Motivational Interviewing in Tough Sessions: 7 Strategies That Work
- Monique McNamara
- Sep 23
- 8 min read
You know the theory. You’ve had the training. And you’ve seen Motivational Interviewing work beautifully in session after session. But then there's that one client who keeps circling the same issue, week after week. No forward motion. No shift in motivation. Just a loop of "maybe," "not yet," or "I don't know."
That loop? It can leave you feeling stuck, too.
When that happens, it doesn’t mean you’re doing anything wrong. It just means something’s getting in the way, and it might be time to shift the conversation. Because while MI is collaborative and client-centered, it's not passive. It’s meant to be responsive, alive, and gently directed.
Sometimes it’s not the theory that needs refining, but the way it's being used in the room. And that can be hard to see when you're in the middle of it. Especially when you're doing all the right things, reflecting, affirming, asking open-ended questions, and still, nothing seems to land. You might notice the client leaning back, repeating the same doubts, or growing quieter each week. And suddenly, the familiar MI tools feel a bit less effective.
We'll look at some of the most common moments where MI can stall, and share ideas to help you move forward when the conversation feels stuck. If you’ve ever wondered how to reconnect with a client who seems ambivalent or unsure, you’re in the right place. We'll explore fresh angles, gentle pivots, and subtle questions that can help spark momentum again.
💡 If you’re newer to MI or want a quick, friendly introduction, we’ve also created a free resource just for you. 👉 Download our Introduction to Motivational Interviewing
If you’re looking for a more comprehensive MI refresher, this blog post offers a great foundation.
Let’s start with what it actually means when a client feels stuck, and what it might be telling you about your next move.
1. How to Get a Resistant Client to Open Up
Empathy also makes a big difference here.
Here are a few questions that can gently open the door:
What do you wish felt different in your day-to-day life?
What would life look like if things were more in line with your values?
What feels hardest to say out loud about this situation?
Reflective listening isn’t just a technique, it’s a way of saying, "I’m here with you, not against you." And sometimes that shift in tone is what allows a client to finally open the door a little wider.
If you’re sitting with someone who seems closed off, don’t underestimate the power of small, gentle curiosity. A well-placed question, grounded in compassion, can do more than a whole paragraph of insight ever could.
2. What to Say When a Client Feels Stuck in Indecision
One way to do this is through decisional balance questions:
What feels good about how things are right now?
What might feel better if something shifted?
These allow the client to explore the perceived benefits of staying the same, alongside the potential gains of changing. You might ask, "What feels good about how things are right now?" followed by, "And what might feel better if something shifted?"
Scaling questions can also be helpful:
On a scale of 1 to 10, how important does this change feel to you right now?
What made you choose that number instead of a lower one?
What might help move you one step closer to a higher number?
These subtle nudges can uncover motivation that’s already present, just hidden beneath uncertainty.
It can be tempting to jump in with solutions when a client is stuck in indecision. But what they often need most is a calm, grounded presence who isn’t rushing them to choose. By holding space for the tension, and gently exploring both sides, you can help them move from confusion to clarity in their own time.
3. How to Help a Client Commit to Change Without Pushing Them
When a client starts to lean toward change, it can feel like progress is finally happening. But even then, there’s often a pause before the next step. A hesitation. A moment of "I want to, but..."
This is where commitment comes in , and where MI can help turn a spark into momentum, without making the client feel pressured.
One useful tool is the confidence ruler. You might ask, "On a scale of 1 to 10, how confident are you that you could follow through with this change?" Then, just like with importance scaling, explore what made them choose that number, and what might help them move one point higher.
It’s not about trying to boost their number. It’s about understanding what feels shaky or uncertain and helping them name what they need in order to move forward. Sometimes it’s support. Sometimes it’s clarity. Sometimes it’s permission to take a smaller step first.
This is also a moment where affirmations can be incredibly meaningful. Reflecting back strengths you’ve seen in them, persistence, honesty, resilience can gently reinforce their belief that change is possible. It helps shift the focus from "Can I do this?" to "Maybe I already have the tools."
The goal here isn’t to convince, but to invite. To meet the client in that space between intention and action, and offer just enough support to help them take the next step on their own terms.
4. What to Do When a Client Isn’t Ready to Change Yet
Not every client walks into the room ready to take action. Some are still unsure that change is even necessary. Others might know they need to do something different but feel too overwhelmed to start. And sometimes, they’re just not ready, even if part of them wishes they were.
This is where pacing becomes essential. Trying to push too quickly can backfire, creating more distance and less trust. Instead, meet the client where they are, even if that place is full of hesitation, uncertainty, or avoidance.
One helpful strategy is to get curious about their current stage of readiness. You might ask:
What brought you in today?
What made you decide to talk about this now?
Questions like these can open the door without pressure. You're not asking them to commit. You're just inviting reflection.
You can also validate that stuck feeling. Sometimes just hearing, "It makes sense that this feels hard to look at right now," is enough to ease their defenses. From there, small conversations about values, strengths, or what a better future might look like can gently nudge the process forward.
