Motivational Interviewing (MI) uses the mnemonic OARS to refer to the four key communication skills that are essential to person-centred guiding. These four skills specify how to actively listen to the young person. They should be used regularly throughout conversations.
O = Open-ended questions
A = Affirming
R = Reflections
S = Summaries
‘Open-ended questions’ are a good place to begin a conversation. They are also particularly useful when the conversation grinds to a halt or to elicit information from people who do not perceive themselves as having a problem (e.g. What is it that other people are concerned about’). Open-ended questions allow and invite any kind of response, in contrast to closed-ended questions which invite a single word such as yes or no, and do not encourage conversation. For young people who do not volunteer information in response to open-ended questions, consider ‘multiple choice’ questions (e.g. ‘Do you feel upset by this, fine with it, or maybe something else?) (p33-35).
‘Affirming statements’ serve to validate and confirm something that a young person has said or done; they notice and reinforce a young person’s strengths. Affirming statements help to create a sense of safety and enhance self-efficacy. The key to effective use of affirming statements is honesty and specificity, and to stay close to what the young person has said about themselves. Positive statements that are too broad or generic do not ring true (e.g. ‘You are smart’, ‘You are fabulous’, ‘You have the strength to achieve anything you set your heart on’). A more challenging adolescent can disengage from these cheerleader type statements. Rather affirmations must target a specific strength or effort (e.g. ‘It’s smart that you are thinking of all your options’, or ‘It’s a big step forward that you have decided to cut down on your drinking’, or ‘You have the strength to cut back your drinking if you set your heart on it’) (p35-36).
Avoid affirming statements that are too broad or generic (e.g. ‘You are smart’, ‘You are fabulous’, ‘You have the strength to achieve anything you set your heart on’). These broad statements often come across as untrue. Avoid statements that express your own personal approval (e.g. ‘I think you are smart’). This shifts the focus away from the person’s own values and detracts from development of self-validation.
‘Reflections’ are the foundation of active listening and perhaps the most core skill of MI. Reflections involve stating to the person what you heard, possibly adding an emphasis or meaning. They are used to communicate accurate empathy and provide validation. They also provide an opportunity to fine tune the shared understanding that is being developed and test hypotheses you have about what is going on for the client. Reflections should be used more often than questions (approximately 2-3 reflections per question).
Take care to avoid letting reflections turn into questions as this may suggest you have not been listening. Reflections are framed as statements. The client is invited to confirm or refute the reflection but this is not the same as a question.
Simple reflections involve a simple paraphrasing of the words used by the client. You do not add any emphasis or interpret the meaning (p30-31).
Complex reflections involve adding something of your own interpretation with the aim of testing a hypothesis or eliciting more from the client. An important example is to offer a reflection on how the young person may be feeling even if s/he has not stated a feeling directly. Metaphors and similes are helpful (p31-33). Complex reflections should be used more often than simple reflections.
‘Summaries’ involve selecting key statements from the conversation, ‘connecting the dots’, and incorporating some motivating statements. Summaries demonstrate that you have been listening intently. They also help clients with limited abstract thinking to pull together all the pieces of the puzzle. Summaries should be made periodically to present a collection of related reflections or themes (p36-37). Summaries of key points recently covered can be used as a stepping point to take the conversation to a deeper level, or before transitioning to another focus.