The Principles Of Motivational Interviewing
As a form of therapy, Motivational Interviewing, while established on a foundation prioritizing a set treatment process and spirit of being, is still a very personal experience. Thus, particularly when used as a form of substance abuse treatment, this technique emphasizes a need to adhere to certain principles in its approach to treating clients, including:
- Expression of Empathy
- Support of Self-Efficacy
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Motivational Interviewing For Addictions: Improving Motivation To Change
Jessica Payne, LMSW, CAADC
Jessica Payne, LMSW, CAADC, is currently in the final year of her Doctorate of Clinical Psychology. She has previously earned a Master of Arts in Clinical Psychology and a Master of Social Work. She is a Licensed Master of Social Work and Certified Advanced Alcohol and Drug Counselor in the State of Michigan. Her work experiences include a: school social worker, hospice medical social worker, co-occurring substance abuse counselor, private practice therapist, and an emergency mental health evaluator.
Reading Time: 7minutes
Motivational interviewing is a collaborative therapy type to strengthen your motivation and commitment to make a change.1 Motivational interviewing for addictions was developed specifically to improve motivation to change and enter substance abuse treatment. Research has shown it is effective in helping people cut down and stop the use of alcohol, drugs, and tobacco.
In this Article:
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Motivational Interviewing For Addiction Recovery
Motivational interviewing for addiction recovery entails a unique blend of techniques that help people develop autonomy and self-sufficiency in sobriety.
Motivational interviewing for substance abuse treatment has become one of the most common addiction therapy techniques used by mental health specialists.
This approach is adaptive to a wide spectrum of substance abuse patterns and histories, and is designed to be flexible for different levels of addiction treatment.
Evidence of successful clinical results and outcomes supports the efficacy of motivational interviewing for clients who have difficulty accepting transitions in recovery.
Does Motivational Interviewing Work
Motivational interviewing is an evidence-based therapy that has proven effective for many.
It tends to be more effective in one-on-one versus group health care settings, and its effectiveness may depend on a range of personal factors, including the counselor, and patients receptiveness to counseling and behavior change.
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Motivational Interviewing In Drug Rehab
Motivational interviewing is a form of counseling that can serve as one component of a full rehab program for drug or alcohol addiction.
Overcoming addiction requires a holistic approach that takes into account the physical, emotional, and psychological aspects of substance misuse.
A full addiction treatment plan may include:
Motivational interviewing may also be found through an individual counselor, primary care provider, or counseling center.
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Collaboration Instead Of Confrontation
Collaboration is a partnership formed between the counselor and the client. In motivational interviewing, this relationship is based on the point of view and experiences of the client.
This approach contrasts with some other therapeutic approaches, specifically those in which the counselor is confrontational and imposes their own point of view about their client’s behavior.
Collaboration builds rapport between the therapist and the client. It allows the client to develop a trusting relationship with their counselor, something that is difficult to do in a more confrontational environment.
Benefits Of Motivational Interviewing For Drug Addiction
Motivational Interviewing is effective because it works fast, is more affordable than other therapeutic approaches, and results in a longer commitment to treatment.
For some, progress occurs after just two to four sessions.
This is much faster than many other approaches. There is also evidence that MI reduces risky behavior in people and increases the likelihood of someone to stay in addiction treatment longer. This improves their odds of successful long-term recovery.
One of the reasons MI is effective is because it acknowledges how contradictory the mind can be.
A person might want to change, but thoughts and actions prevent change from occurring. The MI approach helps a person get past mental and emotional roadblocks, as long as a person is ready to improve.
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The Four Processes Of Motivational Interviewing
Motivational Interviewing is described by its founders, Dr. William Miller and Dr. Stephen Rollnick, as a therapeutic tool intended to be used in addition to other forms of therapy or addiction treatment. MI is meant to inspire change in clients who may otherwise feel reluctant to do so. To achieve this, Dr. Miller and Rollnick formulated 4 client-centered processes to help patients identify their goals and begin to work towards them. They are as follows:
This is a good way of being with people, that helps people be less defensive, less resistant, and more able to think about how to make changes and move in that direction.
