I agree that remembering the ‘spirit’ of Motivational Interviewing can be super helpful in grounding ourselves in harm reduction! I think there is a time and place for when clinicians can lean on MI in their practice, but I wonder if it is more realistic for us to weave in and out of it (for example, MI encourages clinicians to have a focused discussion, but sometimes preceding this conversation with empathy and validation is needed before clients are open to discussions about change…).
One tool that I was exposed to at a Motivational Interviewing course that I have found helpful with my clients is the risk vs. benefit matrix. I think this allows clients to consider their options regarding choosing to commit to an action- as well as their thoughts and feelings related to it. I think this can help guide clients through an exploration of their values and how they would like to prioritize them.