Unlocking the Power of Motivational Interviewing for Positive Change
By We Level Up | Author Alex Evans, PharmD, MBA | Editorial Policy | Research Policy
Motivational interviewing is a counseling approach that helps people make positive changes in their lives. It’s a collaborative process where you work with a therapist to explore your goals and values. Through open-ended questions and reflective listening, the therapist helps you build motivation and commitment to change.
With motivational interviewing, the therapist acts as a supportive guide, helping you identify your own reasons for change and develop a plan of action that aligns with your values and priorities.
This approach has been shown to be effective for a wide range of issues, from substance abuse and addiction to chronic disease management and mental health concerns. Here, we’ll learn more about motivational interviewing.
Key Takeaways
- Motivational interviewing is a collaborative, non-judgmental approach that helps people make positive changes by exploring their own motivations and values.
- Key principles of motivational interviewing are expressing empathy, developing discrepancy, rolling with resistance, supporting self-efficacy, and engaging in collaborative conversation.
- Motivational interviewing uses specific techniques like open-ended questions, reflective listening, and the OARS and DARN-C models to evoke change talk and strengthen commitment to positive transformation.
What is Motivational Interviewing?
We Level Up Treatment Centers offer Motivational interviewing at select locations. Motivational interviewing (MI) is a counseling approach to motivate clients to change destructive behaviors. MI was first described by Professor William R. Miller, Ph.D., in an issue of Behavioral Psychotherapy in 1983. Call to learn about the We Level Up Motivational Interviewing program availability. Motivational Interviewing facilities and treatment are subject to change.
This technique is often used for substance use disorders as a lack of motivation to quit can be one of the most significant barriers for individuals struggling with addiction, despite health issues and financial, social, and legal consequences.
The thought behind motivational interviewing is that all individuals dealing with substance use are at least partially aware of the negative consequences of addiction. Each individual is also currently in a particular stage of readiness when changing their behavior. The MI therapist facilitates getting “ready to change” by overcoming ambivalence or a fear of change, increasing the client’s motivation.
What is Motivational Interviewing Used For?
Motivational interviewing is a versatile approach that can be applied to various mental health concerns and behavioral challenges. It’s particularly effective in helping people make positive changes and overcome obstacles in their lives.
Motivational Interviewing for Addiction Treatment
Motivational interviewing is widely used for substance use disorders. It helps people explore their ambivalence about change and develop intrinsic motivation to overcome substance abuse.
By using open-ended questions and reflective listening, therapists guide clients to identify their own reasons for change. This approach is especially beneficial for those who may be resistant to traditional confrontational methods. Motivational interviewing has been shown to increase treatment engagement, reduce substance use, and improve long-term outcomes in addiction recovery.
Motivational Interviewing for Anxiety and Depression
Motivational interviewing may also be effective in treating anxiety and depression.
Therapists use empathetic listening and gentle guidance to help clients explore their ambivalence about change and develop actionable plans for improving their mental health. By focusing on the client’s strengths and resources, motivational interviewing can enhance motivation and confidence in overcoming anxiety and depression. Research shows that this approach can lead to significant improvements in mood, coping skills, and overall quality of life.
Motivational Interviewing for Alcohol Abuse
Motivational interviewing is particularly useful in addressing alcohol use disorder. It helps people explore their drinking patterns, identify the consequences of their behavior, and develop a desire for change. Studies have shown that this approach can lead to significant reductions in alcohol consumption and improved health outcomes for people struggling with alcohol abuse.
Motivational Interviewing Stages of Change
MI recognizes that change is a process involving several distinct stages. These stages, known as the Transtheoretical Model, include precontemplation, contemplation, preparation, action, and maintenance, and termination.
In the precontemplation stage, people may not be aware of the need for change or feel ambivalent about it. The role of the therapist is to raise awareness and plant seeds of change.
During contemplation, clients acknowledge the need for change but may feel uncertain or hesitant. Your therapist can help you explore the pros and cons of change to foster intrinsic motivation.
The preparation stage is characterized by creating a plan of action. Collaborate with clients to set realistic goals and identify potential obstacles. Provide support as they take concrete steps toward change in the action stage. Celebrate successes and help them troubleshoot challenges.
Maintenance focuses on sustaining change over time. Assist clients in developing coping strategies and preventing relapse. Termination is sometimes used to describe the phase when people have no temptation to return to their previous habits and are sure they will not relapse.
Progress isn’t always linear. Setbacks are normal. Use them as learning opportunities to strengthen commitment and resilience.
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Motivational Interviewing Principles
Motivational interviewing (MI) is a collaborative, person-centered counseling approach guided by five key principles. These principles help foster a supportive environment that encourages positive change and personal growth.
Expressing Empathy
Your therapist will start by expressing empathy and understanding. They will acknowledge your feelings without judgement so you feel heard and understood. In doing so, they can gradually explore sensitive topics so you can consider change.
