Motivational Interviewing Cheat Sheet for Goal Setting

Page one follows the conversation in order. It starts with a script for opening the conversation and three ways to ask what matters to the client. Next come three stages:

• Focus: turn a big goal into SMART goals built around activities.

• Evoke: draw out the client’s reasons and listen for change talk.

• Plan: pick a first step and check readiness.

The sheet ends with prompts for talking through barriers before they come up.

Page two covers the skills that make the conversation work:

• The spirit of MI: partnership, acceptance, compassion, and evocation.

• OARS: open questions, affirmations, reflections, and summaries.

• Change talk vs. sustain talk: how to recognize each one, with examples.

The “Record it” section at the bottom captures the long-term goal in the client’s own words, why it matters to them, a SMART goal for this week, a readiness score, and likely barriers. It works as a session worksheet or as notes you transfer into documentation.

The questions are written around rehab goals, so the sheet fits inpatient rehab, outpatient, community, and home health settings. In the study behind the sheet, the goal-setting conversation usually took place in the second or third session. That gave clinicians a chance to build rapport first. The sheet also works at re-evaluation, or whenever progress stalls and the goals need a fresh look.

For a deeper look at motivational interviewing in practice, see OT Potential’s full guide to motivational interviewing.

The goal-setting structure comes from a feasibility study by Wintle and colleagues (2026), published in Disability and Rehabilitation. A feasibility study asks whether an approach can work in real practice. It doesn’t test whether the approach works better than usual care.

In the study, four physiotherapists in a community rehab program in Melbourne, Australia, built MI into a single goal-setting conversation with 60 adults. The average age was 68. Most of the adults were in rehab for musculoskeletal problems, and the rest were in neuro rehab or general reconditioning. Before the study, each clinician completed a two-day MI workshop and had one-on-one coaching from a certified MI trainer.

Patients and clinicians both accepted the approach:

• 86% of eligible patients agreed to take part.

• 95% of patients rated their satisfaction with the goal-setting conversation 8 or higher out of 10.

• The conversation took a median of 20 minutes.

• Patients set a median of two goals each. Of the 150 goals set, 69% were met by discharge and another 26% were still in progress.

• Most patients reported a meaningful improvement in their ability to do the activities tied to their goals.

• Clinicians said MI helped them turn vague or unrealistic goals into ones patients were ready to work on. Audio recordings showed that all four met the benchmarks for MI competence.

The limits matter, though. The study had no comparison group, so it can’t show that MI goal setting leads to better outcomes than standard goal setting. All the clinicians were physiotherapists. Patients who couldn’t hold a conversation in English, or who had moderate to severe cognitive impairment, were excluded, and that was about a third of those screened. The authors say a randomized controlled trial is the next step.

• Plan for about 20 minutes. That was the median length in the study. Clinicians found it took longer than their usual goal setting but felt the extra time was worth it.

• Use the readiness ruler with a cutoff of 7. If the client rates themselves below 7, stay curious and ask what would move the number up. If they’re still below 7, ask whether there’s a different goal they’d feel more ready for. A smaller goal they’re ready to start beats a bigger one they aren’t.

• Track your ratio. The sheet suggests at least two reflections for every question. A reflection is a statement, not a question. If the conversation starts to feel like an interview, add more reflections.

• Treat sustain talk as information. Sustain talk is when a client gives reasons not to change, like “I’m too tired after work.” Reflect it, then ask about the other side. Asking about barriers before you finish the plan brings these up while you can still plan around them.

• Use the client’s words. Write the long-term goal the way the client says it, then turn it into the SMART goal for this week.

• Treat the sheet as a prompt, not a substitute for training. Clinicians in the study had a two-day workshop plus individual coaching, about nine 30-minute sessions on average. The sheet is most useful once you know the basic MI skills.