Solution-Focused Approach vs.
Motivational Interviewing
What the Solution-Focused approach can add to your Motivational Interviewing practice, how the two approaches differ, and what the research tells us about each.
Solution-Focused vs. MI: Two Approaches. One Goal. Different Starting Points.
If you work in healthcare or performance coaching, you've almost certainly encountered Motivational Interviewing. With over 1,300 randomized controlled trials across four decades, MI is one of the most widely trained communication approaches in clinical settings.
Solution-Focused Brief Therapy (SFBT), which is the foundation for solution-focused coaching, may be less familiar, but a substantial body of research spanning four decades also supports it as an evidence-based practice, including randomized trials, systematic reviews, and a 2024 meta-analysis reporting a large overall effect size (g = 1.17). It has also been found effective in relatively few sessions and may support engagement early in the conversation.
Both approaches are collaborative. Both avoid the traditional directive model of telling people what to do. Beneath those surface similarities, the SFBT vs MI comparison highlights differences in starting assumptions, conversational structure, and mechanism of change that shape how conversations unfold, what practitioners listen for, and how change begins.
Solution-Focused Approach (SF)
SF starts with the end: helping the client define meaningful goals, create a detailed description of their preferred future when the goals are met, explore times in which they were successful moving toward their goals, work backwards from their better future to the present to discover the keys to success along the journey.
The focus of SF conversations is to help the client craft descriptions of the life they want in terms of a lived outcome in concrete behavioral and relational details along the journey.
Motivational Interviewing (MI)
MI starts with the person's own motivation for change and growth: helping them strengthen their desire, ability, reasons, and need for change, and move toward stronger commitment and follow-through.
The focus of MI conversations is to strengthen the person's own motivation and commitment in the midst of ambivalence, so that movement forward is guided more by their own values and goals than by hesitation, conflict, or outside pressure.
What Each Approach Does
Starts with the end: helping the person create a detailed description of their preferred future. Works backward through what they would have done differently at each point along the journey from that better future to the present.
The Solution-Focused approach begins by helping the person describe the future they want to be living, not a goal, but a lived outcome, in concrete behavioral and relational detail. From there, the conversation works backward: what is already happening that points in that direction? When is the problem absent or less present? What would be the next visible sign of progress?
Strengthens a person's own motivation and commitment throughout the journey of change and growth.
MI helps people strengthen their desire, ability, reasons, and need for change (DARN). The practitioner uses four core communication skills, open-ended questions, affirmations, reflections, and summaries (OARS), to help people discover and deepen their own motivation and commitment, whether they're facing a specific decision or navigating broader change and growth.
What Can the Solution-Focused Approach Add to Your Practice?
If you're already trained in Motivational Interviewing, you don't have to give it up to benefit from learning the Solution-Focused approach. You may find ways to incorporate Solution-Focused questions and principles into the MI conversations you're already having. Or you may discover that you prefer an entirely Solution-Focused approach.
The two models share important commitments to collaboration, respect for client autonomy, and avoiding unnecessary advice. But they differ in how they approach change.
MI helps people explore and strengthen their motivation for change. Solution-Focused coaching begins with a different assumption: People have a good reason for showing up for a conversation about change. They must want something to be different, even if they aren't yet sure what that is or how to make it happen.
Rather than trying to increase motivation, we become curious about what they're already motivated to achieve.
As Teri Pichot, a recognized authority in Solution-Focused Brief Therapy, explains: "the therapist does not need to enhance the clients' motivation. The therapist simply listens to hear what the client is already motivated to achieve and focuses there."
From there, we help clients describe what they want their lives to look like when things are better, what difference that would make, and what they and others would notice. We explore which parts of that preferred future are already happening, how they're making those things happen, and what might be different next.
This approach doesn't require clients to resolve their ambivalence or commit to a particular behavior before the conversation can be productive.
MI Has Continued to Evolve
If your MI training predates 2023, it's worth knowing that Miller and Rollnick substantially revised the approach in the fourth edition of Motivational Interviewing: Helping People Change and Grow.
