Motivational interviewing was developed by William Miller for work with problem drinkers, and it is unusually honest about the fact that it is persuasion.
The method uses reflective listening, but the reflection is selective. The practitioner attends to and reflects back change talk — the client's own statements about wanting, needing or being able to change — and lets sustain talk pass. It evokes discrepancy between the client's stated values and their current behavior. It rolls with resistance rather than confronting it, because confrontation produces reactance.
These are real persuasive techniques with real effects, and outcome research supports them.
Miller's 1994 paper on the ethics of motivational intervention is the response to the obvious objection, and it is worth reading because he does not deny the charge. He accepts that MI is directive, and argues that the ethical constraint has to be structural rather than technical, because the techniques themselves are the same either way.
Three constraints.
The direction is the client's. MI is used to help someone move toward a goal they hold, not toward one the practitioner holds. A clinician who deploys it to produce compliance with a treatment the client does not want has changed what the method is.
The method must be disclosable. Miller's position is that MI can be explained to a client without losing its effect — this is what I do, this is why, here is what I will be listening for — which is chapter 331's test, and it passes.
And the power relationship changes the analysis. The same reflective listening becomes coercive when the practitioner controls the client's liberty, benefits, custody or housing, because in that context there is no meaningful ability to decline.
The tell Miller trains clinicians to notice in themselves is the righting reflex: the pull to fix someone, to argue them out of their position, to supply the answer. It feels like care and it produces resistance, and its presence usually means the practitioner has adopted a goal the client has not.
The question that operationalizes all of this, and it generalizes well outside a consulting room — to management, teaching, parenting and medicine — is short.
Whose goal is this?
If the answer is mine, the influence is not being exercised on behalf of the person in front of you, and the fact that you believe you are right does not change the answer.