Free Therapist Training›Motivational Interviewing Toolkit›Practice Scenarios
Last updated: November 11, 2026
Motivational interviewing practice scenarios are short client statements that a clinician answers out loud, with feedback, to build MI skills through repetition. The set has three motivational interviewing practice exercises (open questions and reflective listening, evoking change talk, and double-sided reflections), each with skill criteria, twelve original statements at beginner, intermediate and advanced levels, and sample responses, along with a worked practice round, a free PDF and a guide to using the scenarios in pairs, classes and supervision.
The practice set comes from Sentio's free motivational interviewing toolkit, and MI is one of the core therapy models taught in the Sentio MFT program. Supervisors can pair it with the toolkit's recording review form, which shows the skill a clinician's sessions most need, before choosing which exercise to run.
This is an optional aid from Sentio's motivational interviewing toolkit, free to adapt to your setting.
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How to run a round
- Take three roles: client, therapist and observer. In a pair, the person playing the client also gives the feedback.
- The client reads one statement aloud with the feeling behind it, the way a real client would say it.
- The therapist answers at once with a single spoken response aimed at the exercise's skill criteria.
- The observer gives brief feedback against those criteria: what the response did well and, if needed, one thing to change.
- The client reads the same statement again and the therapist responds again, until the response comes fluently and meets the criteria.
- Move to the next statement, and rotate roles at the end of each level so that everyone practices as the therapist.
Adjusting difficulty
- Begin each exercise at the beginner level.
- Move up a level when the therapist's responses come easily and meet the criteria within one or two tries.
- Step down a level when the therapist freezes, goes blank or finds the round overwhelming. The client can also lower the difficulty by reading more calmly, or raise it by reading with more feeling.
Exercise 1: Open Questions and Reflective Listening
Pairs with Episode 7 of Practice Time, Reflection and Questions.
Skill criteria
- Offer one reflection or one open question. An open question invites the client to say more and cannot be answered with yes, no or a single fact.
- Say each reflection as a statement, with the voice going down at the end, and let it reach a little past the client's words to the meaning or feeling underneath.
- In this exercise, hold back advice, reassurance and solutions, even when the client seems to invite them.
Beginner statements
- Health coaching. Karen, 45, at her first coaching session: “I signed up for the gym in January. I went maybe six times, and now I'm paying every month for a card I don't use. I feel a little silly about it, honestly.”
- Primary care. Ray, 58, after a high blood pressure reading: “I had no idea it was that high. I feel fine. I guess that's the part that bothers me, that I wouldn't even have known.”
- Mental health, outpatient. Jess, 29: “Work has been a lot lately. I get home, lie on the couch and scroll until midnight, and then I'm wiped out the next day and do it all again.”
- School counseling. Tyler, 16: “My grades aren't great this semester. My mom asks about it every single day. I've got it handled.”
Intermediate statements
- Substance use, outpatient. Monica, 41: “I don't think I drink more than anyone else at work. We all go out on Fridays. It's just that lately I'm the one who can't remember the end of the night.”
- Criminal justice, court-ordered program. Kevin, 24: “The court says I have to be here, so I'm here. The program's fine. Getting across town three times a week while I'm working doubles is the problem.”
- Family therapy. Angela, 44, mother of a 14-year-old: “Every night it's a fight about the phone. I take it away, she slams her door, and I end up feeling like the villain in my own house.”
- Primary care. Walt, 67, who smokes: “I've smoked since I was fifteen. My wife quit last year, and she's been after me ever since. I'm not saying she's wrong.”
Advanced statements
- Substance use, intake. Lorraine, 55: “You people all ask the same questions. I've been in and out of programs since before you finished school. What are you going to tell me that I haven't already heard?”
- Criminal justice, reentry. Ron, 49, two months after release from prison: “I did eleven years. I come out, everything's on a phone, my kids are grown, and my parole officer wants me working in thirty days. I'm trying. Nobody seems to see that I'm trying.”
- Mental health, outpatient. Nadia, 38: “My last therapist said I was catastrophizing, like I was making it all up. The panic attacks are real. I've stopped driving on the freeway because of them. So if you're about to tell me to just breathe, please don't.”
- Health coaching, employer wellness program. Greg, 52: “No offense, but I'm only doing this because HR knocks money off our insurance if we sign up. I've done coaching before. You give me a step goal, I ignore it, and we both pretend it went fine.”
