elaborate and allow them greater influence over where the conversation goes. Open questions remain valuable, particularly when they invite exploration rather than simply gather facts. Used alongside reflective listening, they can help practitioners meet assessment requirements while maintaining partnership and curiosity. Explore further: Reflective Listening in Motivational Interviewing | Open Questions in Motivational Interviewing Can you use Motivational Interviewing when time is limited? A common concern for practitioners is whether there is enough time to use Motivational Interviewing. In busy mental health, healthcare and support settings, conversations may be brief and practitioners can feel pressure to move quickly towards assessment, advice or action. MI does not necessarily require a long conversation. What matters is the quality and direction of the interaction. Even within a brief encounter, a practitioner can communicate partnership, listen carefully for what matters to the person, reflect rather than immediately advise, and create opportunities for the person to voice their own reasons for change. The question therefore shifts from “Do I have time to do MI?” to “How can I bring an MI-consistent way of being and communicating into the time that I have?” This does not mean squeezing every MI process or skill into a short conversation. Sometimes the most useful outcome may simply be stronger engagement, a clearer focus, or helping someone articulate something important about change. The four processes are not a checklist The four processes of Motivational Interviewing, Engaging, Focusing, Evoking and Planning, provide a helpful way of understanding how conversations about change develop. They are not four stages that practitioners must complete in order during every encounter. In a brief conversation, much of the useful work may involve Engaging and Focusing. At another time, a clear focus may already exist and a few carefully chosen reflections or questions can create space for Evoking. Planning becomes relevant when the person is ready to consider what they might do next. Skilled MI therefore involves responding to where the person is in the conversation rather than trying to move them through a predetermined sequence. Explore further: Engaging | Focusing | Evoking | Planning MI does not happen in a vacuum Another important theme in the conversation is the influence of the systems in which practitioners work. Mental health professionals may practise within services shaped by assessment procedures, documentation requirements, risk management, targets, limited appointment times and expectations about what a practitioner should accomplish. These pressures can influence how we communicate. When practitioners feel responsible for producing a particular outcome, it becomes easier to move towards directing, persuading, correcting or solving. In MI, this is closely related to the Fixing Reflex, our understandable tendency to want to put things right for another person. Developing MI skill therefore involves more than learning conversational techniques. It also involves noticing the pressures acting on us as practitioners. A useful question is: What is happening in me, or around me, that is making it harder to remain curious about this person’s perspective? This does not remove professional responsibilities. Rather, it helps us distinguish between what the situation genuinely requires of us and the additional pressure we may place on
