Free Therapist Training›Motivational Interviewing Toolkit›OARS Cheat Sheet
Last updated: November 11, 2026
A motivational interviewing cheat sheet is a short reference to the skills and ideas a clinician uses in MI conversations. This free motivational interviewing cheat sheet PDF covers the spirit and four tasks of MI, the OARS skills of motivational interviewing with two examples each, four kinds of reflection, information and advice with permission, the seven types of change talk with a question that evokes each, and responses to sustain talk, discord and the fixing reflex. The post adds an annotated exchange between a counselor and a fictional client, with every response labeled.
The template comes from Sentio's free motivational interviewing toolkit, and MI is one of the core therapy models taught in the Sentio MFT program. The skills on the sheet are the ones rehearsed in the motivational interviewing practice scenarios, which give original client statements at three levels of difficulty.
This is an optional aid from Sentio's motivational interviewing toolkit, free to adapt to your setting.
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The spirit and the four tasks of MI
| The spirit of MI | The four tasks |
|---|---|
| Partnership: work alongside the person, the expert on their own life. Acceptance: respect the person's worth and choices, seek to understand, and notice strengths. Compassion: put the person's well-being first. Empowerment: help the person draw on their own strengths, motivation and resourcefulness. | Engaging: build a working relationship. Focusing: agree on a direction for change. Evoking: draw out the person's own reasons for change. Planning: build commitment and a specific plan, when the person is ready. |
OARS: the core skills
| Skill | What it does | Two examples |
|---|---|---|
| Open questions | Invite answers in the person's own words, at some length | “What would you like to be different by summer?” “What do you notice about your mood on days you get outside?” |
| Affirmations | Recognize a specific strength or effort, genuinely | “You've kept every appointment through a hard month.” “You kept up your walks through two weeks of rain.” |
| Reflections | Mirror, in a statement, what the person said or meant | “You're tired of feeling checked up on.” “Getting your license back matters a lot right now.” |
| Summaries | Draw together several things the person said, then ask what was missed | “You've cut down to half a pack, you're proud of that, and evenings are still the hardest. Did I get that right?” “So the walks lift your mood, your knee limits how far you go, and you'd like three short walks a week. What did I miss?” |
Four kinds of reflection
A client in health coaching says, “I know I need to move more, but by the time I get home I'm wiped out.”
| Reflection | What it does | Example |
|---|---|---|
| Simple | Stays close to the person's words | “You're worn out by evening.” |
| Complex | Adds meaning or feeling the person implied | “Evenings feel like the wrong time for it.” |
| Double-sided | Holds both sides of the ambivalence, change side last | “Your energy is gone by evening, and you also know moving more matters to you.” |
| Amplified | Overstates the sustain side, without sarcasm, so the person may voice the other side | “So there's no time in your week when moving more could fit.” |
Information and advice with permission: Ask-Offer-Ask (called elicit-provide-elicit in Miller and Rollnick's third edition)
| Ask | Offer | Ask |
|---|---|---|
| Ask permission and what the person already knows. “Would it help to hear what others have tried?” | Offer a small piece of information or advice; the person is free to disagree. “Some people set a quit date, and others cut down first.” | Ask what the person makes of it. “What fits for you?” |
Change talk
| Type | Client example | A question that evokes it |
|---|---|---|
| Preparatory change talk (DARN) | ||
| Desire | “I want to stop fighting with my son about his grades.” | “How would you like things to be at home?” |
| Ability | “I could walk at lunch on my office days.” | “What strengths could you draw on to make this change?” |
| Reasons | “If I keep passing my drug tests, I could get off probation early.” | “What would be better for you if you made this change?” |
| Need | “I have to get my blood pressure under control.” | “What makes this important to do now?” |
| Mobilizing change talk (CAT) | ||
| Commitment | “I'm going to tell my roommate I'm taking a month off drinking.” | “What will you do?” |
| Activation | “I'm willing to try leaving the house once a day.” | “What are you willing to try this week?” |
| Taking steps | “I gave my vape to my mom last night.” | “What have you already done toward this?” |
Sustain talk, discord and the fixing reflex
| Pattern | What it is | Sounds like | What helps |
|---|---|---|---|
| Sustain talk | The person's own case for keeping things as they are; it is about the change itself | “Smoking is the one thing I do just for me.” | Reflect it (simple, amplified or double-sided), reframe it, or emphasize that the choice is the person's |
| Discord | Tension in the working relationship; it is about the clinician or the conversation | “You sound just like my doctor.” | Reflect the person's concern, apologize if you contributed to it, and change direction; do not argue |
| The fixing reflex (called the righting reflex in Miller and Rollnick's third edition) | The helper's natural urge to set things right and steer the person toward change, which tends to draw out sustain talk and discord | “You need to cut back before this costs you your marriage.” | Notice the urge and ask instead: “What concerns, if any, do you have about the drinking?” |
What Does the Motivational Interviewing Cheat Sheet Look Like in a Session?
