OARS in Motivational Interviewing

OARS are the core communication skills used throughout MI. This article explains what each skill does, where it fits, and how it can sound in real clinical conversations.

Related articles: Change Talk vs Sustain Talk: A Practical MI Guide, Using Motivational Interviewing to Address Client Resistance.

More resources: Explore Motivational Interviewing Training.

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Introduction

OARS in motivational interviewing refers to open questions, affirmations, reflections and summaries. Together, these skills help practitioners understand a client’s perspective, communicate empathy, explore ambivalence and elicit the client’s own language about change (Miller & Rollnick, 2023; Substance Abuse and Mental Health Services Administration [SAMHSA], 2019).

OARS is not a rigid four-step script. Nor does using the four skills automatically make a conversation motivational interviewing (MI). The skills become MI-consistent when they are used within a collaborative, goal-oriented conversation that protects autonomy and attends carefully to change talk, sustain talk, and the therapeutic relationship (Miller & Rollnick, 2023).

The examples below are prompts for clinical judgement, reflection, and skills practice–not phrases that must be delivered verbatim. If you need a broader foundation first, begin with MHA’s guide to motivational interviewing training for mental health practitioners.

What does OARS stand for in motivational interviewing?

OARS skill	What it does	Short therapist example
O Open questions	Invite the client’s perspective, experience, values, and ideas rather than a yes/no answer.	“What concerns you most about the way things are now?”
A Affirmations	Recognise genuine strengths, values, efforts, or past successes.	“You have kept looking for a way forward, even after several setbacks.”
R Reflections	Offer an understanding or considered hypothesis about what the client means.	“Part of you wants relief now, and part of you is worried about the longer-term cost.”
S Summaries	Gather and link important material, check understanding, and support a transition.	“You value the relief this gives you, but you are increasingly concerned about its effect on your health and relationships.”

The acronym makes the skills memorable. Effective use, however, depends on timing, accuracy, and purpose. A technically “open” question can still feel leading; an affirmation can sound like praise; and a reflection can become an argument if it moves too far beyond the client’s meaning (Miller & Rollnick, 2023; Rosengren, 2017).

O: Open questions that create room for exploration

Open questions give clients room to describe their experience in their own language. In MI, they may also evoke the client’s desire, ability, reasons, or need for change–often remembered through the change-talk acronym DARN (Miller & Rollnick, 2023; SAMHSA, 2019).

Useful openings commonly begin with what or how, but grammar alone is not the test. The question should be purposeful, non-judgmental, and genuinely open to the client’s answer.

Less useful or more leading	More MI-consistent alternative
“Don’t you think your drinking is making things worse?”	“What effects, if any, have you noticed from your drinking?”
“Why didn’t you complete the activity?”	“What got in the way of trying the activity?”
“Are you ready to make a change?”	“Where are you now in your thinking about change?”
“Wouldn’t your family be happier if you stopped?”	“How does this situation fit with the kind of family life you want?”

Open-question script

• Client: “I know everyone wants me to change, but I’m not sure I do.”
• Therapist: “What feels important to you–not to everyone else–about this situation?”

That question removes the immediate pressure to agree and returns attention to the client’s priorities. Closed questions are not prohibited; they remain useful for factual clarification, consent, structured assessment, and safety screening. The problem is an interview dominated by questions that leaves little room for reflection (Lubman et al., 2012; SAMHSA, 2019).

A: Affirmations that recognise strengths rather than give approval

An MI affirmation notices something credible and specific in the client: effort, persistence, honesty, care, courage, creativity, values, or an existing capacity for change. It is not a reward for agreeing with the therapist (Miller & Rollnick, 2023; SAMHSA, 2019).

Compare:

• Praise: “I’m proud of you for doing what we discussed.”
• Affirmation: “You followed through on a difficult step even though your confidence was low.”