The updated edition broadens MI's applications beyond resolving ambivalence, with increased attention to helping people change and grow. It also emphasizes empowerment, recognizing people's capacity to make choices and direct their own lives.
The distinction between MI and SF isn't about whether we respect clients' autonomy. Both approaches do. It's about how we organize the conversation. In Solution-Focused coaching, we begin by discovering what clients want to be different, what that would look like in their everyday lives, and what's already happening that might help them get there.
What Does This Mean for Your Practice?
You can begin by incorporating elements of Solution-Focused practice into MI. For example, you might spend less time exploring what has prevented change and more time helping clients describe what they want to be different and what is already working.
As you become more proficient, you may choose to conduct entire conversations using the Solution-Focused approach. At that level, it's not simply a matter of asking different questions. You're learning a different way to think about clients, what to listen for, and how to respond.
You don't have to choose between MI and SF to benefit from learning both. Understanding their differences gives you more choices about how you want to work, what fits your setting, and how you can best help the people you serve.
Five Solution-Focused Questions You Can Use in Your Next MI Session
You don't have to change your entire approach to begin incorporating Solution-Focused practices into your conversations. Start with these five questions, and pay attention to how the answers influence what you ask next.
1. Open with what they want from the conversation itself.
What are you hoping to take away from our conversation together today that would be helpful for you?
You don't have to ask about what brought them in, which often invites the problem story, but what they're hoping to get out of talking with you. That difference in wording can change where the conversation goes next.
2. When they tell you what they don't want, find out what they want instead.
So what would you like instead?
Knowing what you want to get away from doesn't tell you where you want to go. It's like telling a taxi driver, "I don't want to go to the airport." That doesn't give the driver a destination.
The same is true of change. "I don't want to be so stressed" tells us what the client wants to eliminate, but not what they want their life to look like instead.
"What would you like instead?" turns the conversation toward something the client actually wants to experience, something they can describe, recognize, and work toward.
3. Ask them to describe it as if it were already happening.
Suppose things were going the way you want. What would be different? What would you and others notice?
The purpose is to help clients describe their preferred future in enough detail that they can recognize it in everyday life. Don't rush to ask what they'll do to get there. First, explore what would be different and why that difference matters to them.
4. Explore when parts of the preferred future are already happening.
When are times when you're already experiencing a little of what you want?
Once clients have described their preferred future, explore when parts of it are already happening in their everyday lives, even a little. If they want to be calmer, ask, "When are times when you feel even a little more calm?" If they want to eat healthier, ask, "When do you manage to eat even just a little bit healthier?"
These aren't random exceptions. They're occasions when something the client wants is already present. Exploring them helps clients recognize that their preferred future isn't entirely in the future. Parts of it are already happening.
5. Close by exploring what they might notice next.
Suppose the next day or two went a little better. What would you notice that would tell you things were going in the direction you want?
Rather than asking clients to commit to an action, invite them to describe what a little progress would look like. Then explore what they might have done to make that possible.
What you might notice first
When you start by asking what clients want and stay curious about their answers, you may find that you spend less time discussing what's wrong and more time developing a description of what they want, what's already working, and what might happen next.
SFBT vs. MI: The Structural Differences
Both approaches are collaborative and respect autonomy. The architecture beneath those surface similarities is different in ways that matter in practice.
MI is organized around four tasks: engaging, focusing, evoking, and planning. In practice, much of the conversation is spent building the relationship, developing a shared direction, and drawing out the person's own motivation before turning to a specific plan for what they will do differently.
The Solution-Focused approach begins from the first question by helping the person define what they want to be different and build a concrete, behavioral and relational description of their preferred future, then work backward to what is already moving in that direction and what they would be doing differently as progress becomes visible.
Same Person. Different Conversation.
A person wants to eat healthier but is struggling to follow through, citing a busy schedule and frequent travel.
Begin with what the person wants and help them build a detailed picture of their preferred future
The practitioner does not stay inside the problem story, analyze the barriers, or shift into advice. The questions are brief, strategic, and built to help the client describe the future they want in concrete personal terms. The conversation moves quickly from the presenting problem to the difference the client wants, and then into visible signs of a better future. From there, the dialogue flows naturally: what else would be different, what others would notice, when this is already happening even a little, and what small next steps would fit.