Sample responses
- Beginner, statement 1 (Karen): “What were you hoping for when you signed up in January?”
- Intermediate, statement 7 (Angela): “You keep holding the line, and it hurts to end up as the bad guy every night.”
- Advanced, statement 9 (Lorraine): “You've been through a lot of programs and heard a lot of advice, and you're not convinced this one will be any different.”
Exercise 2: Evoking Change Talk
Pairs with Episode 8 of Practice Time, Eliciting Change Talk.
Skill criteria
- Respond to the change talk in the statement: reflect the client's own desire, ability, reasons or need for change, or ask an open question that invites more of it.
- Let the client make the case for change, with no arguing against the sustain talk, no warnings and no reasons of your own.
- Keep the response short enough that the client does most of the talking.
Beginner statements
- Substance use, outpatient. Teresa, 50: “I've cut back to two glasses of wine on weeknights, and I'm sleeping better. I'm just not sure I want to give it up completely.”
- Primary care. Hank, 71, after a fall at home: “My daughter wants me using the walker around the house. I suppose I'd rather use a walker than end up with a broken hip.”
- Health coaching. Lena, 33: “I want to bring lunch from home more. I spend a fortune on takeout, and I feel sluggish every afternoon.”
- Criminal justice, probation. Evan, 27: “I need to keep this job. Steady work counts for a lot with my probation officer, and honestly, I like having my own money again.”
Intermediate statements
- Mental health, outpatient. Corinne, 40: “I know getting out of the house would probably help. My friend keeps inviting me to walk with her on Saturdays. Most weeks I say yes and then cancel that morning.”
- Family therapy. Doug, 47, father of a 13-year-old: “I yell. I know I yell. My dad yelled, and I swore I'd never be like that. But when my son lies to my face about homework, I lose it.”
- Substance use, outpatient. Jordan, 31: “Smoking weed at night is the only way I fall asleep. Without it I'm up until three. But I'm tired of being foggy at work, and my partner says I'm not really there in the evenings.”
- Health coaching, diabetes prevention program. Bev, 58: “The program says thirty minutes a day. That's not happening with my hours. I could maybe do ten minutes at lunch. Would that even count?”
Advanced statements
- School counseling, after a suspension. Connor, 17: “I'm not ditching my friends just because you think they're a bad influence. They're the only ones who have my back. I just don't want to get kicked out before graduation.”
- Primary care, heart failure clinic. Elaine, 66: “Everyone wants me weighing myself every morning and cutting out salt. My mother lived to ninety eating whatever she wanted. I'll take my chances. Although I would like to see my grandson start kindergarten.”
- Criminal justice, drug court. Tina, 36: “I haven't used in nine months, and the judge still looks at me like I'm about to slip. I do everything they ask. Some days I wonder why I bother. Then I think about getting my kids back.”
- Mental health, psychiatric follow-up. Victor, 44, who has bipolar disorder: “The medication makes me feel flat. I miss the energy. My psychiatrist says that's the illness talking. Maybe. I did lose my last job when I stopped taking it.”
Sample responses
- Beginner, statement 1 (Teresa): “What else have you noticed since you cut back?”
- Intermediate, statement 6 (Doug): “Being a different kind of father than your dad was matters a lot to you.”
- Advanced, statement 11 (Tina): “You've put in nine months of hard work, and getting your kids back is what keeps you going on the hard days.”
Exercise 3: Reflecting Both Sides of Ambivalence
Pairs with Episode 9 of Practice Time, Double Sided Reflections.
Skill criteria
- Name both sides of the client's ambivalence, the pull toward change and the pull away from it, in the client's own terms.
- Join the two sides with “and” or “at the same time” instead of “but,” and put the side that leans toward change last.
- Keep the response a reflection, with no question, advice or reassurance added at the end.
Beginner statements
- Primary care. Ruth, 70: “I know I miss half of what my grandkids say. But hearing aids make me feel old, and they cost a fortune.”
- Mental health, outpatient. Owen, 26: “I want to go to my friend's birthday dinner. I also know I'll spend the whole night worrying about what to say.”
- Substance use, outpatient. Gail, 48: “A drink after work helps me unwind. I've also noticed that one turns into three more often than I'd like.”
- Family therapy. Luis, 39, father of a 10-year-old: “I want my son to be more independent, so I let him walk to school now. Then I check the location app every two minutes until he gets there.”