In this fictional exchange from an early session at a community clinic, the counselor, D.O., talks with Marcus, 46, who has been drinking most evenings since a layoff eight months ago, and each line is labeled with the skill or the kind of client language it shows.
| Speaker | What was said | What it is |
|---|---|---|
| D.O. | “Last time you mentioned that your wife has been worried. What's been on your mind about the drinking since then?” | Open question that keeps the focus on the change Marcus raised |
| Marcus | “Part of me thinks it's no big deal. Plenty of guys have a few beers at night. But it's most nights now, and I don't even enjoy it anymore.” | Sustain talk, then change talk (reasons) |
| D.O. | “Part of you sees a few beers as ordinary, and you've also noticed it has turned into most nights without giving you much back.” | Double-sided reflection, with the change side last |
| Marcus | “Right. And I wake up foggy. I've got a phone interview Thursday morning, and I can't show up like that. I need to be sharp.” | Change talk (reasons, need) |
| D.O. | “You've kept looking for work through eight hard months, and you're already thinking about how to give yourself the best chance on Thursday.” | Affirmation of his persistence and his effort to prepare |
| Marcus | “I have to. I don't think I want to quit for good, though. I just want to get back in control.” | Change talk (need), sustain talk, then change talk (desire) |
| D.O. | “Let me pull this together. The drinking has crept up to most nights since the layoff, and it isn't giving you much anymore. You wake up foggy, and you want to be sharp on Thursday. Quitting for good doesn't feel right to you, and getting back in control does. What would being back in control look like this week?” | Summary that gathers his change talk and briefly acknowledges the sustain talk, then an open question that invites mobilizing change talk |
| Marcus | “I'm going to skip the beer tonight and tomorrow, before the interview. I can do that. I cut way back for two weeks last spring.” | Change talk (commitment, ability) |
D.O. reflects Marcus's sustain talk together with his change talk, so Marcus hears both sides in his own words, and the summary ends on what Marcus wants before the question about this week. The question invites a next step without prescribing one, and the step Marcus names is his own.
What Are OARS in Motivational Interviewing?
OARS stands for open questions, affirmations, reflections and summaries, the core skills that carry a motivational interviewing conversation (SAMHSA, 2019). The fourth edition of Miller and Rollnick's text keeps OARS as it was in the third edition and stresses using the skills with direction, so that what the clinician asks about, reflects and summarizes moves the conversation toward the change in focus (Miller & Rollnick, 2023).
- Open questions invite the client to answer at length and in their own words, and in evoking, a well-aimed open question invites change talk.
- Affirmations recognize the client's strengths and efforts, genuinely and specifically. TIP 35 suggests building them around the word “you,” so the statement stays about the client (SAMHSA, 2019).
- Reflections are statements that mirror what the client said or seemed to mean. A simple reflection repeats or rephrases, and a complex reflection adds meaning or feeling the client implied, which invites the client to explore further (SAMHSA, 2019).