When a client isn't ready to change, your presence, patience, and gentle curiosity might be the most powerful intervention you offer. Sometimes, being the one person who doesn’t rush them is exactly what helps them start moving.
5. Which Motivational Interviewing Questions to Use When Clients Are Stuck
Knowing what to say in a stuck moment can feel like walking a tightrope. You want to ask something that opens a door, but not so directly that the client shuts it again. That’s where well-crafted, thoughtful questions become one of your most important tools.
Instead of focusing on the problem, consider asking about what matters most to the client. Questions that explore personal values, long-term goals, or past moments of strength can often help clients connect with their motivation in a more grounded way.
You might ask:
"What does a meaningful day look like to you?"
"When in your life have you felt most confident or proud?"
"What would you like to be different, even if you’re not sure how to get there yet?"
Questions like these come from a place of curiosity, not pressure. They help your client hear their own wisdom out loud.
And when you’re not sure which direction to go, you don’t have to reinvent the wheel. Having a resource with ready-to-go questions based on confidence, ambivalence, values, and more can take some of the guesswork out of those quiet, tricky moments.
It’s not about having a script. It’s about having the right prompts on hand to meet your client where they are, with compassion and clarity.
6. A Resource to Keep Beside You When Sessions Feel Stuck
When the room goes quiet or the conversation circles back to the same point again and again, it helps to have something simple and supportive within reach.
The Motivational Interviewing Questions & Theory Cheat Sheets were created for exactly these moments. Whether you're working with a client who’s unsure, shut down, or just not moving forward, these sheets offer a practical path to keep the conversation flowing.
Inside the bundle, you’ll find two comprehensive A4 tools:
The Motivational Interviewing Questions Sheet is organized into 14 categories, including Exploring Personal Goals, Building Commitment, Exploring Ambivalence, Developing a Change Plan, and more. Each category includes open-ended, client-centered prompts you can draw from directly in session.
The Theory Cheat Sheets outline MI principles like the R.U.L.E. framework, OARS skills, and the Stages of Change. It also includes the DARN-CAT model for change talk and real examples to guide your responses.
You’ll get:
Thoughtful prompts for stuck moments and emotional roadblocks
Ready-to-go questions grouped by theme, from values to confidence to self-efficacy
A full breakdown of how MI principles unfold in practice
Visual summaries you can use to refresh your memory between sessions
You can keep them printed in your therapy binder, hang them on your wall, or use them digitally during telehealth sessions. Whether you’re looking for a quick question to open things up or a reminder of the deeper process you’re supporting, this resource is designed to support you when you need it most.
✨ New to Motivational Interviewing?
If you’d like a soft starting point or something simple to share with colleagues or interns, we’ve created a FREE Introduction to Motivational Interviewing
7. What to Do When You Feel Stuck as the Therapist
There’s something that rarely gets talked about in MI trainings: the therapist’s own experience of stuckness. When a client isn’t progressing, you might start to question your own instincts. You wonder if you’re missing something. Or if you should be doing more.
But these moments are part of the work too. Feeling stuck doesn’t mean you’re failing. It usually means you’re sitting in the exact discomfort your client is sitting in, and holding it with care.
This is when returning to your own values, training, and resources can help ground you. Sometimes reviewing a favorite MI framework or flipping through your go-to tools is enough to reset your focus. And
sometimes, giving yourself a moment of kindness is all you need to keep going.
Change is slow. MI honors that. And so can you, for yourself.
✨ Looking for something light to start with? Our Freebie Library is full of tools to help you take the next small step. You’ll find things like:
Printable support you can reach for when you're ready. |
Gentle Observation: Sometimes it feels like you’ve tried every question, every angle, and every bit of reflective listening you know, and your client is still circling the same place. Those are the moments that can leave you wondering if anything is actually shifting.
But just because change isn’t visible yet doesn’t mean nothing is happening. Often, these slow sessions are the groundwork. The quiet before the clarity. The pause that builds safety and trust.
Even when it feels stuck, the work you’re doing matters. Every question you ask, every pause you hold, and every bit of compassion you offer helps create a space where change can begin to feel possible. Sometimes that’s all a client needs to take the next step.
Keep trusting that.
Jemma (Gentle Observations Team)
P.S.
If you're a member of the Therapy Resource Library, don’t forget, you already have access to the Motivational Interviewing Questions & Theory Cheat Sheets. You can download it directly from your member dashboard.
Not yet a member? You can learn more about the Therapy Resource Library and all the resources included right here.
P.P.S
💛 P.S. If you could use a little MI grounding or a fresh start, grab our free Introduction to Motivational Interviewing
P.P.P.S.
If you’re interested in brushing up on the fundamentals of Motivational Interviewing, don’t forget to check out our original blog post: Mastering Motivational Interviewing: A Therapist’s Guide to Effective Change.
It’s a great companion to this guide, especially if you’re looking to reconnect with the foundational principles of MI before diving into more advanced strategies.
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