Motivational interviewing (MI) is a counseling style that facilitates meaningful conversations with patients about their health.
Originally developed to treat alcohol addiction, MI helps individuals examine whether they want to change a health-related behavior, consider how to approach that change, and, most importantly, discover their personal โwhyโ for making it.
MI has demonstrated success in smoking cessation, with nearly 85% of participants reporting less nicotine dependence. If you are interested in following this therapy option for addiction treatment, keep reading to learn about how motivational interviewing reshapes addiction recovery.
Table Of Contents:
- What is Motivational Interviewing?
- How Does Motivational Interviewing Work?
- What Are The 5 Principles of Motivational Interviewing?
- Other Motivational Interviewing Techniques
- Effectiveness of Motivational Interviewing
- Motivational Interviewing Near Me
- Getting Started with Addiction Therapy
- People Also Ask
What is Motivational Interviewing?
Motivational Interviewing (MI) is a therapeutic communication style designed to help individuals tap into their motivation for making positive behavioral changes during addiction treatment.
Developed by clinical psychologist Dr. William R. Miller in the 1980s, Dr. Miller noted that a non-confrontational, empathetic approach was more effective at reducing drinking levels among alcoholics than traditional, directive outpatient treatment.
Motivational interviewing is built on the idea that change is more likely when individuals feel understood and empowered. By fostering an open, patient-centered conversation, MI helps people explore their ambivalence toward change, identify their reasons for shifting, and strengthen their commitment to positive actions.
How Does Motivational Interviewing Work?
Motivational Interviewing (MI) works by guiding individuals through a structured yet empathetic conversation that strengthens their motivation for change.
It is designed to help people explore their ambivalence about changing behavior and to build the self-confidence needed to make that change. The process involves four key steps, or โprocesses,โ conducted within a supportive climate of compassion, acceptance, partnership, and empowerment.
Hereโs how each process of MI works:
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Engaging
This first step focuses on building a trusting relationship. Practitioners use active listening and empathic communication to create a safe space, making patients feel valued and understood. Effective engagement establishes a collaborative partnership and encourages open dialogue.
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Focusing
In this stage, the practitioner and patient work together to clarify the patientโs goals, concerns, and priorities. This shared focus helps set a clear agenda for the conversation, ensuring that both parties are aligned on what the patient wants to achieve and addressing their unique needs.
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Evoking Motivation
This core process involves drawing out the patientโs motivations for change. Through techniques like โsoftening sustain talkโ (reducing resistance to change) and โcultivating change talkโ (encouraging expressions of desire, ability, or reasons for change), practitioners help patients resolve ambivalence and recognize their motivations for healthier behaviors.
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Planning for Change
The focus shifts to action planning once the patient is ready to commit to change. Practitioners support patients in setting specific, achievable goals and developing concrete steps to achieve them. This collaborative goal-setting reinforces the patientโs commitment and provides a roadmap for sustainable behavior change.
Each process in MI is designed to empower individuals by encouraging them to articulate and act on their reasons for change. No matter how much the therapist motivates you to change if you do not want to in the first place.
What Are The 5 Principles of Motivational Interviewing?
In addition to the processes, MI involves a series of principles designed to establish a supportive, collaborative relationship between a therapist and a patient.
These principles help the patient develop a cheerful outlook toward change and create a foundation of trust and respect. Just as successful outcomes in therapy often stem from a strong, empathetic relationship with the therapist or the addiction specialist, these principles guide the process by fostering understanding and encouraging self-efficacy.
The 5 principles of MI are as follows:
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Express Empathy
The practitioner creates a safe, respectful environment through active listening and empathetic communication. This principle is crucial for building trust and encouraging open dialogue, as patients feel understood and accepted without judgment.
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Develop Discrepancy
This principle involves helping individuals recognize the gap between their current behaviors and personal goals or values. By pointing out these discrepancies gently, the practitioner encourages patients to see the benefits of change, which can foster internal motivation.
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Avoid Argumentation
Rather than confronting resistance directly, MI practitioners โroll with resistance.โ This principle discourages confrontational or directive tactics and instead uses a collaborative approach to reduce defensiveness, allowing patients to explore their ambivalence at their own pace.
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Support Self-Efficacy
MI emphasizes the belief that change is possible and that the individual can achieve it. By encouraging self-confidence and celebrating small successes, practitioners help individuals believe in their capacity to make positive changes.
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Roll with Resistance
When patients resist change, MI practitioners do not push back; instead, they use strategies like reflective listening to understand the patientโs perspective. This approach helps patients feel respected and reduces defensiveness, making them more open to discussing potential changes.
Other Motivational Interviewing Techniques
Another set of core techniques fosters a productive and compassionate therapeutic relationship, helping patients explore and resolve their ambivalence toward change.
One of the key frameworks used in MI is the acronym OARS, which stands for Open Questions, Affirmations, Reflective Listening, and Summarization. These techniques also guide the interaction and ensure that patients feel understood and empowered throughout the process:
Open Questions
Open questions encourage patients to share their thoughts, feelings, and experiences, providing valuable insights into their goals, values, and beliefs. These questions invite deeper reflection and promote dialogue. For example:
- โWhat was it like when you were drinking a 12-pack of beer every day?โ
- โCan you tell me more about how using cocaine affected your marriage?โ
These questions help the provider meaningfully understand the patientโs life and struggles, fostering a collaborative, patient-centered conversation.
Affirmations
Affirmations are expressions of genuine appreciation and recognition of the patientโs strengths, whether they are openly shared or subtly expressed. This technique boosts patients’ confidence and self-esteem, reinforcing their positive behaviors and progress. For instance:
- โYou got discouraged last week but kept going to your AA meetings. You are persistent!โ
- โThatโs a good idea for avoiding situations where you might be tempted to drink.โ
Affirmations create a positive reinforcement loop, helping patients recognize their strengths and resilience.
