Evidence-based approaches are the cornerstone of substance use disorder treatment, proven to help people achieve long-term recovery.
Motivational interviewing (MI) is one such treatment used in drug rehab programs, helping people replace addictive behaviors with healthy ones.
Learn more about MI, including how it’s applied and its effectiveness, by continuing to read on.
What Is Motivational Interviewing?
Motivational interviewing (MI) is a collaborative counseling technique used in addiction healthcare settings to explore and strengthen a person’s intrinsic motivation for positive behavior.
MI was developed by psychologists William R. Miller and Stephen Rollnick in New York and outlined in their book “Motivational Interviewing: Helping People Change” as a way to combat substance misuse.
By fostering empathy and understanding and resolving ambivalence, MI helps people overcome resistance to change and achieve their goals.
Techniques Of Motivational Interviewing
The technique is often provided by licensed clinicians in an individual or group setting.
Building Empathy And Understanding
Building empathy and understanding in motivational interviewing involves actively listening to the client’s perspective without judgment and acknowledging their feelings and experiences.
The therapist seeks to understand the client’s motivations, values, and goals, creating a supportive and non-confrontational environment to facilitate positive behavior change.
Once the client feels comfortable with the therapist, the next step is to begin to recognize the discrepancy between their current drug use and their values or desired outcomes.
By highlighting this contrast, the therapist encourages the client to explore their ambivalence and motivation for change, promoting self-motivated decisions toward recovery.
Rolling With Resistance
Change does not happen immediately when beginning any form of mental health treatment. People often feel resistance when breaking away from old patterns.
For this reason, therapists using MI avoid confrontation and argumentation when the client expresses reluctance or hesitation during the different stages of change.
Instead, the therapist acknowledges and respects the client’s perspective, using reflective listening, or listening closely and summarizing statements back to the client, and open-ended questions to explore the client’s concerns.
In this way, the therapist supports the client in finding barriers to moving forward as well as facilitators of change.
Throughout MI, the therapist uses positive reinforcement to encourage the client’s ability to make and sustain positive changes.
This includes acknowledging “change talk,” or how the client expresses their desire, need, ability, and reasons for change.
It also includes encouraging the client to identify past successes and strengths, which fosters confidence, and not to focus on any past negative consequences.
Affirmations may be used, such as “It took a lot of courage not to use alcohol at your family gathering this week. That’s a big step forward.”
By reinforcing a sense of self-belief, the therapist helps the client become more motivated and committed to achieving their goals in overcoming negative behaviors.
Motivational Interviewing Vs. Motivational Enhancement Therapy
Motivational enhancement therapy (MET) is a form of therapy that serves as a brief intervention and is based on motivational interviewing techniques.
The main difference, however, is that MI only provides suggestions to the client with permission, while MET offers a meta-analysis of a client’s behaviors versus the general population.
This feedback can help clients see their behaviors in a new light, motivating them to make healthy changes. MET is typically completed in five sessions.
Benefits Of MI For Substance Abuse Recovery
There are several benefits found in the use of MI in substance use disorder (SUD) treatment.
It helps people explore their ambivalence about change, enhancing intrinsic motivation for recovery.
By building rapport and empathy between the therapist and client, it also establishes a non-confrontational, trusting, and supportive therapeutic alliance.
At the same time, MI’s person-centered approach respects clients’ autonomy, fostering a sense of empowerment and self-efficacy.
This approach aligns well with various psychotherapy modalities, contributing to improved treatment engagement, adherence, and long-term success in overcoming substance abuse.
Drawbacks To MI In Addiction Care
Though it’s a proven effective mental health treatment, motivational interviewing does have some drawbacks.
One is its potential time-intensiveness, as it requires highly skilled practitioners to effectively implement. This can lead to low retention of information in clients.
Additionally, not all people may respond equally to the MI approach, as some might require more structured interventions.
Furthermore, clients with severe drug addiction, alcohol use disorder (AUD), or cognitive impairments may find it challenging to engage fully in the process.
Combining MI With Other Therapeutic Approaches
Motivational interviewing is commonly just one of many evidence-based approaches offered in individualized treatment plans.
Below we’ve highlighted some other treatment options that may be combined with MI.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is often combined with motivational interviewing to create an integrated approach to addiction treatment.
MI helps explore the person’s own motivation for change, and CBT helps identify their harmful thought patterns and behaviors.
Together, the two bring light to what needs changing and foster the will to adopt new, healthier habits to support long-term recovery.
Incorporating motivational interviewing into 12-step programs involves enhancing intrinsic motivation for recovery and exploring ambivalence about change.
MI complements the spiritual and support aspects of the 12 steps, promoting a more personalized and client-centered approach to addiction recovery.
Dialectical Behavior Therapy
Combining dialectical behavior therapy (DBT) with MI involves integrating DBT’s emotion regulation and interpersonal skills training with MI’s focus on enhancing intrinsic motivation.
This integration offers a comprehensive approach to addressing complex emotional and behavioral challenges in addiction treatment.
Mindfulness-based interventions aim to address the whole person, including the client’s spiritual, behavioral, and emotional needs.
Addiction treatment centers may use this and other holistic approaches together with MI to enhance self-awareness and emotional regulation while exploring and strengthening motivation for positive behavior.
How Effective Is Motivational Interviewing?
Motivational interviewing has demonstrated effectiveness in addiction treatment and mental health interventions, helping people adopt healthy behaviors.
Research indicates that MI can lead to increased motivation, increased treatment engagement, and improved outcomes.
Its person-centered and collaborative approach makes it a valuable therapeutic technique in promoting positive behavior change and supporting people in achieving their goals.
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- National Library of Medicine
- Office of the Assistant Secretary for Planning and Evaluation
- Substance Abuse and Mental Health Services Administration (SAMHSA)