Respectfully Reconsidering: A Rebuttal to the PeerTAC Article on MI and Peer Support
Reframing the Relationship Between Motivational Interviewing and Peer Support
By Lisa Ardner, MA, CASAC-M, CARC, PLC, Certified MINT Trainer, Member of MINT
I deeply appreciate Dr. Peggy Swarbrick’s thoughtful discussion on the distinctions between Motivational Interviewing (MI) and peer support skills. Her work continues to elevate important conversations about how we protect the authenticity and integrity of peer roles while integrating evidence-informed practices that serve people in recovery. You can find her July 30, 2024 Peer-TAC article here: https://peertac.org/2024/07/30/why-motivational-interviewing-does-not-align-with-peer-support-skills/
While I share her commitment to preserving the spirit of peer work, I offer this reflection in the spirit of collaboration. Rather than an argument, it is an invitation to bridge understanding. I believe that MI, when taught and practiced within a recovery-oriented and trauma-responsive framework, can strengthen rather than dilute peer support values.
1. MI and Peer Support Share a Common Heart
At its core, Motivational Interviewing is not a clinical intervention; it is a relational style and a way of being with people and greatly impacts our conversations and interactions with others. The Spirit of MI rests on four key elements: Partnership, Acceptance, Compassion, and Evocation. These align closely with peer values of mutuality, respect, empathy, and shared power.
When MI is practiced through a peer lens, it looks less like an intervention and more like intentional listening. It honors the individual’s right to self-direct, to define their own goals, and to move at their own pace. These principles are foundational in both MI and peer support.
2. The “Agenda” Belongs to the Person, Not the Professional
Dr. Swarbrick raises a valid concern that MI can sometimes appear guided or agenda-driven. In less skillful applications, this risk can occur. However, the spirit and fidelity of MI explicitly reject practitioner-driven agendas.
As Miller and Rollnick (2023) remind us in Motivational Interviewing: Helping People Change and Grow, “The person’s own values, not ours, are the compass.” When peers use MI-informed conversations, they are not diagnosing or directing. They are evoking the wisdom already present in the person, which is also the essence of peer support.
3. MI Can Enhance Peer Support Skills
MI does not replace one's story, empathy, or mutuality. It enhances these skills by giving peers language and structure for what they already do naturally: listening with intention, reflecting hope, and affirming strengths.
Rather than turning peers into clinicians, MI can empower peers to remain grounded in recovery values while gaining tools that improve communication and confidence. This is particularly important in integrated settings where peers collaborate with clinicians, justice systems, and families.
4. MI and Crisis Work Require Discernment
Dr. Swarbrick’s caution about using MI in crises situations is well-taken. Motivational Interviewing is most effective when there is space for reflection, autonomy, and dialogue. In contrast, crisis intervention calls for immediate action, structure, and safety-focused decision-making.
There are moments when we may begin with an MI-consistent approach, listening with empathy, reflecting emotion, and supporting autonomy, and then recognize that the situation has escalated to a level where safety becomes the priority. In these moments, we intentionally and ethically transition from MI skills to crisis intervention skills.
This transition does not mean abandoning compassion or partnership. It means shifting our stance to match the person’s immediate needs. For example:
When someone expresses imminent risk of harm to self or others, the priority becomes ensuring safety, not exploring ambivalence.
When a person is disoriented, overwhelmed, or unable to engage in reflective conversation, the focus moves to grounding, stabilization, and support.
When a person’s physiological or emotional arousal prevents rational problem-solving, we use techniques from Crisis Intervention, Psychological First Aid, or Stress First Aid to help regulate the nervous system before returning to any exploratory dialogue.
In these instances, MI may still inform our tone and approach, maintaining respect, empathy, and nonjudgment, but the structure shifts. We move from asking open questions to making clear, supportive statements and taking protective actions. Once the immediate crisis stabilizes, we can return to an MI-consistent stance, inviting the individual to reflect, identify values, and explore next steps.
This flexibility, knowing when to pivot from motivational dialogue to safety intervention, demonstrates professional competence and compassion. As Miller and Rollnick (2023) affirm, MI “honors the person’s autonomy, but not at the expense of their safety.” Effective practitioners and peer supporters hold both the heart of MI and the responsibility of crisis care.
When someone is in emotional distress, MI’s micro-skills such as presence, empathy, reflections, and support for autonomy can de-escalate tension and affirm dignity, even while more directive safety steps are taken. The question is not whether peers should use MI in crisis, but how MI-informed communication can support safety while preserving choice and connection.
5. Integration, Not Imitation
The goal is not for peers to imitate clinicians, but to integrate evidence-based communication methods that align with peer philosophy. In this way, MI becomes a shared language across disciplines and helps create continuity in person-centered care.
When peer supporters are trained in MI through trauma-responsive and recovery-based programs, they learn to adapt the model. They use reflections, affirmations, and open-ended questions in a way that remains authentic, relational, and non-hierarchical.
6. Preserving the Integrity of Both Roles
Peer support is transformative because it is mutual and grounded in lived experience. MI is powerful because it is respectful, evidence-based, and focused on evoking change. Together, they expand the continuum of recovery-oriented care.
Rather than seeing these frameworks as incompatible, we might imagine them as two instruments in harmony. Each brings a unique tone, but together they create a richer, more compassionate sound. Both aim to help people rediscover their own strength, choice, and hope.
7. When Peer Values and MI Spirit Work Hand in Hand
The core values and skills of peer support align closely with the spirit and concepts of Motivational Interviewing (MI) as described by Miller and Rollnick (2023) in Motivational Interviewing: Helping People Change and Grow. Both approaches are rooted in a deep respect for human dignity and the belief that meaningful change emerges through connection, compassion, and collaboration, not coercion.
The MI Spirit which comprises of partnership, acceptance, compassion, and empowerment, mirrors the foundational peer principles of mutuality, respect, and empathy. Both emphasize genuineness and unconditional positive regard, creating safe and nonjudgmental spaces where individuals feel heard and valued. Peer professionals, like MI practitioners, seek to empower rather than direct, focusing on choice and autonomy as essential components of recovery.
Through reflective listening, affirmations, and authentic presence, both MI and peer support instill hope and confidence by highlighting strengths rather than deficits. Together, these shared values foster an environment where people can explore their own motivations, discover their capacity for growth, and move forward with a renewed sense of purpose and self-determination.
Closing Reflection
Both MI and peer support emerged from movements that challenged traditional power structures in care. Each invites a shift from fixing to listening, from control to collaboration, and from authority to partnership.
In that shared spirit, let us move beyond “either/or” and embrace “both/and.” When practiced with humility and shared purpose, Motivational Interviewing and Peer Support are not competing languages; they are complementary expressions of hope and healing.
Reference:
Miller, W. R., & Rollnick, S. (2023). Motivational Interviewing: Helping People Change and Grow (4th ed.). Guilford Press.
Swarbrick, P. (2024, July 30). Why Motivational Interviewing does not align with peer support skills. PeerTAC. https://peertac.org/2024/07/30/why-motivational-interviewing-does-not-align-with-peer-support-skills/