Reflective Listening
Reflective listening is one of the most crucial elements of MI. It involves restating or paraphrasing what the patient has shared to confirm understanding and validate their experience. By reflecting on the patientโs thoughts or emotions, the provider demonstrates empathy and helps them process their feelings more deeply.
For example, if a patient shares:
- โIt can be tough to deal with Dave when heโs stressed and has been drinking.
The provider might respond with:
- โWhen Dave gets stressed out and drinks, it makes it harder for you to pick the kids up from school on time.โ
- โIt can be very frustrating when Dave gets stressed out and drinks. Then, when you canโt pick the kids up on time, you feel like youโre being a bad parent.โ
These reflections allow the patient to clarify and confirm that the provider understands their perspective, promoting trust and deeper insight.
Summarization
Summarization involves distilling critical points from the conversation to ensure the provider fully understands the patientโs experience and to guide the direction of the discussion. Summarizing helps reinforce what has been discussed and can be used to focus on important aspects of the patientโs situation, offering a concise recap of the session.
For example:
- โOkay, let me make sure I understand. Youโre interested in attending some AA meetings, but your only free time is after work, and someone else would have to pick up the kids. Do I have that right?โ
Skilled MI providers use summaries throughout a session to confirm understanding and provide clarity, helping patients feel heard and ensuring alignment in the conversation.
Effectiveness of Motivational Interviewing
In approximately 80% of studies, psychologists and physicians achieved significant results with MI, and even brief 15-minute sessions were effective in 64% of cases.
For instance, MI has shown varying effectiveness depending on the targeted behavior. MI has proven to be most effective in helping individuals reduce or eliminate behaviors considered harmful to health, such as:
- MI has been successful in helping patients reduce binge drinking and frequency of drinking.
- Studies have shown MI to be beneficial in helping people quit smoking.
- MI has shown positive outcomes in reducing substance use.
For gambling addiction, the evidence is still low in quality but suggests that MI may have some beneficial effects in the short and long term.
MI has since gained widespread application across fields, proving effective in addiction recovery, chronic disease management, and health behavior changes. This approach underscores how counseling that centers on empathy and collaboration can profoundly impact lasting behavior change.
Motivational Interviewing Near Me
Finding the right support can make all the difference in the journey to overcoming addiction or building healthier habits. Follow the tips below for a faster pathway into recovery:
- Ask your primary care provider for recommendations for local therapists specializing in MI.
- Search online directories like Psychology Today for a list of professionals in MI.
- Check with local health clinics for referrals to mi-trained therapists.
- Contact addiction support groups for information on MI resources in your area.
- Look for licensed counselors and social workers with specific training in MI techniques.
- Verify experience in MI by checking professional profiles and client reviews for insight.
Getting Started with Addiction Therapy
Motivational Interviewing (MI) has become a valuable tool for strengthening patients’ motivation and commitment to making positive health changes, especially in behaviorally influenced conditions like drug addiction, smoking cessation, and chronic illness management.
Through its person-centered, non-confrontational approach, MI creates a supportive environment where individuals feel empowered to explore their intrinsic reasons for change. MI respects each patient’s unique journey and fosters lasting change that feels personally meaningful.
If you or a loved one are ready to take the next step toward addiction support, consider reaching out to a local rehab center for more information on MI.
People Also Ask
Who created motivational interviewing?
Psychologist William R. Miller developed Motivational Interviewing in the early 1980s, inspired by his research on non-confrontational counseling methods for reducing alcohol consumption among individuals with alcohol use disorders.
For what is motivational interviewing used?
Motivational Interviewing helps enhance patients’ motivation to change behaviors. It is often used in addiction treatment, chronic disease management, mental health, and improving adherence to medical recommendations.
What is change talk in motivational interviewing?
Change talk refers to patient statements expressing desire, ability, reasons, or commitment to change, which MI practitioners encourage to strengthen motivation and resolve ambivalence toward behavior change.
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Page Sources
- Okasha, T., et al. (2017). Motivational interviewing for smoking cessation in patients with cardiac diseases. https://www.semanticscholar.org/paper/Motivational-interviewing-for-smoking-cessation-in-Okasha-Fatah/dd6ac3986fce4fdda194f840b7050c283826b04b
- Khanfer, R., et al. (2012). Motivational interviewing. In Springer eBooks (pp. 1263โ1264). https://doi.org/10.1007/978-1-4419-1005-9_656
- Cole, S. A., Sannidhi, D., Jadotte, Y. T., & Rozanski, A. (2023). Using motivational interviewing and brief action planning for adopting and maintaining positive health behaviors. Progress in Cardiovascular Diseases, 77, 86-94. https://doi.org/10.1016/j.pcad.2023.02.003
- Substance use disorders: Motivational interviewing - UpToDate. https://www.uptodate.com/contents/substance-use-disorders-motivational-interviewing#H10072449
- Substance Abuse and Mental Health Services Administration. (2021). Using Motivational Interviewing in Substance Use Disorder Treatment. Advisory. https://store.samhsa.gov/sites/default/files/PEP20-02-02-014.pdf
- Berger, B. A., & Bertram, C. T. (2015). Motivational Interviewing and Specialty Pharmacy. Journal of Managed Care & Specialty Pharmacy, 21(1), 10.18553/jmcp.2015.21.1.13. https://doi.org/10.18553/jmcp.2015.21.1.13
- Frost, H., et al. (2018). Effectiveness of Motivational Interviewing on adult behavior change in health and social care settings: A systematic review of reviews. PLoS ONE, 13(10), e0204890. https://doi.org/10.1371/journal.pone.0204890