Evoke the person's own motivation and commitment for change
The practitioner stays with the person's current reality and uses reflections to capture both the pull of the old pattern and the desire for change. The conversation remains in the present struggle: busy schedule, travel, convenience, frustration, and importance. It does not move quickly toward planning, and that is realistic MI structure rather than a weakness in the example. Here, the MI task is to help the client hear more clearly their own ambivalence, motivation, and desire for change before moving toward a specific plan of action.
In the Solution-Focused conversation, the practitioner uses brief, strategic questions to move quickly toward the person's preferred future and what would be different. In the Motivational Interviewing conversation, the practitioner uses reflections to stay with the person's current experience and strengthen motivation before planning. That is why the SFBT dialogue flows naturally into future-focused work, while the MI dialogue remains closer to the present struggle.
See a complete Solution-Focused conversation in practice, in under 20 minutes.
Watch the Free TrainingSee both approaches in a full conversation
You just read a brief sketch of how the two approaches sound in a real conversation. Here is the full thirty minutes, including a complete side-by-side demonstration of both approaches with the same person.
SF vs. MI: Different Assumptions. Different Language. Different Time Horizon.
The deepest difference between the Solution-Focused approach and MI is not procedural. It is philosophical, and it shows up in how each approach uses language moment to moment.
SF: People are already capable. MI: People benefit from building motivation before action.
SF: People are capable and already doing things that work. The conversation reveals and amplifies what is already happening, no motivation enhancement required.
MI: People benefit from strengthening their desire, ability, reasons, and need for change in order to lay the foundation for commitment and action. Motivation is something to be evoked and developed, not assumed.
SF selects and preserves. MI reformulates strategically.
Person: "I'm tired of how things are going. I just want to feel normal again."
SF builds directly from the part that points toward the preferred future: "What might be the very first sign that you were starting to feel normal again?" The person's exact language returns as a question, intact, not interpreted.
MI uses a complex reflection to extend and amplify: "You're really done with how things have been, and feeling normal again sounds like it would change everything." The practitioner reformulates strategically to invite more change talk.
SF structures time explicitly. MI supports planning, but not through the same temporal sequence.
SF: Time is a deliberate tool. The conversation begins with a detailed description of the preferred future, then moves to the intermediate future, often the next 7-10 days, to identify visible signs of change. From there, it moves to the immediate future: the next small step, often within 24 hours, that would make those signs more likely. Each step is anchored to the person's own preferred future, not to an externally imposed goal.
MI: Planning is the fourth of four processes, after engaging, focusing, and evoking. MI supports change planning based on the person's readiness and commitment, but it does not typically use the same structured temporal map from a vividly imagined preferred future to a 7–10 day intermediate future to an immediate next step.
MI is a technically specified approach with rigorous performance standards. Published MI fidelity benchmarks include a 2:1 ratio of reflections to questions with more than half being complex reflections. Many practitioners in routine settings may not reach published MI fidelity thresholds without sustained practice and feedback. Many who think they are "doing MI" are working well below what its own researchers consider competent. That is not a criticism of MI. It is a description of how demanding it actually is.
Solution-Focused coaching's early behavioral shifts, asking more, contributing less content, are themselves productive. Research using microanalysis of face-to-face dialogue (Godat & Czerny, 2025) found measurable, observable changes in conversational behavior after three days of training, changes that directly produced more contribution from the people practitioners were speaking with. The early shifts are the mechanism, not preparation for it.
Brain imaging research by Jack, Passarelli, and Boyatzis (2023, Frontiers in Human Neuroscience) suggests that starting with a person's hopes and vision may work differently than starting with their problems, involving different neural processes related to motivation, attention, and future-oriented thinking. Using fMRI, the study found that coaching conversations focused on the ideal self, hopes, dreams, and the future a person wants to be living activate the brain's Empathic Network, associated with creativity, imagination, and intrinsic motivation. Conversations focused on problems and current deficits activate the Analytic Network instead, associated with narrower attention, external motivation, and vigilance. These two networks are mutually inhibitory: activating one suppresses the other. Beginning with a vivid description of the preferred future may engage different cognitive and motivational processes from the start of the conversation.