- Summaries draw together several things the client said and check whether anything was missed. At the turn toward planning, a summary that gathers the client's change talk, followed by a key question about what the client will do, invites a decision (SAMHSA, 2019).
Information and advice have a place in MI as well. The fourth edition describes offering information and advice in an MI-consistent way and renames elicit-provide-elicit as Ask-Offer-Ask: ask permission and what the client already knows, offer a small piece, then ask what the client makes of it (Miller & Rollnick, 2023; SAMHSA, 2019).
What Is Change Talk, and Why Listen for It?
Change talk is anything a client says in favor of a particular change, and sustain talk is anything the client says in favor of keeping things as they are (SAMHSA, 2019). Miller and Rollnick sort change talk into two groups: preparatory change talk, which expresses desire, ability, reasons or need (DARN), and mobilizing change talk, which expresses commitment, activation or steps already taken (CAT) (Miller, 2023; Miller & Rollnick, 2023).
Research has linked this client language to what clients do after the session, with mixed results for change talk on its own. In a study of MI for drug use, the strength of clients' commitment language predicted later abstinence more strongly than their statements of desire, ability, need and reasons did (Amrhein et al., 2003). A meta-analysis of 36 studies found that clinicians' MI-consistent skills went with more change talk and also with more sustain talk, that a higher proportion of change talk relative to sustain talk went with less risk behavior at follow-up, and that sustain talk went with worse outcomes (Magill et al., 2018). An earlier meta-analysis found sustain talk related to worse outcomes but did not find a significant link between change talk and outcome (Magill et al., 2014).
In practice, the clinician listens for change talk and responds to it by reflecting it, asking about it and gathering it into summaries, while still acknowledging sustain talk (SAMHSA, 2019). The questions on the cheat sheet are starting points, and the client's own words are what the clinician reflects next.
How Do You Respond to Sustain Talk and Discord?
Sustain talk and discord need different responses because they are about different things. Sustain talk is about the change itself: the client's own reasons for keeping things as they are, such as “Smoking is the one thing I do just for me.” Discord is about the relationship: arguing, interrupting, discounting or ignoring, signs of strain in the working relationship, such as “You sound just like my doctor” (Miller, 2023; Miller & Rollnick, 2012). Sustain talk on its own is not discord.
For sustain talk, TIP 35 lists simple, amplified and double-sided reflections, agreement with a twist, reframing, a shift in focus and an emphasis on personal autonomy (SAMHSA, 2019). A double-sided reflection pairs the sustain talk with change talk, joined by “and,” so the change side comes last. An amplified reflection overstates the client's position, without sarcasm, and the client may then voice the other side.
For discord, the clinician changes direction or listens more carefully (SAMHSA, 2019). Reflecting the client's concern, apologizing when the clinician has moved too fast or pushed too hard, and shifting the focus to a more useful topic all help repair the working relationship. The fixing reflex, the helper's natural urge to set things right and steer the client toward change, tends to produce both sustain talk and discord (SAMHSA, 2019), and the fourth edition gave it that name in place of the righting reflex (Miller & Rollnick, 2023). Noticing the urge and asking an open question instead leaves the client to voice the reasons for change.
Practice the Skill Behind This Template
The skill to rehearse next is the complex reflection, because turning what a client says into a short statement of what the client means, within a second or two, takes repetition before it comes easily in a live conversation. Rehearse it with the motivational interviewing practice scenarios, watch Episode 7 on Practice Time, and use the exercises in Deliberate Practice in Motivational Interviewing (Manuel et al., 2022).
Keep reading
Motivational Interviewing Practice Scenarios, original client statements for rehearsing reflections, evoking change talk and double-sided reflections.
Readiness Ruler Worksheet, importance and confidence rulers with the follow-up questions that draw out change talk.
Change Plan Worksheet, the client's own plan for when the conversation turns from why to how.
