The fundamental MI skill — the expression of empathy through reflection. The therapist forms a hypothesis about what the client meant, and voices it as a statement (not a question). A simple reflection is a repeat or paraphrase; a complex reflection adds meaning, feeling, or a shift of emphasis. Key distinction: the intonation goes down. Reflection is the main instrument for expressing empathy and evoking change talk.
Step-by-step guide
- Listen actively — form a hypothesis about what the client means
- Choose the level of reflection: simple (close to the words) or complex (deeper, beyond the words)
- Say the reflection as a statement, with a falling intonation
- Go quiet — wait for the client's reaction
- If the client corrects you — accept the correction, that too is good
When to use
- Constantly, as the main instrument in all the processes of MI
- When the client expresses ambivalence — a double-sided reflection
- When you need to explore experience more deeply — a complex reflection
- In sustain talk — an amplified reflection (without sarcasm)
Key phrases
This is troubling you.
On the one hand, you enjoy relaxing this way — and at the same time you notice it is pulling you further from your family.
Follow-up questions
Behind all of this is the wish that your family respect you.
Alternative phrasings
So you don't need to change anything, in principle. (amplified)
Warnings
- ⚠️ Do not finish a reflection with a rising intonation — it turns into a question
- ⚠️ Do not overuse the amplified reflection — it must be without sarcasm
- ⚠️ Do not actively reflect sustain talk — that strengthens it
Source: Miller & Rollnick, 2013
Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.