Background: This case study demonstrates how motivational interviewing (MI) may be used in the physical therapy management of a patient with persistent neck pain. Case Description: The patient was a 57-year-old female with activity limitations of walking >1 mile and riding her stationary bicycle. Motivational interview-based patient education was provided, focused on supporting self-efficacy with symptom self-management and exercise. Outcomes: The patient was discharged after 3 in-person visits and 2 additional follow-ups via secure email over 12 weeks. The Fear Avoidance Belief Questionnaire score was reduced by 33% and numeric pain rating scale decreased from 5/10 to 0/10 at rest. In addition to her home program, the patient also reported performing regular aerobic exercise 3 to 4 times per week. Discussion: Improvements in activity avoidance beliefs and self-efficacy beliefs related to exercise appeared to be associated with improvement in disability. Clinical Relevance: Motivational interview is both clinically feasible and evidencebased to promote beneficial health behavior changes in a patient with persistent neck pain.