The second response keeps the focus on the client and identifies a strength that may support future action. Useful affirmations are grounded in evidence from the conversation:

• “It took honesty to describe both what you enjoy about this and what worries you.”
• “You have protected your children through an extremely demanding period.”
• “Even after that lapse, you returned and tried to understand what happened.”
• “Independence matters to you; you want any decision to be one you can genuinely own.”

Affirmations should also be culturally responsive. Not every client will welcome direct statements about personal qualities. Some may respond better when the practitioner acknowledges effort, relationships, collective values, or a specific action, and then notices the client’s response (Rosengren, 2017; SAMHSA, 2019).

R: Reflections that deepen rather than merely repeat

Reflective listening is central to MI. The practitioner listens, forms a hypothesis about meaning, and offers it as a statement that the client can confirm, correct, or extend (Miller & Rollnick, 2023; SAMHSA, 2019).

Simple, complex and double-sided reflections

Client statement	Reflection type	Therapist response
“I’m tired of people telling me what to do.”	Simple	“You have had enough of other people directing you.”
“I’m tired of people telling me what to do.”	Complex	“Having control over this decision matters as much as the decision itself.”
“Drinking helps me switch off, but I hate losing the next morning.”	Double-sided	“Alcohol gives you immediate relief, and you are increasingly unhappy with what it costs you afterwards.”

A simple reflection shows that the practitioner has heard the explicit message. A complex reflection adds meaning or feeling that is implied but not fully stated. A double-sided reflection holds both sides of ambivalence without declaring a winner (Miller & Rollnick, 2023; SAMHSA, 2019).

Accuracy matters. A complex reflection is a considered hypothesis, not permission to invent motivation. If the client corrects it, that correction is useful information:

• Therapist: “You are starting to think the current pattern cannot continue.”
• Client: “Not exactly. I just want fewer arguments at home.”
• Therapist: “The immediate problem for you is the conflict, rather than the behaviour itself.”

Notice that the practitioner does not defend the first interpretation. They adjust and continue listening.

S: Summaries that collect, connect and move the conversation

Summaries are extended reflections. They can:

• collect several important points;
• link current material with an earlier value, concern, or success;
• check whether practitioner and client share an understanding; or
• mark a transition from exploring to focusing or planning (Miller & Rollnick, 2023; SAMHSA, 2019)

Summary script

“Let me see whether I have the full picture. Staying home lowers the anxiety in the moment, which is a real relief. At the same time, you miss your friends and worry that your world is becoming smaller. You do not want to be pushed into a big step, but you are curious about whether a smaller experiment could be manageable. What have I missed?”

The summary includes both sides of the client’s ambivalence, supports autonomy, and ends by inviting correction. When the purpose is to evoke change, a practitioner may place the client’s emerging reasons for change near the end, where they are more likely to be elaborated–without erasing or dismissing sustain talk (Miller & Rollnick, 2023; SAMHSA, 2019).

How OARS fits within the four tasks of motivational interviewing

Contemporary MI is organised around four overlapping tasks: engaging, focusing, evoking and planning. OARS is used flexibly across all four (Miller & Rollnick, 2023; Rosengren, 2017).

MI task	How OARS may be used
Engaging	Open questions invite the client’s story; reflections communicate understanding; affirmations identify strengths and values.
Focusing	Summaries organise competing concerns; open questions help negotiate a shared direction rather than impose one.
Evoking	Questions invite the client’s reasons for change; reflections and summaries selectively explore change talk while responding respectfully to sustain talk.
Planning	A summary consolidates motivation; an open question asks what the client wants to do; affirmations support realistic confidence and autonomy.

OARS therefore does not replace the broader method. As MHA’s article Motivational Interviewing: Update Your Understanding explains, contemporary MI also requires attention to its relational spirit and the flow of its four tasks.

OARS motivational interviewing examples: three therapist scripts

The following fictional composites show how the skills can work together. They are deliberately brief and are not complete assessments, treatment plans, or substitutes for case formulation.

