Integrating ACT and Motivational Interviewing: A Synergistic Approach to Lasting Change
Why This Integration Matters
In therapy, one of the greatest challenges isn’t teaching clients what to do—it’s helping them want to do it. Motivation is often the missing ingredient between insight and meaningful change. That’s why Acceptance and Commitment Therapy (ACT) and Motivational Interviewing (MI) make such a powerful pair.
ACT provides clients with tools to live in alignment with their values, even in the presence of pain or fear (Hayes et al., 2011). MI, on the other hand, is a conversational method that strengthens a person’s own motivation for change by exploring ambivalence without pressure (Miller & Rollnick, 2013). Together, they offer a compassionate, evidence-based roadmap that empowers clients to take steps toward a life that matters to them.
A Quick Refresher: The Core of Each Approach
Motivational Interviewing (MI):
Developed by Miller & Rollnick, MI is a client-centered counseling style designed to explore ambivalence and elicit intrinsic motivation (Miller & Rollnick, 2013). Instead of persuading, therapists evoke the client’s own reasons for change. Its foundation rests on empathy, autonomy, and collaboration.
Acceptance and Commitment Therapy (ACT):
ACT is a behavioral therapy that helps clients build psychological flexibility—the ability to stay open, present, and engaged in values-based action, even in the presence of difficult thoughts and feelings (Hayes et al., 2011). ACT uses mindfulness, acceptance, and values clarification to help clients move toward what matters most.
Both approaches resist the “fix-it” mentality and honor the client’s wisdom, autonomy, and readiness.
Where ACT and MI Meet
Values as a Compass
MI: Helps clients articulate their goals, hopes, and desired direction.
ACT: Deepens this exploration by connecting values to identity and purpose, turning them into a daily compass.
Example: A client says, “I want to quit smoking so I can play soccer with my kids.” MI uncovers this motivation; ACT expands it into a value of being an engaged, active parent, anchoring change in identity, not just behavior.
(See Lundahl et al., 2010 for evidence of MI’s impact on behavior change, and Vilardaga et al., 2009 on ACT’s value-based processes.)
Working with Ambivalence
MI: Normalizes ambivalence and uses reflective listening to explore both sides of change (Miller & Rollnick, 2013).
ACT: Helps clients make space for discomfort and self-doubt, teaching them they don’t need to eliminate these feelings before moving forward (Hayes et al., 2011).
Language of Change
MI: Looks for “change talk” (statements about desire, ability, reason, and need to change).
ACT: Strengthens this talk by linking it to chosen values and teaching skills for persisting when obstacles arise.
Example: “I think I could start exercising” becomes, “Exercising is how I live my value of health, even when I feel tired.”
Practical Strategies for Integration
Start with MI to Open the Door:
Use OARS (open questions, affirmations, reflections, summaries) to explore ambivalence and elicit reasons for change.
Bring in ACT to Deepen Commitment:
Once values emerge, use ACT metaphors (Passengers on the Bus, Choice Point) and mindfulness skills to help clients take steps forward, even with difficult emotions.
Cycle Between the Two Approaches:
MI can re-engage clients when they feel stuck, while ACT keeps them moving in the direction of values. Think of MI as igniting the flame of motivation and ACT as sustaining the fire when winds of doubt blow in.
A Case Illustration
Client: A 35-year-old man seeking support for alcohol misuse.
MI Phase: Therapist explores ambivalence: “On one hand, drinking helps you relax. On the other hand, you’ve noticed it gets in the way of being present with your kids.” The client begins to express a desire for change.
ACT Phase: Together they clarify his values: being a caring, reliable father. Therapist introduces acceptance skills for cravings and mindfulness practices to ride out urges.
Integration: When resistance arises (“I don’t know if I can do this”), MI reinforces autonomy and strengths, while ACT invites willingness: “Can you bring that fear with you, and still take one small step toward your value of fatherhood?”
This blend keeps the process both client-driven and values-centered.
Why Clinicians Benefit from This Integration
Reduces the pressure to “convince” clients.
Builds strong therapeutic alliance through empathy and collaboration.
Enhances resilience by equipping clients to navigate setbacks with psychological flexibility.
Aligns with trauma-informed and strengths-based care by honoring autonomy and lived experience.
Watch: Integrating ACT and MI in Practice
To dive deeper into how these approaches come alive in real sessions, check out our video on the Zen Social Worker YouTube Channel:
In this video, we walk through examples of using MI to explore ambivalence and ACT to sustain committed action, showing you how the two flow together in practice.
Resources for Going Further
If you’re ready to integrate these tools into your personal growth or clinical practice, here are some resources we’ve created to help:
Each of these resources is designed to help you not only understand ACT but also apply them in ways that create lasting change.
Final Thoughts
ACT and MI aren’t competing approaches—they’re complementary. MI lights the path by drawing out the “why” of change. ACT equips clients with the skills to keep walking that path, even when the road gets hard.
By integrating these two evidence-based approaches, clinicians can help clients not only make changes but also sustain them—anchored in values, guided by motivation, and supported with compassion.
