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Published: October 17, 2024
Reviewed by Matthew N. Parker, MD
Motivational interviewing (MI) is a therapeutic approach that is being used more and more during substance abuse treatment as a way of motivating new patients.
A lack of motivation and ambivalence towards change are some of the most common barriers that prevent people from seeking the help that they need while living with a substance use disorder (SUD), but MI in addiction treatment works to help with this. And, while some people lack true internal motivation, others are simply hesitant to try because they do not believe that they can change or have tried in the past and been unsuccessful.
Read on to learn more about how motivational interviewing can help people to find the motivation and commitment they need to overcome addiction through personalized treatment, and more about how you can find this type of evidence-based therapy in rehab.
Motivational interviewing works to resolve feelings of ambivalence towards positive change through empathy, understanding, and acknowledging how difficult change can be.
Motivational interviewing is a type of therapy that works to resolve feelings of resistance and ambivalence to change negative behaviors in a person’s life.
Core principles of MI include:
Motivational interviewing is most different from other types of therapy in that it focuses on the experiences of the patient, without the therapist interjecting or imposing their own views and opinions.
MI also differs in that it is meant to be very short-term and not an ongoing process like other therapies, but is instead meant to set the stage for the use of other therapies and treatments.
It is essentially understood that a person undergoing motivational interviewing treatment will eventually progress through five basic stages of change.
Five stages of change in motivational interviewing:
While not for everyone, MI can be just what some addiction treatment patients need in order to overcome ambivalence and move forward with their treatment.
It is not uncommon for people with an SUD to be ambivalent towards behavior change. This is especially true regarding alcohol use, as the commonality and legality of alcohol make it less likely for people to view it as a problem.
MI can help with this through a process known as evoking, which encourages the patient to talk about how and why they might change, essentially helping them build their own motivation to change.
Motivational interviewing is a patient-centered engagement approach that encourages the patient to talk about themselves and their own goals, perspectives, and experiences, as well as about what motivates them.
In a way, it thus encourages patients to be their own therapists and plan their own course of treatment in a way that would best help them.
Research suggests that motivation is one of the strongest precursors to effective treatment. The use of MI has been shown to be more effective than no treatment and as effective as other forms of treatment.
Furthermore, studies have also shown concrete evidence for MI’s effectiveness when treating both marijuana addiction and gambling addiction, while more research is needed to show its effectiveness on other forms of addiction.
Motivational interviewing is becoming more commonplace in rehab centers and is often combined with other types of addiction treatment services such as behavioral health therapies, detox, medication-assisted treatment (MAT) for opioid disorders, and aftercare.
Motivational interviewing is most often used in addiction treatment programs at the very beginning before more intensive treatments and services begin. This is done in part to help with drafting an individualized treatment plan, and also to prepare the patient for what is to come as they progress through treatment or enter hospitalization.
While MI in rehab centers is meant to exist as a conversation between patient and therapist, it does follow certain rules of structure.
Motivational interviewing is based on four common techniques:
Motivational interviewing is an important step in healthcare settings for helping providers to create individualized treatment plans for patients.
This is because the process of MI allows providers to understand the patient’s own perspective as well as their own goals and motivations, which can then be used to create a tailored and empowering treatment plan for them.
Motivational interviewing has proven to be beneficial for a variety of conditions and mental health disorders but may be most beneficial for people in certain situations.
Motivational interviewing can be used to treat people with substance use disorders at most stages, including prevention, in combination with other therapies, as a stand-alone therapy, or before they begin more intense treatment, such as an inpatient program.
It is often used with patients who are ambivalent about their substance abuse and don’t see a need for change, but who have friends and family who are concerned about them.
Motivational interviewing can also be very beneficial to people who are suffering from mental health issues at the same time as their drug or alcohol addiction, in a type of treatment known as dual diagnosis treatment.
Mental health conditions that MI is most effective with include anxiety disorders, depression, and eating disorders. It can also be helpful with health conditions such as chronic pain and weight loss or gain.
Many of the people who enter a recovery center have already experienced multiple relapses and are either resistant to change or have given up on the belief that they can change.
Motivational interviewing can help with this resistance to change by putting people in charge of their own plans and goals while taking in their own perspective and the things that truly motivate them to change.
Every addiction treatment center is different, however, motivational interviewing programs tend to follow specific standards and patterns so that certain rehab center expectations can be met.
The initial assessment with MI is done to give the therapist an idea of what the patient needs in order to be successful, motivated, and committed to their treatment.
After this is established, the therapist and other members of the treatment team can put together a solid plan for the types of treatments and therapies that would be most appropriate for that individual.
Therapists who use motivational interviewing are typically specially trained in this technique so that they know the right questions to ask and how to respond accordingly.
They are also trained in active listening techniques so that they know how to participate in a way that is present and appropriately responsive and so that their patients feel respected and truly listened to.
Motivational interviewing can be used in group therapy settings as well as individual therapy settings, offering the benefits of both shared experiences and peer support. A group setting can also help with the skill-building aspect of MI, as it encourages communication and improves social skills among participants.
Not all rehab centers offer motivational interviewing as an option, but finding one that does can be a relatively simple process for those who are interested.
When researching rehab centers that offer motivational interviewing, it is always a good idea to visit facilities in person, so that you can ask questions or address any concerns that you have.