Developing Discrepancy
In this stage, your therapist will help you recognize discrepancies between your current behaviors and your desired goals or values.
They will guide you in exploring the pros and cons of your choices. This process builds intrinsic motivation for change as you become aware of the consequences of your actions and the benefits of positive transformation.
Rolling with Resistance
Your therapist will avoid arguing or confronting resistance head-on. Instead, they will acknowledge and explore your perspective, reframing resistance as an opportunity for deeper understanding. This approach helps you feel in control of your positive change.
Supporting Self-Efficacy
This principle focuses on strengthening your belief in your ability to make and sustain positive changes. They will highlight past successes and help you recognize your strengths and resources. They will also work with you to set realistic goals and develop actionable plans.
Rolling with Resistance
Your therapist will avoid arguing or confronting resistance head-on. Instead, they will acknowledge and explore your perspective, reframing resistance as an opportunity for deeper understanding. This approach helps you feel in control of your positive change.
Supporting Self-Efficacy
This principle focuses on strengthening your belief in your ability to make and sustain positive changes. They will highlight past successes and help you recognize your strengths and resources. They will also work with you to set realistic goals and develop actionable plans.
Motivational Interview Questions Fact Sheet
Motivational Interviewing Definition
MI is a collaborative, goal-oriented counseling style that aims to strengthen personal motivation for change. It focuses on exploring and resolving ambivalence, guiding people to identify their own reasons for making a change.
Motivational Interviewing Book
“Motivational Interviewing: Helping People Change” is a renowned book by William R. Miller and Stephen Rollnick. This seminal work introduces and explores the concepts, principles, and techniques of Motivational Interviewing.
Examples of Motivational Interviewing
Below is an example of a motivational interviewing therapist with a patient struggling with liver health issues and alcohol drinking.
One of the core principles of Motivational Interviewing (MI) in addiction therapy is the non-judgmental stance taken by the therapist. MI therapists strive to create a safe and accepting environment where individuals feel comfortable discussing their addiction-related issues without fear of judgment or criticism.
Clinician: “We took a blood sample at your last appointment, and I would like to discuss the findings with you. Your values are normal—only one liver enzyme value is elevated. You can see here your gamma-GT is 220; a normal value would be 66 at the most. The gamma-GT level generally rises when, over a long period, one drinks more alcohol than the liver can break down. How does that sound to you?”
Patient: “I can’t imagine that; I don’t drink that much. Okay, sometimes when I’m under a lot of stress at work, I’ll have a few more beers in the evening than usual, but otherwise, I have my after-work beer and never any hard stuff.”
Clinician: “So this surprises you….”
Patient: “Yes, of course; I don’t drink that much. I mean, I hardly ever get drunk.”
Clinician: “Overall, you’ve got your drinking well under control; you only really drink a bit more when you’re under a lot of stress.”
Patient: “Of course, I’ll admit that now and again, I need something in the evening to switch off. But I can’t imagine my liver can’t cope; after all, I used to drink a lot more while training and never had any problems.”
Clinician: “You don’t see any problems with your alcohol consumption, and now the findings bother you. Would you be interested in the link between alcohol consumption and liver values?”
Patient: “Oh well, why not? Of course, I once read that too much alcohol is not good for the liver, but not in the case of one or two after-work beers….”
Clinician: “Recent studies have shown that alcohol consumption, even in comparatively small amounts, can cause several physical effects. Low-risk alcohol consumption is considered to be a daily amount of no more than two small alcoholic drinks in healthy men, which corresponds to about half a liter of beer. Higher alcohol consumption increases the risk of health consequences such as liver and cardiovascular diseases. Also, the recommendation is not to drink alcohol two days a week. What does hearing that make you think?”
Patient: “Well, to be honest, I’m already above that. I sometimes have four or five beers in the evening. But it never seemed that much to me—it doesn’t make me drunk. But what you’ve told me about my liver values does, of course, sound quite worrying….”
Clinician: “On the one hand, you found your alcohol consumption quite normal, but on the other, you’re worried now….”
Patient: “Of course, I don’t want it to worsen. But does that mean I can’t ever drink beer again?”
Clinician: “The idea that your liver values will continue to worsen scares you. From a medical perspective, it would be a good idea to abstain from alcohol completely for the time being so that your liver can regenerate, but only you can make that decision. So what do you think about what we’ve discussed so far?”
Patient: “Well, I suppose I should cut down. To start with, no more alcohol until my liver is okay again. How long will that take?”
Clinician: “Not drinking anything for a while might be a good option. It generally takes 2–3 months for liver values to return to normal. How does that sound to you?”
Patient: “Well, 2–3 months sounds like a long time—I mean, I can manage it if I have to, but it’s probably okay to drink a beer occasionally with friends. Isn’t it? The main thing is that I don’t drink as much as I have been drinking.”
