Motivational Interviewing in Addiction Treatment

Motivational Interviewing in Addiction Treatment

Authored by Pin Ng PhD

Edited by Hugh Soames

Reviewed by Michael Por, MD

Motivational Interviewing in Addiction Treatment

Motivational Interviewing (MI) attempts to get a drug addict or alcoholic to change their destructive behaviors. It is a therapeutic technique which addresses a person’s addiction and substance misuse. MI works by improving the strength of an individual and their motivation to reach a goal.1 In this case, the goal is to stay sober and to remain committed to clean living free of substance misuse. Often times, treatment centers and therapists find that clients lack a motivation to quit their destructive behavior. MI enables a person to uncover why their addiction started and to deal with the trauma and issues that may have created substance misuse in the first place.

Living substance-free can be a daunting task for an individual. Although they face financial, social, legal, and physical and mental health issues by using alcohol and drugs, they depend on these substances to get by on a daily basis. Giving up drugs and alcohol can feel like an impossible task in spite of the negative consequences they create. This creates a lack of motivation that cannot be overcome by addicts.

Some individuals addicted to drugs and alcohol see sobriety as an impossible target. Whether it is too difficult a target to reach or they are not ready to stop using drugs and alcohol, addicts do not want to seek help. Stopping drug and alcohol use creates uncertainty and restricts one’s desire to rid themselves of substance abuse. MI can help a person overcome the fear of giving up drugs and alcohol.

How does Motivational Interviewing work?

MI is regarded as a relatively simple procedure and can be completed in a few sessions. MI focuses on the client and attempts to figure out what the individual wants, needs, and hopes to gain by quitting drugs and alcohol. It focuses on what is best for the client rather than what the therapist or counselor believes is best. The sessions can be straightforward and involve the following steps:

Engagement – The therapist talks to the patient about their issues, concerns, desires, and hopes. This creates a trusting relationship between both parties.

Focus – The therapist will direct the conversation and narrow it down to the topic of patterns and habits that the client wants to change.

Evoke – The therapist will talk to the client about the importance for their change in behavior and habits. They will also focus the client building confidence and show that they are ready for the change in lifestyles.

Planning – The client and therapist will create practical steps that can be implement to foster the desired changes.

Why does Motivational Interviewing work?

MI focuses on a client overcoming the internal struggle they have with quitting drugs and alcohol or not quitting. Although there are clear ways to stop abusing these substances, not all addicts can or want to quit.

Clients can struggle with their decision making and that is why having motivation to stop works and keeps them from going back to a life of substance misuse.2 Clients can lose motivation to stop abusing drugs and alcohol, but with the right techniques, a therapist or counselor can use MI to create long-term sobriety.


References: Motivational Interviewing in Addiction Treatment

  1. Alterman AI, Brown LS, Zaballero A, Mckay JR. Interviewer severity ratings and composite scores of the ASI: a further look. Drug Alcohol Depend. 1994;34:201–209. [PubMed] []
  2. Ball SA, Bachrach K, Decarlo J, Farentinos C, Keen M, Mcsherry T, Polcin D, Snead N, Sockriter R, Wrigley P, Zammarelli L, Carroll KM. Characteristics of community clinicians trained to provide manual-guided therapy for substance abusers. J Subst Abuse Treat. 2002;23:309–318. [PubMed] []
  3. Carey KB, Purnine DM, Maisto SA, Carey MP. Assessing readiness to change substance abuse: a critical review of instruments. Clin Psychol: Sci Pract. 1999;6:245–266. []
  4. Carroll KM, Nich C, Sifry R, Frankforter T, Nuro KF, Ball SA, Fenton LR, Rounsaville BJ. A general system for evaluating therapist adherence and competence in psychotherapy research in the addictions. Drug Alcohol Depend. 2000;57:225–238. [PubMed] []
  5. Donovan DM, Rosengren DB, Downey L, Cox GC, Sloan KL. Attrition prevention with individuals awaiting publicly funded drug treatment. Addiction. 2001;96:1149–1160. [PubMed] []
  6. Fals-Stewart W, O’farrell TJ, Freitas TT, Mcfarlin SK, Rutigliano P. The timeline followback reports of psychoactive substance use by drug-abusing patients: psychometric properties. J Consult Clin Psychol. 2000;68:134–144. [PubMed] []
  7. Maisto SA, Mckay JR, Connors GJ. Self-report issues in substance abuse: state of the art and future directions. Behav Assess. 1990;12:117–134. []
  8. Miller WR, Mount KA. A small study of training in motivational interviewing: does one workshop change clinician and client behavior? Behav Cogn Psychother. 2001;29:457–471. []
  9. Miller WR, Zweben A, Diclemente CC, Rychtarik RG. Motivational Enhancement Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals with Alcohol Abuse and Dependence. NIAAA; Rockville, MD: 1992. []
  10. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420–429. [PubMed] []
  11. Walters ST, Ogle R, Martin JE. Perils and possibilities of group-based motivational interviewing. In: Miller WR, Rollnick S, editors. Motivational Interviewing: Preparing people for change. 2nd. New York: Guilford Press; 2002. pp. 377–390. []
  12. Wei LJ. An application of an urn model to the design of sequential controlled clinical trials. J Am Stat Assoc. 1978;73:559–563. []
Chairman & CEO at Remedy Wellbeing | Website | + posts

Alexander Bentley is the Chairman & CEO of Remedy Wellbeing™ as well as the creator & pioneer behind Tripnotherapy™, embracing ‘NextGen’ psychedelic bio-pharmaceuticals to treat burnout, addiction, depression, anxiety and psychological unease.

Under his leadership as CEO, Remedy Wellbeing™ received the accolade of Overall Winner: Worlds Best Rehab 2022 by Worlds Best Rehab Magazine. Because of his incredible work, the clinic is the world’s first $1 million-plus exclusive rehab center providing an escape for individuals and families requiring absolute discretion such as Celebrities, Sportspeople, Executives, Royalty, Entrepreneurs and those subject to intense media scrutiny.

At Worlds Best Rehab, we strive to provide the most up-to-date and accurate Addiction Recovery and Rehab information on the web so our readers can make informed decisions about their healthcare.
Our reviewers are credentialed subject matter experts specializing in addiction treatment and behavioral healthcare. We follow strict guidelines when fact-checking information and only use credible sources when citing statistics and medical information. Look for the medically reviewed badge Worlds Best Rehab on our articles for the most up-to-date and accurate information.
If you feel that any of our content is inaccurate or out-of-date, please let us know via our Contact Page