This is especially true when starting inpatient treatment, as you will be spending a significant amount of your time there and will want to make sure that it feels comfortable and safe.
When seeking an addiction treatment center, you will want to make sure that any potential facility is accredited and licensed by the state, and that it holds memberships or certifications with relevant addiction treatment organizations.
You should also ensure that staff members are properly licensed and that all motivational interviewing therapists are specifically trained to perform this therapeutic technique.
To ensure that you are choosing the right alcohol and drug abuse program, it can be helpful to prepare questions in advance when visiting potential facilities.
Questions to ask potential rehab programs include:
Motivational interviewing and cognitive behavioral therapy are often used together, though it is important to remember they have several differences as well as characteristics in common.
Motivational interviewing and CBT are quite different counseling approaches but can be used together successfully to treat alcohol and drug addiction or other mental health conditions.
The main difference between these two approaches is that MI focuses on enhancing a person’s motivation to change, while CBT focuses on identifying and changing patterns of negative thoughts and behaviors. They also differ in method and approach in that MI uses open-ended questions and reflective listening to accomplish its goals while CBT uses structure, problem-solving, and skill teaching as its main components.
Motivational interviewing is often more effective as a form of initial engagement and for encouraging and empowering patients toward positive change. In this sense, it may be more helpful in patients who are resistant or hesitant towards change, or who are having trouble gathering the motivation to get started.
Motivational interviewing is frequently combined with other types of therapy and treatment services, including holistic care options. Combining therapies is most effective when MI is used first to lay the groundwork for what is to come with additional therapies, as this increases both the MI effectiveness and the effectiveness of the other therapies.
Holistic care options that you might find used along with motivational interviewing are art and music therapy, pet-assisted therapy, yoga and meditation, and breathing exercises.
Family members and loved ones often play a vital role in motivational interviewing, and it is not uncommon for family therapy to take place along with individual therapy sessions.
Family support can enhance MI treatment, especially in those who are ambivalent to treatment and do not see a need for change. In fact, it is not uncommon for family members to be the ones to suggest MI in the first place.
Oftentimes, however, when a patient knows that they have their family’s support throughout the process, it can make them more easily motivated toward the change that MI seeks to inspire.
Enhancing the family role in MI can be a beneficial tool in the recovery process, as it allows families to both address past traumas and create healthier dynamics for future interactions.
By allowing for family support in recovery, family wounds can be healed, communication can be improved, and families can better understand and support each other through the recovery process and after.
Motivational interviewing has been found to have a profound impact on families, especially on couples and within intimate relationships, as it can emphasize the role of communicating in therapy.
This is because, as often is the case with family or couples counseling, one of the participants may be hesitant to participate. MI treatment outcomes can be improved by providing motivation and encouraging people to find their own solutions to address the change they want to see.
Choosing to enter a rehab program is a big and important decision, and it is equally important to ensure you are choosing the right program for yourself.
You can take a few simple steps when you are ready to begin enrolling in an MI rehab program.
Steps when entering a rehab center with MI include:
During the first motivational interviewing session, you can expect to first and foremost work on developing a rapport with the therapist, as it is essential to build trust for this type of therapy to work.
You can also expect to answer a series of open-ended questions, talk about your experiences, and work on setting collaborative goals with the therapist.
When starting MI-based rehab, it can be helpful for some people to access additional resources and support so that they have a better understanding and stronger foundation.
This can mean joining support groups either online or in-person, as well as reading books, listening to podcasts, or visiting websites that focus on motivational interviewing.
The following are frequently asked questions about motivational interviewing.
Motivational interviewing is effective for addiction treatment because individuals who enter treatment are often ambivalent to treatment and see no reason to change, especially if they were forced into treatment by the courts or their family.
MI can then help them to become more motivated to see what is wrong with their behavior and what they need to do in order to change for the better and achieve long-term recovery.
Motivational Interviewing is meant to be a short-term form of treatment, and typically only lasts for one or two sessions.
Yes, motivational interviewing is often combined with medication-assisted treatment as well as with other types of counseling and addiction treatment services. Other types of treatment that can be combined with MI are psychotherapy, medical detox, cognitive behavioral therapy, and group therapy.
Yes, motivational interviewing is a form of mental health treatment that is often covered by health insurance. However, some locations may only cover this service partially or with certain insurance policies, so it is always a good idea to check in advance.
While not all drug and alcohol rehab centers offer motivational interviewing as a therapeutic approach, it can be an excellent option for people with a variety of substance use disorders and mental health conditions.
If you have already decided that this is a treatment approach you would be looking to take, RehabNet.com can connect you with providers and treatment centers in your area that are offering it.
For more information about rehab facilities in your area offering motivational interviewing and more, call us on our helpline today.
Centers for Disease Control and Prevention (CDC). “Motivational Interviewing to Help Your Patients Seek Treatment.”
National Library of Medicine. “Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice.”
National Library of Medicine. “Motivational interviewing for substance abuse.”
National LIbrary of Medicine. “Training Providers in Motivational Interviewing to Promote Behavior Change.”
Psychology Today. “Motivational Interviewing.”
Substance Abuse and Mental Health Services Administration (SAMHSA). “Using Motivational Interviewing in Substance Use Disorder Treatment.”
Medically reviewed by
Matthew N. Parker, MD Medical Advisor
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