OARS in motivational interviewing: what the four skills are, with examples

OARS is a set of four skills used in motivational interviewing: Open questions, Affirmations, Reflections and Summaries. Motivational interviewing is described in the research as “a counseling approach to facilitate behavior change” (Arayasirikul and colleagues, 2020), and OARS are the skills the counsellor uses through that conversation. This page explains each skill with an example, the slips to avoid, and how to practise.

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What OARS stands for

• Open questions: invite more than yes or no.

• Affirmations: recognise a strength or an effort.

• Reflections: say back what you heard, as a statement.

• Summaries: pull the threads together and check them.

A training guide from the University of Washington covers the same four skills in its role-play rubric. It defines open questions as questions that invite more than a yes or no answer; affirmations as positive comments on a strength, noticing what the person is doing for their well-being, or expressing hope, care or support; reflections as statements, “rather than a question”, that reflect back what the person said; and summaries as pulling together what was discussed, linking points and collecting the themes raised, ideally including a goal for change.

UW Department of Psychiatry & Behavioral Sciences, Behavioral Health Support Specialist Workforce Development Project, "MC7-a Motivational Interviewing" (Educators Guide)

An article by the Australian Institute of Professional Counsellors describes the same four skills, and calls reflective listening the key skill.

Australian Institute of Professional Counsellors (30 April 2010), "Motivational Interviewing Techniques"

An open question invites more than a yes or no answer. The UW guide advises starting with “What”, “How”, “When” or “Where”, and avoiding “Why” (UW guide).

For the wider list of skills that questions belong to, see counselling microskills.

The AIPC article presents affirmations as a strong way to build rapport, and says they should match the progress the client has really made, because over-praising can seem insincere and damage rapport. Its example is thanking a client for arriving on time (AIPC, 2010). The UW guide adds noticing what the person is doing for their well-being, or expressing hope, care or support (UW guide).

A note on Practicium: its rating covers five skills: contracting, open questions, reflection and summarising, holding back advice, and boundaries. Affirmations are not one of them, so the app does not rate them.

The AIPC article says reflections should vary in depth, that reflecting emotion can be a strong motivator, and that if a reflection misses, the client corrects it and the session goes on. Its example: “Your wife has left you. That appears to be giving you a lot of pain.” (AIPC, 2010). The UW guide describes a reflection as a statement, not a question (UW guide).

For three levels of reflection, each with an example, see reflective listening.

The AIPC article describes a summary as a specialised form of reflective listening that highlights the key points and shows the counsellor has been listening. It advises announcing the summary and inviting the client to correct it. Its example: “So, this heart attack has left you feeling really vulnerable.” (AIPC, 2010).

The UW role play asks students to start a summary by minute 12 of a 15-minute session, so there is time to conclude (UW guide). That is how the exercise is designed, not a rule of practice.

How OARS fits motivational interviewing

A 2020 study defines motivational interviewing as “a counseling approach to facilitate behavior change”. It looked at a care navigator's text-message programme for young people living with HIV. Higher use of the four OARS skills, and use of three or more of them, was associated with more change talk.

This is an association in one setting, text messages, and not proof that OARS causes change. This page summarises the study's abstract, not the full paper.

Arayasirikul S, Turner C, Trujillo D, Le V, Beltran T, Wilson EC (2020), "Does the Use of Motivational Interviewing Skills Promote Change Talk Among Young People Living With HIV in a Digital HIV Care Navigation Text Messaging Intervention?", Health Promotion Practice

The AIPC article discusses these skills with clients in addiction, and describes no other group (AIPC, 2010).

Slips to avoid

Only slips that a source names are listed here. The sources do not say how common they are.

• Asking "Why" questions

  The UW guide advises open questions that start with "What", "How", "When" and "Where", and avoiding "Why". It does not say why, so this page does not either.

  UW Department of Psychiatry & Behavioral Sciences, Behavioral Health Support Specialist Workforce Development Project, "MC7-a Motivational Interviewing" (Educators Guide)

• Over-praising

  The AIPC article says an affirmation should match the progress the client has really made, because over-praising can seem insincere and damage rapport.

  Australian Institute of Professional Counsellors (30 April 2010), "Motivational Interviewing Techniques"

• Asking a question where a reflection fits

  The UW guide describes a reflection as a statement, rather than a question, that reflects back what the person said.

  UW Department of Psychiatry & Behavioral Sciences, Behavioral Health Support Specialist Workforce Development Project, "MC7-a Motivational Interviewing" (Educators Guide)

How to practise OARS

Common questions

What it is, and what it is not

Practicium is practice for people learning to counsel. It is not therapy, it is not a service for people seeking help, and it does not give advice to the public. Nothing on this page suggests that OARS or the app can treat any condition.