Powerful Health Coach Motivational Interviewing Questions

People hire a health coach because they want to change. They need help creating behaviors that lead to weight loss. Or they want to know how to make physical activity a daily habit. Sometimes they have a health condition they are trying to better manage. Yet, they can’t seem to figure out how to make change stick.

A health coach can help clients achieve all of these goals. And one technique that can provide positive results is motivational interviewing.

What is Motivational Interviewing?

Motivational interviewing is a strategy designed to boost intrinsic motivation. This is a motivation that comes from within. A client with intrinsic motivation may want to lose weight because it will make them feel more comfortable in their own skin. Or they want to be able to play on the floor with their kids.

This is different than wanting to lose weight to please a partner or because their doctor said so. Intrinsic motivation can make change more personal. It can also make it more important. 

Many health professionals benefit from using this technique. You can use motivational interviewing with personal training clients, for instance. It can also help nutritionists encourage clients to stick with their eating plans. If you are a life coach or wellness coach, this approach can be helpful as well.

The Motivational Interviewing Network of Trainers indicates that this technique works best when clients (1):

• have conflicting feelings about change (referred to as ambivalence);

• lack confidence in their ability to change;

• aren’t sure if they want to change; and/or

• haven’t made change important enough to follow through.

How This Technique Works in Health Coaching

Using motivational interviewing as a health coach is all about asking the right questions. Not just any questions, either. Its focus is primarily on an open ended question.

An open ended question is one that can’t be answered with a simple yes or no. It requires a more extensive response. “What have you tried in an attempt to reach your goals?” is an example of an open ended question. This is much different than asking, “Have you ever tried to reach your goals?” 

The former requires the client to share their previous strategies. This gives you more information than the one-word answer suggested by the latter. This information helps you better understand your client. It can also be used to craft a more effective coaching session. 

This motivational interviewing technique also requires clients to look within themselves when answering. It forces them to consider their thoughts, values, and beliefs. This helps make the connection between their thoughts and actions.

In motivational interviewing, this type of questioning is combined with reflective listening. Reflective listening involves summarizing what the client says to ensure that you understand them correctly. This gives them the opportunity to correct any misunderstandings. Reflective listening also helps show empathy.

What Makes Asking a Powerful Question Important When Coaching?

From a coaching standpoint, asking the right question helps you assess a client’s readiness for change. Each change stage requires a different response. Identifying the stage they are in tells you what to do to help them move forward.

For example, if they are in the precontemplation stage, they aren’t ready for change. Educating them about the benefits of change can help them progress. Yet, a client in the preparation stage is ready for change. Thus, education becomes less effective. Instead, addressing their fears is more beneficial.

Asking the right questions can be just as impactful for clients. A well-designed coaching question can change the way they think. It can get them to see things from a different perspective or viewpoint. This can help them move in the direction of change. This is often referred to as change talk. 

Sometimes coaching questions challenge long-held beliefs. They force clients to identify why they feel the way they do. This can expose beliefs that are false or not self-serving. It brings to light any self-talk that may be stopping positive behavior change. 

Research confirms that motivational interviewing is effective for promoting long-term change. One study found that it helped people stick with a walking routine (2). Another notes that it helped dietitians lower their clients’ saturated fat intake (3).

Admittedly, most of the research has been conducted in the context of mental health therapy. But this just reinforces its ability to prompt behavior change in a health coaching setting. Reaching health and wellness goals does require action. Yet, creating a more motivational mindset helps drive this action. So, thought pushes action and action results in change.

Motivational Interviewing Questions for Health Coaching

If you’d like to incorporate motivational interviewing into your coaching practice, you may wonder what questions can best help clients achieve lasting change. Here are a few to ask during your first coaching session:

• What made you want to hire a health coach? (lose weight, boost health, better diet)

• Why is this goal so important to you? (feel better, more energy, improved wellness)

• What do you see as your biggest obstacles to achieving lasting change and why? (unsupportive family, negative self-talk, fear of change)

• What have you tried in the past? (both formal and self-designed programs, health programs, weight loss programs, etc.)

• Which of these strategies were motivational to you and why?

• Which of these strategies were not motivational to you and why?

Here are a few coaching questions that can further promote positive change talk after you’ve been working together for a while:

• What changes have you noticed in your body since starting my coaching program? (reduced weight, more muscle, etc.)

• What changes have you noticed to your overall wellness? (more energy, fewer chronic disease symptoms, etc.)

• What have you enjoyed the most about the change process and why? (its ease, its simplicity, the confidence it creates)

• What do you do differently now when tempted to return to old habits? (changes that are sticking)

• How do you think this will help you long term? (both in terms of health and wellness)

• What can I do to further support you in reaching your health and wellness goals?

Asking questions such as these can help the client sustain talk that continues to push them toward positive change.

Motivational Interviewing Skills That Further Promote Change

Asking these types of coaching questions is a good start to incorporating motivational interviewing into your practice. Additional skills that can make you more effective in a coaching role include:

• Being empathetic. Showing empathy helps create a better relationship with your clients. It enables them to share how they feel without fear of judgment. 

• Avoiding confrontation. Motivational interviewing requires that you let go of your own agenda. It isn’t about what you think or feel. It’s about what the client thinks or feels. Confronting them directly can cause them to shut down. Instead, your goal is to encourage positive change talk. 

• Pointing out their ambivalence. If you notice that their beliefs don’t match their actions, bring this to their attention. Help them recognize when they think one way yet act another. It’s also important to stress that ambivalence is completely normal. It’s all part of the change process.

• Adjust to their resistance. Changing a long-standing behavior is difficult. Many times, the client will offer some level of resistance. They may resist by defying your suggestions completely. Other times, it’s more of a passive resistance. They do what you say but their heart isn’t in it. When this occurs, it may help to remain neutral. This keeps the resistance from getting any worse. Another option is to shift their focus. Help them focus on the opportunities that the change provides versus the obstacles that stand in their way.

• Stay optimistic. How effective would you be as a wellness coach if you were negative? The answer is not very. Clients won’t want to work with you if you are always talking down. That’s why wellness coaching strives to stay optimistic. This is often referred to as positive psychology. It involves having a “can do” approach to behavior change. 

Want to learn more ways to help clients create positive and lasting behavior change? Become an ISSA Certified Health Coach. This course teaches a variety of motivational interviewing techniques that can take your health coaching business to the next level!

References

1. Understanding motivational interviewing. Understanding Motivational Interviewing | Motivational Interviewing Network of Trainers (MINT). (n.d.). Retrieved October 11, 2022, from https://motivationalinterviewing.org/understanding-motivational-interviewing 

2. Hardcastle, S.J., Taylor, A.H., Bailey, M.P. et al. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up. Int J Behav Nutr Phys Act 10, 40 (2013). https://doi.org/10.1186/1479-5868-10-40

3. Brug, J., Spikmans, F., Aartsen, C., Breedveld, B., Bes, R., & Fereira, I. (2007). Training dietitians in basic motivational interviewing skills results in changes in their counseling style and in lower saturated fat intakes in their patients. Journal of Nutrition Education and Behavior, 39(1), 8–12. https://doi.org/10.1016/j.jneb.2006.08.010