Motivational interviewing session note template (with example)

A motivational interviewing (MI) session note is the written record of a conversation run along Miller and Rollnick's method: the process you worked in (engaging, focusing, evoking, planning), the client's own words for and against change, their answers to the importance and confidence rulers, and the plan they put into words themselves.

Why MI needs its own note

MINT, the international network of MI trainers, defines MI as "a collaborative, goal-oriented style of communication with particular attention to the language of change" (MINT, quoting Miller and Rollnick, 2013). A standard SOAP, DAP or CBT note describes the problem and the interventions, not the client's language. If the note does not keep those words, the next session starts from scratch and you can no longer show that someone moved from "I should" to "I will".

There is also a quality argument. When NICE reviewed individual behaviour change interventions (PH49, 2014), the committee pointed to "a lack of detail in published journal articles on studies claiming to use motivational interviewing" and concluded "This made it impossible to recommend this approach" (NICE PH49). That was about research reports, not clinical files, but the lesson carries over. A note that only says "MI used" proves nothing.

In UK alcohol services, MI is now written into assessment itself. The Department of Health and Social Care's clinical guidelines state that "Assessment should be based on the principles and techniques of motivational interviewing" and that "Since motivation is continually changing, practitioners should continually review a person's priorities, plans and goals" (Clinical guidelines for alcohol treatment, chapter 4, 2025). A structured MI note is how you show that review over time.

This article covers the MI note itself, whatever the target (smoking, alcohol, treatment adherence, physical activity). For a general structure, see our counselling session notes template.

What to record in each of the four processes

Miller and Rollnick describe MI through four processes. They overlap, and a single session often covers only one or two. Record the one that led, rather than forcing all four headings.

Engaging

This is the working relationship, which MINT calls "the foundation of MI". Note what strengthened or strained it: early reluctance, an affirmation that landed, a topic the client did not want to touch.

Focusing

This is choosing the target. Note the target and who proposed it. If the client came about work stress and you agreed together to talk about smoking, note their agreement.

Evoking

This is where the client voices their own reasons. Quote change talk, sorted if you wish into Miller and Rollnick's categories: desire ("I want"), ability ("I could"), reasons ("it would mean"), need ("I have to"), then commitment ("I will"), activation ("I'm ready to") and taking steps ("I've already bought"). Quote sustain talk with the same care.

Planning

This is the "how". MINT describes it as the process that supports the person "to consolidate commitment to change" and presents it as optional. Record a plan only if it comes from the client: what, when, with whose help, and what they will do if it gets hard. If there is no plan, write "no planning today". That is clinical information, not a failure.

Change talk, sustain talk and rulers

Quote the exact words

We suggest two to four quotes per session, in quotation marks, with at least one on each side. Pick the strongest and the newest. A line such as "I've never managed more than three days" shows where the block sits better than a paragraph.

Add one line on the trend (for example "sustain talk early, change talk ahead after the summary").

The importance and confidence rulers

Both questions come from Miller and Rollnick. The client places themselves from 0 to 10 and you write down the number. It is not a test score, it is a starting point for conversation. For the note to be useful, keep three things.

• The exact question, the same from one session to the next. For example "On a scale of 0 to 10, how important is it to you to stop smoking?" and "If you decided to stop, how confident are you that you could?"
• The client's number, never your estimate.
• The reason, drawn out by the classic follow-up "Why 6 and not 3?" (which evokes change talk) and perhaps "What would it take to get to 7?". Write the answer in their words.

High importance with low confidence points to work on ability (past attempts, support). Low importance suggests staying in evoking and not planning too early.

Ambivalence and the decisional balance

Record the ambivalence as the client puts it, both sides. If you used a decisional balance, say so and note what the client placed on each side. The French health authority (HAS) advises using it with caution, as it can indirectly strengthen sustain talk.

What about the stages of change?

The transtheoretical model (precontemplation to maintenance) is a separate model from MI. If you note a stage, say what makes you think so.

Motivational interviewing session note template to copy

Header

• Client (initials or ID), date, session number, length of the MI part.
• Setting (therapy, alcohol or drug service, health coaching), referrer.

Target behaviour

• Behaviour in the client's own words.
• Who proposed it, client agreement (yes, to revisit).

Main process this session

• Engaging, focusing, evoking or planning (one or two).

Engagement and alliance

• What helped, what strained the relationship, client response.

Change talk (quotes)

• Desire, ability, reasons, need.
• Commitment, activation, taking steps.

Sustain talk (quotes)

• Reasons to keep the behaviour, obstacles named, doubts about ability.

Session trend

• One line on how the talk shifted from start to end.

Rulers

• Importance (exact question): number, reason given, previous number.
• Confidence (exact question): number, reason given, previous number.
• What would move it up one point, in the client's view.

Ambivalence

• Both sides in the client's terms. Decisional balance used (yes, no).

Interventions

• Key open questions, reflections, affirmations, closing summary.
• Information or advice given, permission asked, client response.

Change plan (if the client voiced one)

• What I want to change, why, how, when, who can help, what might get in the way and what I will do then. Written in the client's terms.
• Otherwise, "no planning today".