Motivational Interviewing Fidelity Checklist, a recording review form for supervisors and self-review built on MITI 4 concepts.
Deliberate Practice in Motivational Interviewing, the free webinar with Robert Scholz, Tony Rousmaniere and Alexandre Vaz.
Frequently Asked Questions
What does OARS stand for in motivational interviewing?
OARS stands for open questions, affirmations, reflections and summaries, the core skills of motivational interviewing. Open questions invite the client to talk, affirmations recognize strengths and efforts, reflections mirror what the client said or meant, and summaries draw several statements together. The fourth edition of Miller and Rollnick's text keeps OARS unchanged from the third.
What does DARN-CAT stand for?
DARN-CAT is a memory aid for the types of change talk. DARN stands for desire, ability, reasons and need, the preparatory change talk that expresses motivation, and CAT stands for commitment, activation and taking steps, the mobilizing change talk that expresses or implies action. The fourth edition of Miller and Rollnick's text keeps these categories.
What is the difference between sustain talk and discord?
Sustain talk is the client's own speech in favor of keeping things as they are, and it is about the change itself. Discord is strain in the working relationship, such as arguing, interrupting or ignoring, and it is about the relationship between client and clinician. Sustain talk calls for reflection and respect for the client's choice, and discord calls for repair, such as reflecting the client's concern or changing direction.
What is the righting reflex in motivational interviewing?
The righting reflex is the helper's natural urge to set things right and steer a client toward change, and the fourth edition of Miller and Rollnick's text calls it the fixing reflex. Acting on it, for example by warning or persuading, tends to draw out sustain talk and discord. Noticing the urge and asking or reflecting instead leaves the client to voice the reasons for change.
Should you ask permission before giving information in MI?
Yes. The fourth edition of Miller and Rollnick's text calls the pattern Ask-Offer-Ask, and the third edition called it elicit-provide-elicit: ask permission and what the client already knows, offer a small piece of information or advice, then ask what the client makes of it. Asking first respects the client's choice about what to hear and leaves room to disagree.
References
Amrhein, P. C., Miller, W. R., Yahne, C. E., Palmer, M., & Fulcher, L. (2003). Client commitment language during motivational interviewing predicts drug use outcomes. Journal of Consulting and Clinical Psychology, 71(5), 862-878. https://doi.org/10.1037/0022-006X.71.5.862
Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E. F., Tonigan, J. S., & Moyers, T. (2018). A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change. Journal of Consulting and Clinical Psychology, 86(2), 140-157. https://doi.org/10.1037/ccp0000250
Magill, M., Gaume, J., Apodaca, T. R., Walthers, J., Mastroleo, N. R., Borsari, B., & Longabaugh, R. (2014). The technical hypothesis of motivational interviewing: A meta-analysis of MI's key causal model. Journal of Consulting and Clinical Psychology, 82(6), 973-983. https://doi.org/10.1037/a0036833
Manuel, J. K., Ernst, D., Vaz, A., & Rousmaniere, T. (2022). Deliberate practice in motivational interviewing. American Psychological Association. ISBN 978-1-4338-3618-3. https://www.apa.org/pubs/books/deliberate-practice-motivational-interviewing
Miller, W. R. (2023). The evolution of motivational interviewing. Behavioural and Cognitive Psychotherapy, 51(6), 616-632. https://doi.org/10.1017/S1352465822000431
Miller, W. R., & Rollnick, S. (2012). Glossary of motivational interviewing terms. https://www.careinnovations.org/wp-content/uploads/Glossary-of-MI-Terms.pdf
Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press. ISBN 978-1-4625-5279-5. https://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781462552795
Substance Abuse and Mental Health Services Administration. (2019). Enhancing motivation for change in substance use disorder treatment (Treatment Improvement Protocol (TIP) Series No. 35, SAMHSA Publication No. PEP19-02-01-003). https://library.samhsa.gov/product/tip-35-enhancing-motivation-change-substance-use-disorder-treatment/pep19-02-01-003