Script 1: Anxiety, avoidance, and ambivalence about change

• Client: “I cancel nearly every social plan. I feel relieved when I do, but then I’m lonely all weekend.”
• Therapist – reflection: “Avoiding the situation settles the anxiety quickly, and it also leaves you with a different kind of pain.”
• Client: “Exactly. I don’t want to keep living like this, but forcing myself feels unbearable.”
• Therapist – affirmation: “You are looking honestly at both the protection avoidance gives you and the life it is taking away.”
• Therapist – open question: “If change happened at a pace you could choose, what might a tolerable first step look like?”
• Client: “Maybe coffee with one person, somewhere quiet.”
• Therapist – summary: “You are not agreeing to push through anything at any cost. You are considering one small, controlled step: meeting one trusted person in a quiet place. How does that possibility sit with you?”

The practitioner validates the short-term function of avoidance rather than arguing against it. The final question preserves choice and checks readiness. For a fuller application, see Treating Generalised Anxiety with Motivational Interviewing.

Script 2: Alcohol use and emerging concern

• Client: “My partner thinks I drink too much. I think they’re exaggerating.”
• Therapist – reflection: “You are not convinced alcohol is the problem your partner believes it is.”
• Client: “No. Although I admit the mornings are getting rough.”
• Therapist – open question: “What have you noticed about the mornings?”
• Client: “I’m late, foggy, and short with the kids. That part worries me.”
• Therapist – affirmation: “Even while feeling criticised, you are willing to examine the parts that concern you.”
• Therapist – complex reflection: “Being the kind of parent you want to be may matter more to you than settling the argument about who is right.”
• Client: “Yes. I don’t want the kids getting that version of me.”
• Therapist – summary: “You do not accept every concern your partner has raised, and you value the way drinking helps you unwind. You are also noticing harder mornings and behaviour with the children that does not fit the parent you want to be. Where would you like to take the conversation from here?”

The practitioner does not label the client “resistant” or confront the initial sustain talk. They listen for the client’s own concern and reflect its connection with a personally meaningful value. MHA’s article on using motivational interviewing to address client resistance explores the more precise concepts of sustain talk and discord.

Script 3: Depression and low confidence about activation

• Client: “I know walking might help, but I can’t face exercise. I fail every time.”
• Therapist – reflection: “Knowing the possible benefit does not give you the energy or confidence to begin.”
• Client: “Yes. People make it sound simple.”
• Therapist – affirmation: “You have kept searching for something workable despite feeling discouraged.”
• Therapist – open question: “When has even a small amount of movement felt possible?”
• Client: “Last week I walked to the letterbox. That was about five minutes.”
• Therapist – reflection: “Five minutes felt possible in a way that ‘doing exercise’ does not.”
• Client: “Maybe. I could probably do that again.”
• Therapist – summary and planning question: “A full exercise plan feels overwhelming and sets you up to expect failure. A five-minute walk is something you have already managed and might be willing to repeat. What, if anything, would make that easier this week?”

The therapist does not use the affirmation to overstate confidence or turn the client’s tentative language into commitment. Planning follows the client’s emerging willingness and remains proportionate.

Common OARS mistakes – and how to repair them

Common mistake	Why it weakens the conversation	Practical repair
Asking several questions in succession	The interaction begins to feel like an assessment or interrogation.	Follow a question with one or more reflections before asking for more information.
Treating affirmation as praise	Approval can imply that the therapist is judging whether the client has behaved correctly.	Name a specific strength, value, effort, or action and keep the focus on the client.
Turning every reflection into a question	“You felt dismissed?” may sound uncertain or ask the client to do more work.	Offer the understanding as a statement and let the client confirm or correct it.
Reflecting only arguments for change	The client may feel that important concerns are being ignored or strategically edited out.	Acknowledge sustain talk accurately, then explore both sides of the ambivalence.
Moving to solutions too early	Premature planning can produce discord or passive agreement without commitment.	Return to engagement or evoking: “Part of you is not ready to plan this yet.”
Using a summary as a closing argument	A selective recap can become covert persuasion.	Include the client’s genuine ambivalence, check accuracy and protect choice.
Delivering memorised lines	Formulaic language can weaken attunement, especially across cultural and communication differences.	Use scripts as practice scaffolds; adapt wording to the person, context, and relationship.

