Coach Approach vs Motivational Interviewing

What is a Coach Approach in Healthcare?

A Coach Approach in Healthcare is a semi-structured conversation any healthcare or helping professional can use within their existing role. It is a way of asking questions that helps a patient or client identify their own barriers, articulate what matters to them, and build an action plan that supports sustained behavioural change they direct.

At its core, a Coach Approach in Healthcare is four things working together:

• A dialogue rooted in curiosity rather than immediate problem-solving
• A questioning method that activates the other person’s own insight
• A goal-setting process that builds ownership and follow-through
• A clinical framework for addressing the perceptual barriers — fear, low self-efficacy, and self-limiting beliefs — that stall progress even when the clinical work is solid

— Hélène Thériault, 2026

What is Similar?

First and foremost, both motivational interviewing (MI) and the Coach Approach use communication as their methodology, facilitating behavioural change through a semi-structured dialogue between the client or patient and the clinician.

Both require the development of complex skills that are honed through considerable practice over time (Miller & Rollnick, 2023; Cook, Greene, & Maxwell, 2024). A key shared skill is accurate empathy, which goes beyond simply reflecting what was heard, enabling the client to articulate their own reasons for change (or not).

Both approaches are client-centred, emphasising rapport-building, collaboration, and active listening as key components of facilitating change. When compared to the Dive Into a Coach Approach® framework, both follow a four-step process that provides structure to the flow of the conversation.

Healthcare practitioners may find MI and the Coach Approach particularly adaptable, as both can be integrated into other therapeutic approaches such as harm reduction, skill building, and occupational engagement.

Finally, both approaches emphasise a way of being. In motivational interviewing, this is known as the Spirit of MI, grounded in four key elements: partnership, acceptance, compassion, and evocation (Miller & Rollnick, 2023). Similarly, the Dive Into a Coach Approach® Mindsets encapsulate the International Coaching Federation (ICF) core competencies into four ways of being metaphors: Amateur, Environmentalist, Olympian, and Discoverer (Thériault, 2020).

What is Different?

Comparatively, the Coach Approach is a comprehensive practice model that can be used both formally as an intervention and informally as an approach (Pentland et al., 2016; Perlman & Moain Abu Dabrh, 2020). Unlike MI’s focus on ambivalence, the Coach Approach dives deeper, working from the inside out to create lasting transformation.

This deeper work focuses on shifts in perception — including beliefs, attitudes, judgments, and assumptions — which in turn influence behaviour and decision-making (Reynolds, 2020). Because this approach requires a stronger foundation in ways of being, advanced techniques, and more sessions, it supports clients in making sustained behavioural changes (Graham et al., 2021).

Furthermore, the partnering approach inherent in this communication style actively engages the client in developing the skills needed to self-manage their condition. This long-term engagement not only supports individuals in managing chronic illness but can also play a critical role in preventing disease by fostering proactive health behaviours.

Similarities & Differences — An Overview

Using the scuba diving metaphor from Dive Into a Coach Approach® training, clinicians choose their approach based on the client’s needs:

Synergy Between Motivational Interviewing & the Coach Approach

While MI and the Coach Approach are distinct, they can work together in a complementary way:

• MI helps resolve ambivalence, while the Coach Approach supports deeper perceptual and behavioural transformation.
• MI is typically short-term (1 to 2 sessions), focused on exploring readiness for change, while the Coach Approach is longer-term (6+ sessions), allowing for sustained self-discovery and action.
• Both approaches prioritise client autonomy but differ in depth. MI guides clients through their reasons for change, while the Coach Approach supports long-term integration of new ways of thinking and acting.

By integrating coaching into healthcare, clinicians can:

• Enhance client and patient satisfaction
• Reduce burnout and improve clinician retention
• Shift healthcare from a curative model to a preventative one

Coach Approach & Cognitive Behavioural Therapy

Interested in how the Coach Approach can complement CBT? Our article, Coach Approach & CBT: A Synergistic Approach, explores how integrating coaching principles with CBT can be blended for improved patient outcomes. Co-authored with Lara Desrosiers, MScOT, OT Reg. (Ont.), from AMPS Healthcare Education.

Read the full article →

Together, the Coach Approach and CBT create a powerful synergy — deepening client outcomes while reducing therapist burnout.