Motivational Interviewing (MI) in Addiction Treatment

What Is Motivational Interviewing (MI)?

Motivational interviewing (MI) is a person-centered counseling approach that helps people resolve their doubts about treatment and increase their willingness, or motivation, to change.¹ MI techniques can help increase your engagement with treatment, intent to change behaviors, and confidence to make behavioral changes.^2,3

Studies show that MI can be effective in changing drinking behaviors, such as the amount someone drinks and how often they drink, as well as reduce tobacco and other substance use.⁴

How Does Motivational Interviewing Work?

Motivational interviewing works by putting you in charge of the changes you want to make.⁵ It differs from other therapy approaches in that the goal is to help you address your doubts about and motivation to change.¹ Specifically, MI works on increasing your intrinsic, or internal, motivation. Intrinsic motivation is driven by your wants, needs, values, and goals.¹ Exploring these elements is linked to enhanced motivation, which can help you change your substance use or other health-related behaviors.¹

MI therapists use specific processes and techniques to do this, which we’ll explore more below.

The Four Processes of Motivational Interviewing

The MI approach is based on 4 key processes that guide treatment:^1,5

• Engaging: The therapist works on building a relationship with you that is based in mutual trust and respect, so you feel comfortable sharing your experiences.
• Focusing: You work with your therapist to identify the behaviors you want to change and set the direction of your conversations.
• Evoking: This process sets motivational interviewing apart from other therapy approaches by having you, not the therapist, suggest the changes. The therapist asks questions that evoke, or draw out, the reasons you want to change and helps reinforce your motivation for doing so.
• Planning: In this part of the process, you decide how you will make a change. That is, what specific steps will you take to meet your stated goal?

OARS in Motivational Interviewing

In addition to the 4 key processes of motivational interviewing, your therapist will use some core counseling techniques. Therapists may better remember the core MI skills by the acronym OARS:^1,3,5

• Open-ended questions: The therapist asks questions that can’t be answered with a simple “yes” or “no.” This helps your therapist understand your values and goals. An example of an open-ended question is: “What do you think you want to do about your drinking?”
• Affirmations: The therapist notices and genuinely appreciates your strengths and efforts made toward change. An example of an affirming statement is, “You have worked really hard to get where you are.”
• Reflective listening: Sometimes also called “active listening,” reflective listening expresses empathy and can help clarify your thoughts and feelings. The therapist rephrases what you tell them in a way that shows you they understand your feelings and values. In this way, they can help guide you toward change without directly telling you what to do.
• Summarizing: This is a type of reflective listening where the therapist summarizes the content of a conversation back to you in a meaningful way. This gives you a chance to reflect and make sure the therapist presented an accurate summary, as well as correct any misinformation or add other important details.

How Effective Is Motivational Interviewing for Substance Use?

Motivational interviewing was developed specifically to help people with problematic alcohol use change their drinking behaviors.⁴ In one study that looked at results from many studies over the years, roughly 75% of people who took part in MI saw some form of improvement.² Overall, the scientific support for MI suggests that it is effective in making positive behavioral changes related to alcohol, tobacco, and cannabis.^1,4

Benefits of Motivational Interviewing

The benefits of motivational interviewing include:¹

• Enhancing motivation for behavior change.
• Preparing you to engage in treatment.
• Staying in treatment for longer.
• A reduction in alcohol, tobacco, and cannabis use.
• A decrease in alcohol-related problems.
• Being a cost-effective counseling approach.
• Ease of pairing with other evidence-based treatment approaches.

How to Find Motivational Interviewing Therapy for Substance Use

Many addiction treatment programs incorporate aspects of motivational interviewing, including American Addiction Centers (AAC). AAC has treatment centers across the United States. If you’re ready to change your substance use and want to learn more about your options, call the AAC helpline at , or get started online by filling out the form below.