Both Evidence-Based. Different Research Histories.
Both Motivational Interviewing and the Solution-Focused approach are evidence-based practices with substantial, independent research bases. The question is not which is "evidence-based" and which is not. It is what the research says about how each works, and what conditions each requires.
Solution-Focused Brief Therapy
A 2022 systematic review by Neipp and Beyebach identified 365 outcome studies across 33 countries, with 251 meeting full analysis criteria across more than 27,800 participants. The Solution-Focused approach was superior to control in nearly 9 of 10 studies. A 2024 meta-analysis found a large overall effect size (g = 1.17). An umbrella review of 25 systematic reviews found significant positive outcomes across different issues, populations, and cultural contexts, with no evidence of harm. The approach shows strong results in health, mental health, justice, addiction, and coaching settings.
Motivational Interviewing
MI has over 1,300 RCTs and 150+ systematic reviews. Meta-analyses show statistically significant effects with small to moderate effect sizes (OR = 1.55) across substance use, medication adherence, physical activity, and other health behaviors. MI has a highly developed fidelity model and a mature research tradition built over four decades.
MI's 1,300+ RCTs reflect its manualization, a strategic choice that made MI legible to academic funding systems built around standardized, replicable protocols. de Shazer and Berg questioned manualization, believing it would flatten the approach's sensitivity to the individual's own language and the emergent, co-constructed nature of the conversation. The Solution-Focused research base has since grown substantially. For practitioners, the relevant question is not which has more publications. It is which one fits the conditions you actually work in.
The Job Motivational Interviewing Was Designed to Do
Motivational Interviewing has significant evidence for specific populations and contexts. From its beginnings, it has proven effective when the primary barrier to change is ambivalence. MI's research shows strong outcomes with substance use disorders, medication adherence, physical activity, and health behavior change where internal conflict about change is the central issue.
The limitations of Motivational Interviewing become apparent in other contexts. When people are already motivated, they're talking to you for a reason, MI's focus on evoking and amplifying motivation becomes a slower path than accessing what they already want. When time is scarce, MI's four sequential tasks mean that planning and action often wait until sessions 2, 3, or beyond. When you're working with mandated participants or people who didn't choose to be there, MI's reliance on intrinsic motivation building can stall before momentum begins.
Motivational Interviewing in health coaching: MI has growing application in coaching contexts, particularly for behavior change and habit formation. The research on MI for health coaching shows modest effect sizes and requires sustained practice to implement with fidelity. Many practitioners who learn MI find it transfers their conversation quality without always translating to behavior change, which is why understanding its actual limitations matters before investing training time.
The Pattern Most Practitioners Recognize
You explain the plan clearly. The person across from you agrees. They leave committed, or at least they seem to. And then they don't follow through.
The standard explanations are reasonable. They weren't ready. They were overwhelmed. Life got in the way. Sometimes that is exactly what happened.
But when the pattern repeats, across patients, across programs, across conversations where you've done everything right, the question eventually becomes less about them and more about the structure of the conversation itself. Not your intelligence. Not your commitment. The starting point.
If the conversation keeps beginning inside the problem or inside what has not been working, you will keep getting one kind of momentum.
If it begins with the future the person wants to be living, what is already working, and what would be different as change becomes visible : you create another.
That is the shift SF makes from the first question. This is a structured, evidence-based approach that can be adapted to brief clinical encounters, including the short visits that define many clinical settings. The free Stamina Lab training shows you what a Solution-Focused conversation looks like in practice, in under 20 minutes. If you've trained in MI and are wondering whether there's something that fits better in time-constrained settings, that's exactly what it's designed to answer.
Frequently Asked Questions
What is the difference between Solution-Focused and Motivational Interviewing?+
The core distinction is not about technique but about premise. MI is a particular way of talking with people about change and growth to strengthen their own motivation and commitment. The Solution-Focused approach begins from a different premise: the person is already motivated for something, because they are talking to you for a reason, and the conversation helps them define what they want, build a detailed description of the preferred future, locate what is already working, and move forward from there. Both are evidence-based. Both are collaborative. But they operate through different assumptions about what change requires.
