What are the core skills of Motivational Interviewing (OARS), and how do they support change in SUD?

• A. Open questions, Affirmations, Reflections, and Summaries; they elicit motivation, reduce resistance, and guide toward change.
• B. Open questions, Advice, Reflections, and Summaries; they provide direct instructions for change.
• C. Oral statements, Affirmations, Reflections, and Solutions; they offer prescriptive advice.
• D. Organized questions, Approaches, Reflections, and Support; they structure the interview.

Answer: (A)

Motivational Interviewing centers on guiding rather than directing, using four flexible skills that together create a collaborative, nonjudgmental conversation. Open questions invite clients to describe their values, goals, and the reasons they want to change, which helps uncover personal motivation rather than imposing reasons from outside. Affirmations acknowledge strengths, past efforts, and progress, building confidence and reducing resistance. Reflections demonstrate empathic listening by restating or reframing what the client has said, allowing ambivalence to be explored safely and helping clients hear their own statements in a way that supports change. Summaries pull together key points from the session, highlight progress and change talk, and set the stage for planning next steps in a way the client feels is their own. Together, these skills elicit change talk, reduce resistance, and guide toward concrete steps, making them effective for supporting change in substance use disorders. Elements like direct advice, prescriptive solutions, or vague, non-collaborative phrasing do not align with this approach.