In this episode of Compassion in a T-Shirt, I’m joined by Douglas Smith, Professor of Social Work at the University of Illinois at Urbana–Champaign, Director of the Center for Prevention Research and Development, and a long-standing member of the Motivational Interviewing Network of Trainers.

Doug and I explore his 2025 book Motivational Interviewing with Families, which re-imagines how Motivational Interviewing (MI) can be applied when working with couples, parents and children, and wider family systems. Rather than treating MI as something done with one person while others observe, Doug invites us to think systemically, relationally, and compassionately about how change unfolds across conversations with families.

We discuss how MI spirit shows up in family work, why reflective listening is the engine of MI, and Doug’s bold re-ordering of the core skills into ROARS (Reflections, Open questions, Affirmations, Reflective Summaries). We also unpack key innovations from the book, including family-level change talk, family-level equipoise, motivational send-offs, and the risks of the “superfluous engagement trap.”

This conversation will be especially valuable for psychologists, social workers, counsellors, and health practitioners who use MI and want to deepen their work with families, as well as anyone interested in compassion-focused, evidence-based approaches to change.

Timestamps:

00:00 Introduction to Compassion in a T-Shirt

00:13 Meet Professor Doug Smith

00:32 Doug’s clinical and research background

01:12 Why Motivational Interviewing with families

01:49 What counts as “family work”?

03:40 Why MI becomes more complex in family systems

07:09 What MI with families actually looks like in practice

18:13 Why reflections matter most in MI

18:22 ROARS and re-ordering MI core skills

21:27 Family-level reflections

25:02 Navigating complexity in family systems

28:17 Teaching and training MI

30:45 Reflections as the engine of MI

33:00 Autonomy and differing family goals

34:07 Challenges in family counselling

38:30 Family-level equipoise

42:25 Change talk in family contexts

47:26 Engaging reluctant family members

49:55 Balancing engagement and planning

01:00:52 Motivational send-offs and ending well

01:04:06 The future of MI with families

Links:

Motivational Interviewing with Families by Douglas C. Smith (2025)

https://www.guilford.com/books/Motivational-Interviewing-with-Families/Douglas-Smith/9781462557615

Professor Doug Smith website with academic references

https://socialwork.illinois.edu/directory/profile/smithdc/

If you would like to learn more about compassion focused therapy, you can find Dr Stan Steindl's book The Gifts of Compassion here: https://www.ausapress.com/p/the-gifts-of-compassion-how-to-understand-and-overcome-suffering/

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Video hashtags:

MotivationalInterviewing, FamilyTherapy, CompassionInPractice, ChangeTalk, MITraining, FamilySystems