If the conversation becomes strained, resist the urge to apply OARS more forcefully. Name and repair the interaction: “I may be getting ahead of you,” or “I’m sounding more invested in this change than you are.” (Miller & Rollnick, 2023)

A practical OARS skills-review exercise

With appropriate client consent, privacy protections, and organisational approval, review a short segment of your practice in supervision. Ask:

• Did my questions open exploration or lead towards my preferred answer?
• Were affirmations specific, genuine, and grounded in what the client had shown?
• Did my reflections go beyond repetition without over-interpreting?
• Did I accurately hear both change talk and sustain talk?
• Did the summary organise the client’s material or my argument?
• Where did I support autonomy? Where did the fixing reflex appear?
• What did the client say immediately after each response?

That last question is especially useful. OARS skill is not demonstrated only by what the practitioner says, but by whether the response helps the client feel understood, elaborate meaning, and speak more freely about change. Formal tools such as the Motivational Interviewing Treatment Integrity code can support structured training feedback, but they do not replace supervision or contextual clinical judgment (Moyers et al., 2016).

OARS is a foundation – not the whole of motivational interviewing

OARS skills appear in many forms of counselling and healthcare communication. What makes their use recognisably MI is the combination of:

• partnership, acceptance, compassion, and empowerment;
• a shared and ethically appropriate change focus;
• careful attention to the client’s language about change and non-change;
• flexible movement between engaging, focusing, evoking, and planning; and
• respect for the client’s informed autonomy (Miller & Rollnick, 2023).

Scripts should never override responsiveness to culture, language, neurodiversity, communication preference, cognitive capacity or the realities of power within a service. Nor is MI a substitute for comprehensive assessment, evidence-based treatment, informed consent, mandated reporting, or urgent risk management. Direct and closed questions may be essential when assessing immediate safety or clarifying critical clinical information.

Practitioners should use MI within their competence, role, and professional obligations. Course learning can build knowledge and provide demonstrations; skill development also benefits from deliberate practice, feedback, and supervision (Moyers et al., 2016; Rosengren, 2017).

Develop your motivational interviewing skills

A useful learning sequence is to consolidate the spirit, OARS and four processes before applying MI to more complex cases.

Motivational Interviewing: The Basics

• Format: Text
• Duration: 4 hours

A current foundation in MI spirit, OARS, four processes, ambivalence, change talk, sustain talk, and relational repair.

View course details >

Introduction to Motivational Interviewing: Resolving Ambivalence and Changing Behaviour

• Format: Video
• Duration: 1 hour

A concise demonstration of DARN-CAT, confidence rulers, and OARS for moving from ambivalence towards resolution.

View course details >

Using Motivational Interviewing with Alcohol Dependence and Depression

• Format: Video
• Duration: 1 hour

A case-based demonstration of open questions, affirmations, reflections, summaries, and eliciting change talk in a clinically complex presentation.

For a broader pathway across foundational and applied topics, explore the MHA course catalogue’s motivational interviewing course suite.

Related practitioner reading

• Motivational Interviewing: Update Your Understanding  –  review how the language and emphasis of MI have evolved.
• Using Motivational Interviewing to Address Client Resistance  –  distinguish sustain talk from discord and explore broader response strategies.
• Treating Generalised Anxiety with Motivational Interviewing  –  examine MI within a specific clinical application.
• Compliance vs Engagement: What’s the Difference? – consider why apparent behavioural compliance is not the same as meaningful therapeutic engagement.

Conclusion

OARS gives motivational interviewing much of its conversational form, but its value lies in how the skills are used. Open questions create room for the client’s perspective; affirmations identify credible strengths and values; reflections test and deepen understanding; and summaries organise important material while supporting transitions. Used within partnership, acceptance, compassion, and empowerment, these skills can help clients examine ambivalence and develop their own language about change (Miller & Rollnick, 2023; SAMHSA, 2019).

