The MI Macro Stack
Welcome to the Motivational Interviewing (MI) Macro Substack!
Welcome to the Motivational Interviewing (MI) Macro Substack!
(We call it the “The MI Macro Stack.”)
We hope you will enjoy deeply and join us often in this journey.
First, what’s this all about?
There are a few moving parts. Briefly, it’s about Motivational Interviewing (MI) and specifically how we understand MI as applied to change, growth and flourishing for people in the macro context.
· By “Macro MI” we refer to person-centered, change conversation skills described within MI as applied to making structural sense of personal concerns; in the conversation, we seek to understand the person’s psychological pain and resilience within the context of oppressive factors, and make way for awareness and anti-oppressive shifts. (1)
· “Motivational Interviewing,” or “MI,” is currently described as “a particular way of talking with people about change and growth to strengthen their own motivation and commitment.” (2)
· Over time in this MI Macro Stack, we will share a lot more about MI.
· The “macro context” is in part a contrast to the “micro” or “individual context.” By micro, we mean change on an individual basis, which involves working closely with people to support them through their challenges toward their desired aims.
· In this MI Macro Stack, we refer to the macro context as considering how problems originate, develop, persist and impact us in larger systems–for example, at the state, nation and world levels.
· We often say “macro,” though sometimes we necessarily include the “mezzo.” By mezzo, we mean involving the development, implementation and impact of social service initiatives at a local and more immediate and community level (e.g., schools, neighborhoods, and city or rural districts).
· In traditional MI, practitioners help others enhance their motivation by focusing on individually chosen targets and reinforcing their “change talk” (talk that favors movement toward change); this style of conversation typically amplifies the drivers of their own motivation, including desire, self-efficacy, autonomy, values, reasons for and possible steps toward change.
· In Macro MI, we recognize that internal motivation is impacted by external factors—including systemic pressures—that require or impose upon people to behave in ways that help them function in their environment but might not reflect their personal motivations at all. Consider the person who seems disengaged and/or disinterested in their behavioral health appointments who wants to connect with a provider but cannot show up at the clinic because they have nowhere to park their shopping cart with all of their belongings when they arrive at the office. Or the person who faces systemic and intersectional barriers when applying for stable housing.
· Macro MI practitioners will use person-centered skills such as “OARS” (open questions, affirmations, reflective statements and summaries) to support individuals managing the external factors impacting their world. Also, the practitioner might intentionally focus on other clinical interventions, such as advocacy, linkage, and partnership.
Second, what do we hope to facilitate in the MI Macro Stack?
We hope to explore ideas and information at the intersection of MI and the macro context. We imagine holding space for a different and emerging timbre. We intend to reveal and generate thought-pieces, discussions and activities that any and all people—and especially those most impacted within socially engineered trauma and the service providers and training professionals that work alongside—will find valuable.
Third, who exactly are “we?” (3)
The guiding collaborative generating and organizing these writings are a subset of a larger Macro MI interest group sprung from the Motivational Interviewing Network of Trainers (MINT) (4). This subset is joined with a network of community members dedicated to learning together and further describing concepts within Macro MI. Over time, various of our community will share contributing within this Stack. And we hope you will come to consider and include yourself within our larger “we.”
Fourth, what’s next?
· Please look for us on a monthly basis.
· Our next posts will include more information about MI and an overview of Macro MI.
· Subsequent deep dives will offer many more details about Macro MI, the Macro MI framework, socially engineered trauma, structural competence, broaching difficult topics, as well as various applications of and considerations related to Macro MI.
For now—please enjoy some additional material:
Reading:
“Our DreamSpace Has Been Stolen and We Want it Back”: Reimagining/Reclaiming the Role of Resistance with Meditations on Macro Motivational Interviewing: https://www.tandfonline.com/doi/full/10.1080/10428232.2025.2515779?scroll=top&needAccess=true
Art:
Song:
Mon Rovîa: Heavy Foot
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Quote:
“You can’t shift the world alone. Too often, we’re fed the lie that all the problems are personal and that working on ourselves is enough—and that if it’s not enough, there’s something wrong with us. But changing culture is collective work, not individual work—even though it begins with ourselves.”
Elise Loehnen & Courtney Smith (2025, The Dial Press) Choosing Wholeness Over Goodness: A Process for Reclaiming Your Full Self, p. 5.
Footnotes:
(1) SHARP: A Framework for Addressing the Contexts of Poverty and Oppression During Service Provision in the United States (Shaia, 2019) & Macro MI: Using Motivational Interviewing to Address Socially-engineered Trauma (Avruch & Shaia, 2022)
(2) Miller, WR and Rollnick, S. (2023). Motivational Interviewing: Helping Others Change (Guilford Press).
(3) Guiding Collaborative of Jess Sneed, Casey Bohrman, Kristin Dempsey, Ali Hall and the Macro MI Interest Group.
(4) https://motivationalinterviewing.org/