Overview of Motivational Interviewing
- Helps people work through resistance to treatment.
- Used to treat a number of addictions.
- Uses questions to help you think about how your addiction has affected your life.
- May be combined with other treatments.
- Shown to help people move forward with the recovery process.
What Is Motivational Interviewing?
Motivational interviewing is a type of psychotherapy that targets your motivation toward change by exploring the internal motivations for your behavior and resolving any ambivalence. In contrast to cognitive behavioral therapy, which focuses more on problem-solving, motivational interviewing focuses more on your attitudes and empowering you to make a change.
Motivational interviewing may be used for treating addictions to:
Further, this technique may be used to treat other mental or behavioral health conditions that occur with substance abuse disorders, such as anxiety, depression, or bipolar disorder.
How Motivational Interviewing Is Used to Treat Addiction
In the early stages of treatment with motivational interviewing, the focus is on the change process and addressing your ambivalence and resistance to change.
Ambivalence and resistance to change are part of both the addictive process as well as the treatment prescribed for addiction. Accepting this is an important facet of motivational interviewing counseling and provides you with a supportive space to explore your particular situation. You can then more openly examine the pros and cons to change and even identify underlying reinforcements to your own substance abuse.
William Miller, PhD, originally described motivational interviewing for treating problem drinkers in 1983.3 With help from Stephen Rollnick, PhD (both clinical psychologists), the ideas and techniques behind motivational interviewing were more fully developed and then ultimately published in 1991.
There are four basic principles of motivational interviewing that target an individual’s ambivalence and resistance to change: empathy for the individual, identifying discrepancies, allowing for resistance and supporting self-efficacy.
Some example questions addressing each aspect of the change process are provided in the table below.
Common Motivational Interviewing Questions:
What are examples of why you think this is a problem?
What problems have you had because of your substance use?
In what ways has your substance use prevented you from doing things you want to do in your life?
How concerned are you about this?
What are your biggest worries about your drug or alcohol addiction?
What can you imagine happening to you?
Why do you think you need to change?
What are all the reasons why you should change?
What are the things preventing you from changing?
If you decide to change, what makes you think you can do it?
What encourages you to change if you want to?
If you need to change, what do you think would work?
What to Expect in a Therapy Session
Therapy sessions typically last about 1 hour. Your therapist will likely spend the first few minutes of every session checking in on your mood and any difficulties you’re having.
This treatment approach is person-centered and, as such, treatment sessions are generally focused on difficulties you’re facing. Given that the goal of motivational interviewing is to address ambivalence and resistance to change, you are not expected to maintain abstinence while undergoing treatment, though this may be the ultimate goal of therapy.
Cost of Treatment
The cost of treatment can vary widely from program to program, and individual insurance plans will differ in terms of available coverage.
If You Have Insurance
- If you have insurance coverage, call our helpline at 1-888-892-1840Who Answers? to discuss mental health and substance abuse coverage options.
- Ask whether there will be any out-of-pocket costs and what those would be, including your deductible and any copayments required.
- When considering different treatment programs, it’s also important to ask whether that facility accepts your insurance plan.
If You Don’t Have Insurance
- If you don’t have insurance, look into programs that offer treatment fees based on a sliding scale.
- You may want to check with your state’s substance abuse agency to ask about affordable treatment options in your area.
- You may also contact the Substance Abuse and Mental Health Services Administration (SAMHSA) office of the U.S. Department of Health and Human Services. This agency offers an extensive list of certified treatment facilities.
Motivational Interviewing with Other Treatments
Motivational interviewing may be used as a standalone therapy, or as an add-on to another treatment.4
Some examples of other treatments that may be used in combination with motivational interviewing include:
Effectiveness in Treating Addiction
A number of studies have examined whether motivational interviewing is a useful tool in helping individuals with substance abuse and dependence.
Findings from these studies have provided some support for the benefits of motivational interviewing for individuals, particularly those who are initiating treatment for substance abuse or who are demonstrating some resistance to change, compared to either no treatment or comparison approaches.5
Motivational interviewing has also received support as an add-on approach to standard sessions of drug and alcohol addiction treatment.6
Drawbacks of This Approach
While motivational interviewing has received some support for its efficacy in treating a wide range of disorders, it is not for everyone.
In particular, it is recommended that individuals with very severe or long-standing histories of substance dependence or addiction seek more intensive treatment before undergoing a trial of outpatient psychotherapy with a focus of motivational interviewing.
Moreover, motivational interviewing is not recommended for those seeking detoxification.
Where to Get More Information
If you’d like to know more about motivational interviewing, or to locate a therapist in your area who is trained in motivational interviewing, visit the following websites:
Find a Treatment Program
If you’re looking for an addiction treatment program that offers motivational interviewing or another type of behavioral therapy, call 1-888-892-1840Who Answers? to speak with a treatment support specialist.
. Compton WM, Thomas YF, Stinson FS, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007;64:566-576.
. Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007;64:830-842.
. Miller, WR.; Rollnick, S. Motivational Interviewing: Preparing People to Change Addictive Behavior. Guilford; New York: 1991.
. Dutra L, Stathopoulou G, Basden SL, Leyro TM, Powers MB, Otto MW. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry 2008;165:179-187.
. Burke BL, Arkowitz H, Menchola M. The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol 2003;71:843-861.
. Dunn C, Deroo I, Rivara FP. The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction 2001;96:1725-1742.