Effective OARS practice is therefore not a matter of delivering the right line or maximising the number of techniques used. It requires accuracy, timing, cultural responsiveness, and close attention to what happens next in the conversation. Deliberate practice, structured feedback, and supervision can help practitioners move from mechanically performing OARS to using the skills responsively and with clinical purpose (Moyers et al., 2016; Rosengren, 2017).

Key takeaways

• OARS stands for open questions, affirmations, reflections, and summaries.
• OARS is not a four-step script or a substitute for the broader spirit, tasks, and ethical practice of motivational interviewing.
• Open questions should invite the client’s perspective without steering them towards the practitioner’s preferred answer.
• Affirmations recognise specific strengths, values, efforts, or actions; they are not praise or rewards for agreement.
• Reflections are hypotheses about meaning. They should deepen understanding while leaving room for the client to correct them.
• Summaries collect and connect important material, represent ambivalence accurately and support transitions in the conversation.
• Skill improves through deliberate practice, feedback, and attention to the client’s response – not through memorising scripts.

Questions therapists often ask

Q. What does OARS stand for in motivational interviewing?

A. OARS stands for open questions, affirmations, reflections, and summaries. These four core communication skills are used to understand the client, express empathy, explore ambivalence, and support client-generated language about change.

Q. Is OARS the same as motivational interviewing?

A. No. OARS is a set of core skills used within motivational interviewing, not the complete method. MI also requires a collaborative relational spirit, an agreed focus, attention to change talk and sustain talk, and flexible movement through engaging, focusing, evoking, and planning.

Q. What is the difference between a reflection and a summary?

A. A reflection responds to a particular meaning or feeling, while a summary gathers and links a larger body of material. Both are forms of reflective listening, but summaries are especially useful for checking understanding and marking transitions in the conversation.

Q. Are closed questions wrong in motivational interviewing?

A. No. Closed questions are appropriate when a concise fact, consent decision, or direct safety response is needed. Problems arise when repeated questions dominate the interaction or steer the client towards the practitioner’s preferred answer.

Q. How can therapists avoid making OARS feel like an interrogation?

A. Use reflections more often than a conventional question-and-answer interview would, and let each client response shape the next intervention. Slow down, avoid stacking questions, and notice whether the client is elaborating or withdrawing.

Q. Should therapists use OARS scripts word for word?

A. No. Scripts are most useful as learning scaffolds. Practitioners should adapt their language to the client, culture, context, communication needs, and therapeutic relationship rather than delivering memorised phrases.

Q. Can OARS be used when working with anxiety, depression, or substance use?

A. Yes, OARS skills can support MI-consistent conversations across these and many other clinical contexts. Their relevance depends on the client’s needs, the purpose of the conversation, case formulation, practitioner competence and whether MI is appropriate within the broader treatment approach.

References

• Lubman, D. I., Hall, K., & Gibbie, T. (2012). Motivational interviewing techniques: Facilitating behaviour change in the general practice setting. Australian Family Physician, 41(9), 660–667. https://www.racgp.org.au/afp/2012/september/motivational-interviewing-techniques
• Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press. https://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781462552795
• Moyers, T. B., Rowell, L. N., Manuel, J. K., Ernst, D., & Houck, J. M. (2016). The Motivational Interviewing Treatment Integrity code (MITI 4): Rationale, preliminary reliability and validity. Journal of Substance Abuse Treatment, 65, 36–42. https://doi.org/10.1016/j.jsat.2016.01.001
• Rosengren, D. B. (2017). Building motivational interviewing skills: A practitioner workbook (2nd ed.). Guilford Press. https://www.guilford.com/books/Building-Motivational-Interviewing-Skills/David-Rosengren/9781462532063
• Substance Abuse and Mental Health Services Administration. (2019). Enhancing motivation for change in substance use disorder treatment: Updated 2019 (Treatment Improvement Protocol (TIP) Series No. 35). https://www.ncbi.nlm.nih.gov/books/NBK571071/