– Dr William R. Miller, founder of Motivational Interviewing
While conversations during this phase can concern goal setting and other topics regarding change, this is not the focus of the engaging process. The therapist should prioritize developing rapport with their patient, reducing their resistance/defensiveness, and resolving some uncertainty about the recovery process. While engaging, the practitioner strives to create an environment that is comfortable for the client and helps facilitate change talk.
When To Use Motivational Interviewing
Motivational Interviewing as a method of counseling is especially effective for alcohol addiction. Research shows that because of the greater social acceptance and the legality of alcohol use, people with alcohol use disorders tend to be more ambivalent regarding their addiction. According to a study out of Utah published in the Journal of Clinical Psychology, MI is up to 20% more effective that other methods of treatments when addressing alcohol use disorder.
Due to its continuous success, MI is becoming more commonly used to address other substance and behavioral addictions as well as mental illness. These include gambling addictions, eating disorders, internet addiction, and low self-esteem. MI can also be used to increase motivation for positive behaviors, like healthy eating and exercise.
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Motivational Interviewing For Addiction Treatment
Motivational Interviewing is a therapeutic technique used to address addiction and substance use disorders in patients by strengthening ones motivation and commitment to a particular goal, such as sobriety. When battling an addiction, one of the most difficult hurdles to overcome is a lack of motivation. Many people develop an addiction as a coping mechanism to deal with other traumas or other issues that stem from their everyday life.
Despite the inevitable health issues, financial costs, and social and legal consequences of substance abuse, the idea of living without drugs or alcohol can be intimidating. The idea of giving up ones drug of choice can outweigh these negative consequences, ultimately resulting in a lack of true motivation to get sober. For others, a pessimistic attitude keeps them from recovery. They feel like sobriety is not a realistic goal, that they do not need to quit because they arent ready, or it will be too hard. Motivational interviewing helps people overcome their fears or uncertainty, fostering patients ambition to get sober and begin their journey to recovery.
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Rule: Guidelines For Motivational Interviewing
Miller and Rollnick have also outlined some more basic rules for Motivational Interviewing. These rules can be applied in a range of health care contexts.
- Understand the patients motivations
- Listen with empathy
- Empower the patient
Just as with patients who have substance abuse disorders, RULE recommends a similar approach in other contexts. It pushes the idea of helping the patient to help themselves. It also warns against judgement or the righting reflex.
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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 youre having.
This treatment approach is person-centered and, as such, treatment sessions are generally focused on difficulties youre 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.
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Motivational interviewing is just one of the many tools at our disposal at Granite Mountain Treatment Center. Our beautiful Prescott, Arizona campus offers both inpatient and outpatient treatment options. We are taking great measures to maintain high cleanliness and safety measures amid the ongoing COVID-19 pandemic.
Our licensed and professional counselors are ready to assist you with every step in the treatment process-from detox to reintegration plans that work for your life and schedule. If you or a loved one are struggling with addiction, call Granite Mountain today to begin your journey to sobriety.
Article Reviewed by Kyle Schwartz
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Benefits Of Motivational Interviewing For Treating Addiction
The effectiveness of motivational interviewing for people in the process of overcoming addiction, as well as other health conditions, has been well-established through clinical trials.
Some effects and benefits of motivational interviewing include:
- helps counselors build stronger connections with their patients
- can support self-efficacy and confidence
- can help resolve ambivalence about changes required in recovery
- promotes supportive coping strategies
- can demonstrate positive effects in a short period of time
- can help to reduce substance use/promote abstinence
- can increase treatment retention
- increase likelihood of patients engaging in follow-up services
Motivational Interviewing And Enhancement Therapies
Motivational Interviewing is a counseling approach designed to help individuals resolve ambivalence about their alcohol and/or drug use, and support efforts to change it.
Motivational Interviewing is often delivered as a brief intervention based on client-centered principles. Guided by these principles, MI emphasizes strategic use of common counseling skills, such as reflective listening, summarizing, and paraphrasing.
Advice is typically only given on request, and with patient permission. MI is also sometimes combined with other types of interventions in order to enhance treatment retention and engagement.
Motivational Enhancement Therapies are interventions based on the MI approach and practices. Unique to METs is the use of clinically-relevant patient reported assessment data that is summarized and subsequently fed back to the patient in an MI, client-centered counseling style in order to enhance motivation for change.