Intermediate statements
- Health coaching. Simone, 55: “Cutting my hours would probably fix my sleep. I'd finally have my evenings back. Then I think about the money, and how my team would manage without me, and I can't see doing it.”
- Criminal justice, court-ordered anger management group. Jake, 30: “Part of me thinks this class is a waste of my time. Then again, the last time I got that angry I ended up in handcuffs, and I don't want that again.”
- School-based health center. Brianna, 15: “Vaping calms me down before tests. It's also kind of gross that I can't get through first period without it.”
- Primary care, sleep apnea follow-up. Frank, 62: “The machine helps. My wife says I stopped snoring, and I'm not nodding off at my desk anymore. I just hate the mask. I wake up at two and rip it off.”
Advanced statements
- Substance use, opioid treatment program. Carla, 43: “Methadone saved my life. I know that. I'm also sick of standing in that line every morning before work with everybody watching. Some days I think about tapering just to be done with it, even though I remember what happened last time.”
- Mental health, grief counseling. Nathan, 52: “My wife died two years ago. Everyone says I should get out more, maybe start dating. Part of me is lonely. Part of me feels like even thinking about it is betraying her.”
- Health coaching, weight management program. Wendy, 47: “I've tried every plan out there. I want to feel strong again, I really do. And I'm so tired of starting over that part of me would rather just stop trying.”
- Criminal justice, parole. Sean, 38, living in a sober house: “The sober house keeps me out of trouble, I'll give them that. But I'm thirty-eight with a curfew like a teenager, and a caseworker I've met once decides when I get to see my daughter.”
Sample responses
- Beginner, statement 1 (Ruth): “Hearing aids feel like a sign of getting old, and they're expensive. At the same time, you don't want to keep missing what your grandkids are telling you.”
- Intermediate, statement 6 (Jake): “The class feels like a waste of your time, and you also never want to end up in handcuffs again.”
- Advanced, statement 9 (Carla): “That morning line wears you down, and part of you wants to be done with it. And you know methadone saved your life, and you haven't forgotten what happened the last time you stopped.”
What Does a Practice Round Look Like?
This round uses Exercise 3, statement 8, with one trainee as the therapist, a second reading Frank's words and a third observing.
The statement. The client reads it with some frustration: “The machine helps. My wife says I stopped snoring, and I'm not nodding off at my desk anymore. I just hate the mask. I wake up at two and rip it off.”
First attempt. The therapist responds: “The machine is working, but you hate the mask. Have you asked your doctor about trying a different one?”
Observer's feedback against the criteria
- Criterion 1 (both sides named) was met. The response held both what the machine gives Frank and what he hates about it.
- Criterion 2 (“and,” with the change side last) was not yet met. “But” set the two halves against each other, and the reflection ended on the mask, which is Frank's reason to stop.
- Criterion 3 (a reflection with nothing added) was not yet met. The question about a different mask shows the fixing reflex, the helper's pull to solve the problem: it moved to a solution before Frank asked for help with one.
Second attempt. The client reads the statement again, and the therapist responds: “You hate that mask, especially at two in the morning, and you're also seeing what the machine gives you: quiet nights for your wife and staying awake at work.”
Observer's feedback. The second attempt met all three criteria and kept Frank's own details. The group runs the statement once more so the response comes without effort, then moves on to statement 9.
How Do You Use These Motivational Interviewing Practice Exercises?
Run the exercises out loud. The therapist speaks each response to a partner who reads the statement with feeling, because the goal is a response that comes easily in the moment, the way it has to in a session.
Keep the feedback short and tied to the criteria. The observer names what met each criterion and suggests, at most, one change for the next attempt, so that most of the round goes to repetition. The sample responses show one way to meet the criteria; they are illustrations to learn from, and two strong responses to the same statement can sound quite different.
Choose the exercise from the skill that most needs work. Open questions and reflections are two of the core OARS skills, and change talk (the client's own speech in favor of change) is the focus of evoking, one of the four tasks of MI (Miller & Rollnick, 2023). A supervisor who has reviewed a recording with the motivational interviewing fidelity checklist can read the choice from the results: Exercise 1 when questions far outnumber reflections, Exercise 2 when the clinician lets change talk pass without a response, and Exercise 3 when the clinician answers ambivalence by taking one side of it. The OARS cheat sheet summarizes each skill on one page for quick review before a round.
Why Does Rehearsal with Feedback Matter?