Referral and liaison

• Medical advice suggested, letter planned, resources offered.

Next session

• Process to pick up, quote to come back to, date.

Filled example over two sessions (fictional case)

Claire (fictional name), 41, an accountant, sees a counsellor in private practice for work stress. She has smoked 18 cigarettes a day since she was 17.

Session 2, 6 October (MI part about 25 minutes)

Target: smoking. Raised by the counsellor after Claire said "I smoke even more since the restructuring". Claire agrees to talk about it "as long as nobody lectures me".

Main process: engaging and focusing.

Engagement: wary at first, linked to past appointments she found shaming. Clearly more relaxed after her two past quit attempts were affirmed.

Change talk: "I'd like not to smell of smoke when I pick up my daughter." (desire) "I need to stop before I'm 45, my dad had a heart attack at 50." (need)

Sustain talk: "It's the only moment in the day that's mine." "I lasted three days in 2022 and I was unbearable."

Trend: sustain talk dominant early, balanced by the end.

Rulers: importance 6 out of 10 ("not 3 because I think about my daughter and my dad"). Confidence 3 out of 10 ("not 0 because I've done three days before"). To reach 4, "knowing what to do with my 10 o'clock break".

Ambivalence: "I want to stop, but I don't want to lose my break." No decisional balance.

Interventions: open questions about past attempts, double-sided reflections on the ambivalence, closing summary. Information about available support given after asking permission. Claire: "I didn't know you could talk to your GP about it."

Plan: no planning today.

Next session: evoking, return to the 10 o'clock break and confidence.

Session 4, 20 October (MI part about 30 minutes)

Main process: evoking then planning.

Engagement: Claire raises smoking herself.

Change talk: "I tried a walk round the building instead of the 10 o'clock cigarette, two days out of five." (taking steps) "I could do it every day if my colleague comes." (ability) "I'll talk to my GP next week." (commitment)

Sustain talk: "Evenings at my sister's will be hard."

Trend: change talk ahead, sustain talk narrowed to one situation.

Rulers: importance 8 out of 10 (6 in session 2) ("not 6 because I've seen I can do something else with my break"). Confidence 5 out of 10 (3 in session 2) ("not 3 because I managed two mornings"). To reach 6, "having a plan for my sister's".

Ambivalence: weaker, now about social situations.

Claire's plan, in her words: "I'll book my GP to talk about support. I'll walk round the building at 10 with Sonia. I'll pick a quit date with the GP. At my sister's I'll stay in the kitchen with the kids. If I slip, I won't throw it all away, I'll bring it here."

Referral: GP appointment on Claire's initiative, with her consent for a letter from the counsellor.

Next session: review the GP visit and the plan, keep the same ruler questions.

For longer reviews, our therapy progress report template builds on notes like these.

Common mistakes

• Writing down your own argument. "Explained cardiovascular risks of smoking" describes what you did, not where the client is. If you gave information, record their response above all.
• Writing "unmotivated" or "in denial". These labels say nothing and can hurt a client who reads their file. Quote the sustain talk and the ambivalence instead.
• Keeping only change talk. The note becomes too rosy and a lapse seems to come out of nowhere. Sustain talk shows where the resistance sits.
• A ruler number without the question or the reason. A lone 6 compares with nothing. The answer to "why not lower?" is often the best line of the session.
• Writing the plan for the client. "Full stop on 1 November" written by the clinician is not an MI plan. Use their words, however modest.
• Writing only "MI used" under interventions. Say what you did (which open question, which reflection, the summary), or the note proves nothing.

Checklist before signing off the note

• The target is in the client's words and their agreement is noted.
• The main process is named.
• At least one change talk quote and one sustain talk quote.
• Both rulers with the question, number, reason and previous number.
• Any information given is preceded by permission and followed by the client's response.
• The plan is in the client's terms, or "no planning today".
• No labels ("denial", "non-compliant").
• A medical referral is noted when the situation calls for it (withdrawal, medication).

Remember that clients may ask to see their records, which is one more reason to quote rather than comment. On what belongs in the formal record, see process notes versus records. Our other templates are gathered in clinical document templates.

Delta and the MI session note

Delta is the clinical assistant that keeps the memory of each client. During the session it transcribes what is said, so you can find the client's exact words; after the session you can also dictate your observations. The report takes your approach into account and the client record (case summary, tracked goals) is updated after each session, so rulers and quotes from earlier sessions sit in one place. Data stays in Europe, in France, on infrastructure certified for health data; identifying details are pseudonymised before the AI and no audio file is kept.

Sources

• Miller W. R., Rollnick S., Motivational Interviewing: Helping People Change and Grow, 4th edition, Guilford Press, 2023.
• MINT, Understanding Motivational Interviewing (definition, processes, spirit).
• Department of Health and Social Care, Clinical guidelines for alcohol treatment, chapter 4, published 28 November 2025, updated 17 April 2026.
• NICE, Behaviour change: individual approaches (PH49), January 2014.
• Haute Autorité de santé, Entretien motivationnel (French, undated).

French readers can also see our addiction session notes guide (in French) for measuring use over time.