Spirit of MI
Core Skills (OARS)
Change Talk vs. Sustain Talk
MI in Action
Empathy and Connection
100

This word describes working with the patient rather than on them.

What is collaboration?

100

The “O” in OARS stands for this skill used to encourage conversation.

What is open-ended questioning?

100

“I really want to feel more energetic again” is an example of this type of talk.

What is change-talk?

100

Asking, “What matters most to you as you start this new medication?” demonstrates this MI principle.

What is exploring values?

100

This phrase shows empathy: “It sounds like you’ve been juggling a lot.”

What is reflective listening?

200

One of the four elements of the MI spirit that means honoring the patient’s right to make choices about their own care.

What is autonomy?

200

The “A” in OARS is this type of statement that builds rapport and self-efficacy.

What are affirmations?

200

“I’ve tried before, and it never works” represents this type of talk.

What is sustain talk?

200

When a patient says, “I know I should exercise, but I’m just too tired,” the nurse should first do this.

What is reflect or empathize?

200

Pausing before responding allows space for this therapeutic element.

What is processing or active listening?

300

This MI principle involves believing patients have within them the ability to change.

What is evocation?

300

This skill involves rephrasing what the patient has said to show understanding.

What are reflections?

300

Statements that express desire, ability, reason, or need for change are known as this.

What is change talk?

300

When the nurse says, “It sounds like you’ve been feeling discouraged,” she’s using this OARS skill.

What is reflection?

300

“Thank you for sharing that — I know it’s not easy” builds this type of connection.

What is trust or rapport?

400

Demonstrating genuine interest and concern is an example of this MI element.

What is compassion?

400

Summarizing what you’ve heard at the end of a call is an example of this OARS skill.

What are summaries?

400

“It’s not that bad yet” reflects this kind of resistance.

What is sustain talk?

400

Gently guiding the patient to find their own reasons for change shows this part of the MI spirit.

What is evocation?

400

Reflecting emotions instead of just facts helps the patient feel this.

What is being heard or understood?

500

Collaboration, compassion, evocation, and this final element make up the four pillars of MI spirit.

What is acceptance?

500

Asking, “What steps do you think would help most right now?” demonstrates this skill.

What is open-ended questioning?

500

Reflecting and gently exploring sustain talk helps reduce this common barrier.

What is resistance or ambivalence?

500

The goal of MI is to strengthen this — the patient’s own motivation and ________.

What is commitment to change?

500

This combination of tone, pace, and silence helps convey deep understanding.

What is presence or empathy?