Background: People living with mental ill health are among the most socially and economically marginalized members of the community. Unemployment rates are high and suitable support to return to work may not always be available. Motivational interviewing (MI) is a focused method of communication that was originally developed to assist counsellors in the treatment of problem drinking. However, more recent applications have demonstrated success with a variety of health conditions and problem behaviours. MI helps clients identify and change behaviours that may be preventing them from achieving optimal life goals, for instance, returning to paid employment. Content: This article gives an overview of the MI approach and highlights key research to date in the field. The vocational expectations of mental health service users and barriers to achieving them are examined. The potential for using MI in vocational rehabilitation with people living with mental ill health is then explored. Conclusions: A successful return to work can help people regain a lost sense of purpose and identity, which is crucial to achieving optimal life goals. It is proposed that motivation for work can be clarified and enhanced by the skilled application of a MI technique. Further work and research in this area is needed.