WHAT HAPPENS IN MOTIVATIONAL INTERVIEWING AND MOTIVATIONAL ENHANCEMENT THERAPY?
The aim of the combined Motivational Interviewing and Motivational Enhancement Therapy is to increase patient motivation and commitment to reduce or quit using substances usually over the course of 3 to 4 sessions. With this increased commitment to change, the patient is believed to be able to mobilize their own internal and external resources to facilitate change.
Examples of commonly-used open-ended questions MET providers might ask to evoke change talk include:
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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.
Motivational Interviewing And Treatment Resistant Addiction
Motivational Interviewing has shown to be a highly effective form of treatment and often helps patients who have relapsed or not had good results with other forms of therapy such as cognitive behavioral therapy. When seeking treatment, a lack of motivation can make staying on task and valuing long-term results quite difficult. MI helps patients hold themselves accountable during and after treatment. It is also helpful for patients looking for a close relationship with their counselors, as opposed to the sometimes cold, stark, and strictly professional relationships patients form with therapists during other forms of treatment. MI places a high value on the trusting and empathetic relationship between clients and their counselors, providing a lot of support and validation towards patients and their feelings.
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Limitations Of Motivational Interviewing
As stated, Motivational Interviewing is most effective when used in addition to other forms of treatment and therapies. It does not address any of the underlying reasons for an addiction, which is very important to confront for successful results. MI also does not address co-occurring disorders, when a patient has both a substance use disorder in addition to some other diagnosed mental illness or trauma that requires treatment and attention. In some cases, if there are severe underlying mental health issues, trying to inspire interpersonal motivation would be completely futile. This is particularly problematic for individuals with major depressive disorders, which are often characterized by a lack of motivation. Additionally, patients who lack the ability to focus on the concept of pros and cons are unlikely to be helped by MI. This may include patients with severe mental illnesses such as bipolar disorder, schizophrenia, or individuals with intellectual or developmental disabilities.
Stages Of Change In Motivational Interviewing
The stages of change or transtheoretical model is part of the motivational approach. This is an alternative to confrontational approaches that can provoke resistance and adversity.
The stages of motivational interviewing are designed to be cyclical and sequential, and flexible enough that they can be individualized for optimal success in treatment.
Each stage represents the mindset of a person as they gradually approach self-acceptance and the realization that sobriety can help them achieve their goals.
Precontemplation and contemplation entail coming to terms with the consequences of addiction, with the encouragement of unconditional positive regard from a therapist.
Once someone moves into preparation and action, they become more self-aware and motivated to set intentions for themselves as their perspective on sobriety evolves.
The maintenance phase focuses on the continuity of healthy behaviors and thoughts. This is an ongoing process of staying in the present, sustaining positive recovery, and dealing with relapse.
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Motivational Interviewing In Substance Abuse Treatment
Motivational interviewing is a therapeutic modality that is commonly used for the treatment of substance abuse and drug addiction. This type of therapy can help address barriers to recovery and support self-efficacy through various stages of change.
Motivational interviewing is a scientifically-based counseling approach that is commonly used for the treatment of alcohol abuse, drug abuse, and drug addiction.
First developed by clinical psychologists Stephen Rollnick and William R. Miller, motivational interviewing is a collaborative, goal-oriented modality.
Goals of this counseling style include addressing barriers to addiction recovery, such as resistance to change, and increasing intrinsic motivation for maintaining recovery.
Here youll find information on:
- how motivational interviewing works
- examples of motivational interviewing techniques
- benefits of motivational interviewing
- where to find motivational interviewing for addiction
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The Assumptions Behind Motivational Interviewing
One of the main goals of Motivational Interviewing is to overcome ambivalence. Ambivalence means being in two minds about something, in this case, substance abuse.
Often those with substance abuse problems will know, on some level, that their drug abuse is bad for them. However, they may not have fully accepted that fact. It may be useful for them to deny it to themselves. MI tries to help people work through this ambivalence.
There are a few assumptions that underpin this way of looking at addiction recovery. They are:
Understanding these assumptions is key to understanding MI. It is all about helping the client to help themselves.
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