MI skills hold up best when initial training is followed by feedback and coaching. In a randomized trial with 140 licensed clinicians who treat substance use, all four groups that attended a two-day MI workshop gained more proficiency than a self-guided waiting-list group, and adding practice feedback, individual coaching or both raised proficiency further, with gains generally maintained through 12 months (Miller et al., 2004). The same trial found that clinicians' own ratings of their skill were unrelated to their observed proficiency, which is one reason each round includes an observer's feedback.
A meta-analysis of 21 training studies found that the skills gained in MI training eroded over the next six months when no feedback or coaching followed, while skills held steady when it did; three to four feedback or coaching sessions over six months were enough to sustain them (Schwalbe et al., 2014). The studies examined structured feedback and coaching after workshops, and regular practice rounds with a supervisor or peers apply the same principle of continued rehearsal with feedback once a workshop ends.
How Do the Exercises Pair with Practice Time?
Each exercise matches one episode of Practice Time, a free video series hosted by Amy DeSmidt and Jamie Manser. Episode 7, Reflection and Questions, pairs with Exercise 1; Episode 8, Eliciting Change Talk, pairs with Exercise 2; and Episode 9, Double Sided Reflections, pairs with Exercise 3.
Watching the episode first gives the group a model of the skill, and the exercise then turns that model into rehearsal with feedback. The free webinar on the motivational interviewing deliberate practice page, with Robert Scholz, LMFT, LPCC, a member of the Motivational Interviewing Network of Trainers, in conversation with Tony Rousmaniere and Alexandre Vaz, accompanies the APA book Deliberate Practice in Motivational Interviewing (Manuel et al., 2022), which holds its own full set of exercises.
Videos for This Practice Set
- Practice Time, Episode 7: Reflection and Questions
- Practice Time, Episode 8: Eliciting Change Talk
- Practice Time, Episode 9: Double Sided Reflections
- Deliberate Practice in Motivational Interviewing, the webinar with Robert Scholz, Tony Rousmaniere and Alexandre Vaz
Keep reading
Free Motivational Interviewing Toolkit, every template in the set with a completed example.
Motivational Interviewing Cheat Sheet, OARS, change talk and responses to sustain talk and discord on one page.
Motivational Interviewing Fidelity Checklist, a recording review form that points to the skill to rehearse next.
Deliberate Practice in Motivational Interviewing, the free webinar with Robert Scholz, Tony Rousmaniere and Alexandre Vaz.
Deliberate Practice Exercise Library, free client prompts for rehearsing difficult moments in therapy.
Frequently Asked Questions
What do good motivational interviewing practice scenarios look like?
Good practice scenarios sound like real clients: brief, specific and carrying feeling, with the mix of change talk, sustain talk and discord that clinicians hear in sessions. They vary by setting and speaker and come in levels of difficulty, so a clinician can start where responses come easily and move up. Each scenario is paired with one skill and with criteria for judging the response.
How can I practice motivational interviewing alone?
Record yourself reading the client statements, play each one back and answer out loud, then check the response against the skill criteria. Recording your answers as well lets you hear them the way a client would. When you can, add rounds with a partner or supervisor, who can give live feedback on each response.
Can these scenarios be used in a class or in supervision?
Yes. In a class, students can work in groups of three and rotate through the client, therapist and observer roles while the instructor moves between groups. In supervision, the supervisor can choose the exercise that matches what a recording review showed and run several rounds in the same meeting.
Do these client statements come from the APA book Deliberate Practice in Motivational Interviewing?
No. Every client statement and sample response in this set is original and fictional, written for Sentio's free toolkit. The APA book by Jennifer Knapp Manuel, Denise Ernst, Alexandre Vaz and Tony Rousmaniere has its own exercises, and the two can be used side by side.
How many times should each statement be repeated?
Repeat a statement until the therapist's response comes fluently and meets the skill criteria, which may take two attempts or several. Then move on, and return in a later session to the statements that took the most attempts. Move up a level when responses come easily, and step down when the therapist freezes or the round feels overwhelming.
References
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., & 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
Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J., & Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72(6), 1050-1062. https://doi.org/10.1037/0022-006X.72.6.1050
Schwalbe, C. S., Oh, H. Y., & Zweben, A. (2014). Sustaining motivational interviewing: A meta-analysis of training studies. Addiction, 109(8), 1287-1294. https://doi.org/10.1111/add.12558