Is SFBT vs MI a meaningful clinical distinction, or is the overlap more important?+
Both approaches are collaborative. Both avoid the traditional directive model of telling people what to do. Beneath those similarities, the SFBT vs. MI comparison highlights differences in starting assumptions, conversational structure, and approach to change that shape how conversations unfold, what practitioners listen for, and how change begins.
SFBT begins by helping the person describe the preferred future they want to be living, in concrete behavioral and relational terms. MI begins with engaging, building a trusting, respectful working relationship that creates the foundation for strengthening the person's own motivation and commitment.
That difference in starting point matters in practice. SFBT research reports positive outcomes in relatively few sessions, with an average of approximately 4 to 6 across a range of populations and settings. MI organizes conversations around four interrelated processes: engaging, focusing, evoking, and planning. These processes can overlap and recur throughout the work.
Understanding these differences helps practitioners decide how and when to use each approach, including whether to incorporate elements of SF into their existing MI practice.
What are the limitations of Motivational Interviewing?+
MI is a powerful approach, and it is also more technically demanding than many practitioners realize. Full proficiency requires sustained practice with structured fidelity feedback. MI's own researchers have established rigorous performance standards: basic competence requires roughly a 1:1 ratio of reflections to questions with at least 40% complex reflections, a bar many practitioners in routine settings may not reach without sustained practice and feedback. Proficiency benchmarks require a 2:1 ratio with more than half of those reflections being complex. MI's four sequential tasks, engaging, focusing, evoking, and planning, mean that the full arc of an MI conversation often unfolds across multiple sessions before planning becomes the focus. That structure doesn't fit all settings. Knowing that helps in choosing when and how to use it.
I already have MI training. Why would I learn the Solution-Focused approach?+
Motivational Interviewing and Solution-Focused coaching are different approaches to helping people change.
MI is especially useful for exploring ambivalence and helping people strengthen their own motivation for change. Solution-Focused coaching takes a different approach. It begins with the assumption that people have a good reason for showing up for a conversation about change. They must want something to be different, even if they aren't yet sure what that is or how to make it happen.
We help clients describe what they want in concrete, everyday terms. What would be different? What difference would that make in their lives? What would they and others notice? Then we explore which parts of that preferred future are already happening, how they're making those things happen, and what might be different next.
This approach is just as useful when clients are uncertain, discouraged, or ambivalent. They don't have to resolve their ambivalence or commit to a particular behavior before the conversation can be productive.
Perhaps the most important difference is that the practitioner has no agenda for what the client should choose. The conversation isn't about persuading people to make a change we believe is good for them. It's about helping them discover what they want and what they would actually do to make their lives better.
If you're already trained in MI, learning Solution-Focused coaching gives you a different way to think about change and a different way to conduct the conversation, not simply another set of communication techniques.
Is the Solution-Focused approach just a more positive version of MI?+
No. The Solution-Focused approach is not simply "more positive." It uses a different temporal structure, a different response to problem talk, a different treatment of language, and a different mechanism of movement. It is question-led, presuppositional, and future-building. When problem talk appears, it is followed by coping, exception, or difference questions, not denial, but a different direction. That is a markedly different orientation, not a variation on MI.
Can I use both MI and the Solution-Focused approach?+
Absolutely. If you're already using Motivational Interviewing, you don't have to abandon it to benefit from Solution-Focused training.
At the most basic level, you can begin incorporating Solution-Focused questions and principles into your existing conversations. For example, instead of exploring what's preventing someone from changing, you might ask what they want to be different and what difference that would make in their life. You can listen for what's already working, ask how they've managed to do it, and explore what they might notice if things were a little better.
But there's a difference between incorporating Solution-Focused practices into MI and conducting an entirely Solution-Focused conversation.
As you become more proficient in the Solution-Focused approach, it's not just the questions that change. It's how you think about the client, what you listen for, how you respond, and where the conversation goes next. Rather than trying to strengthen motivation for a particular change, you assume the client has a good reason for being there and become curious about what they want and what they would actually do to make their lives better.
You can learn to use both approaches. You might incorporate elements of Solution-Focused practice into your MI conversations, use one approach or the other depending on the circumstances, or eventually make Solution-Focused coaching your primary approach.
To start, you can bring a Solution-Focused practice or question into your work even this week, without retraining.
The important thing is understanding the principles behind each approach, rather than simply mixing techniques without considering the assumptions behind them.
Does the Solution-Focused approach work with mandated or reluctant participants?+
Yes. In the Solution-Focused approach there is no agenda for the person to resist. The conversation is organized entirely around what they want, what's already working for them, and what their next small step might be. When the conversation is organized around what the person wants, rather than around defending against a problem label, reluctance may shift. Pichot's clinical work, developed specifically in justice-involved, externally mandated, and multiproblem populations in substance abuse treatment, suggests the approach can be used effectively even when participation wasn't chosen. The practitioner doesn't need the person to agree they have a problem. The practitioner begins with what the person wants and works from there. Both MI and the Solution-Focused approach have moved away from the language of "resistance," which locates the problem in the person rather than the conversation.
Which approach works better for brief clinical encounters?+
The Solution-Focused approach has been shown to deliver positive outcomes in relatively few sessions, with an average of around 4–6 across a wide range of populations and settings. The Solution-Focused conversation is structured in a way that can be productive whether the encounter is 10 minutes or an hour. MI does not require a fixed time either, but its four sequential processes, engaging, focusing, evoking, and planning, mean that getting to planning typically takes more time across sessions. For practitioners managing high volume, the difference in session count over time matters as much as time per session.
How does Stamina Lab's approach relate to SFBT?+
Stamina Lab's Solution-Focused coaching approach draws directly from SFBT. We haven't invented a new approach, we apply the rigorously researched SFBT framework to coaching contexts, precisely as Berg and de Shazer envisioned. "Brief Therapy" reflects where SFBT was first developed and studied; the approach has since become a significant influence in coaching, education, organizational settings, and social policy. No clinical background is required to learn or apply it effectively.
Can I earn CME credit for learning the Solution-Focused approach?+
Yes. Stamina Lab's Foundations in Solution-Focused Health Coaching is CME-approved for 6.0 AMA PRA Category 1 Credits™ by Indiana University School of Medicine, meeting the same institutional standards as any other continuing medical education offering AMA PRA Category 1 credits.
See the Solution-Focused Approach in Action
Watch a free 5-minute demonstration of how a single shift in conversational structure changes engagement, ownership, and follow-through.
CME-Approved · 6.0 AMA PRA Category 1 Credits™ · Indiana University School of Medicine
Dr. Deborah Teplow
Co-Founder & Chief Program Architect, Stamina Lab
Dr. Teplow earned her doctorate from Stanford University and has spent decades translating behavior-change science into structured professional practice. She was introduced to Solution-Focused brief therapy by its creators, Steve de Shazer and Insoo Kim Berg, and has completed advanced practitioner and supervisor training with BRIEF, Elliott Connie, Adam Froerer, Teri Pichot, Linda Metcalf, and Dr. Jacqui von Cziffra-Bergs.
She holds advanced certificates in Motivational Interviewing from Brown University and the Philadelphia College of Osteopathic Medicine, and the MI courses she developed for healthcare professionals have received recognition from members of the Motivational Interviewing Network of Trainers (MINT).
Dr. Teplow co-founded the Institute for Wellness Education, where she and co-founder David Mee-Lee created the U.S. national occupational standards and training curriculum for the Department of Labor's Registered Apprenticeship in Wellness Coaching. She has trained practitioners for organizations including Healthy Start (HRSA/HHS), Blue Cross Blue Shield of North Dakota, the Los Angeles County Department of Public Health, and Medica.
She is a long-standing educational partner with Indiana University School of Medicine, where she has developed CME programming across major medical specialties. She leads all faculty development and program quality at Stamina Lab.