Clinician: “You’re not sure whether you want to see this through for so long. On a scale of 0–10, how important is it to you at the moment not to drink alcohol for 2–3 months? If 0 means “not at all important” and ten means “very important”?
Patient: “Well, definitely a 6 or 7.”
Clinician: “Being able to sustain temporary abstinence is quite important. Why did you choose a 6 or 7, not a 3 or 4?”
Patient: “If I’m honest, the thing with the liver values does make me think, and you did say that it takes that long for the values to normalize. And perhaps I could prove to myself simultaneously that I can still do that.”
Clinician: “Besides the physical health aspect, you could prove that you don’t need the alcohol. What would happen for your importance rating to increase from a 6 or 7 to an 8 or 9?”
Patient: “I’d need to have some plan for what to do when I’m with my buddies. It would be weird to have water.”
Clinician: “It is normal to drink alcohol with friends. How could you nevertheless abstain from drinking alcohol in those situations?”
Patient: “A good friend of mine once cut out beer on a diet, and everyone accepted it. Maybe I could try that too.”
Clinician: “That’s an excellent idea! If you tell them you’re not drinking for health reasons, that might help you feel less weird about the situation. So to recap: At the moment, you’re worried about your liver values, and you can imagine, in principle, giving up alcohol completely for a while. That way, you would also prove that you don’t need that after-work beer. It would initially feel strange when you meet up with friends, but if you tell them in advance, it shouldn’t be a problem. So what could your next step be?”
Patient: “I think, to start with, I’ll try not to drink any alcohol for the next two months. Maybe that will already make a difference to my liver values, as you said.”
Clinician: “That’s a great idea! I suggest we make an appointment in six weeks and see how it went, and do another blood test simultaneously.”
Motivational Interviewing Techniques PDF
Download the below motivational interviewing pdf for more motivational interviewing examples. This SAMHSA advisory file consists of motivational interviewing questions pdf and motivational interviewing training. The Substance Abuse and Mental Health Services Administration (SAMHSA) addresses the application and fundamentals of motivational interviewing for addiction treatment.
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Hotline(844) 597-1011Motivational Interviewing Statistics
One research published by the (NCBI) National Center for Biotechnology Information provided a systematic review and meta-analysis of randomized controlled trials using motivational interviewing as the intervention.
1
More than 1 encounter with the patient confirms the effectiveness of MI.
Source: NCBI
64%
When using MI in brief sessions of 15 minutes, 64% of the studies showed an effect.
Source: NCBI
75%
In roughly three out of four studies, MI had significant and clinically relevant development, equalizing physiological (72%) and psychological (75%) diseases.
Source: NCBI
Models of Motivation Interviewing
Several models guide the implementation of MI, providing structured frameworks for navigating the change process. These models help therapists understand the stages of change and tailor their approach accordingly. They also offer specific strategies for evoking motivation and supporting clients througheach phase of transformation.
EPE Motivational Interviewing
The Elicit-Provide-Elicit (EPE) model is a fundamental MI approach. Your therapist starts by eliciting your understanding and perspectives on their situation. Then, they provide relevant information or feedback, followed by asking for your thoughts and reactions to the new insights. This collaborative exchange promotes ownership and engagement in the change process.
DARN-C Motivational Interviewing
The DARN-C model focuses on five key elements of change talk: Desire, Ability, Reasons, Need, and Commitment. You explore these elements with your therapist through open-ended questions, reflections, and affirmations.
OARS Motivational Interviewing
OARS stands for Open-ended questions, Affirmations, Reflective listening, and Summarizing. These core MI skills create a supportive, non-judgmental environment. Open-ended questions encourage exploration, while affirmations recognize strengths and efforts. Reflective listening demonstrates empathy and understanding. Summaries clarify key points and reinforce change talk.
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(844) 597-1011Benefits of Motivational Interviewing
The following are the benefits of motivational interviewing in the treatment of substance abuse disorders:
- Increased treatment program retention rates.
- Increased treatment program participation rates.
- Increased probability of successful treatment outcomes.
- Higher treatment post-program abstinence rates.
- Well-suited for managed care setting.
- Designed as a brief intervention.
- Generally delivered in 2-4 sessions.
- Triggers change in high-risk lifestyle behaviors.
- Significant effects from brief motivational counseling have held up across various real-life clinical settings.
- Mobilizes client’s resources for change.
- Invokes behavior change.
- Delivered within the context of a more extensive healthcare delivery system.
- Compatible with health care delivery.
- Do not assume a long-term client-therapist relationship.
- Single sessions have invoked behavior change.
- Emphasizes building client motivation — a strong predictor of change.
- Clients learn something likely to help them within the first few sessions.
- Enhances adherence which improves treatment outcomes.
Motivational Interviewing can be very beneficial for those who have not had good results with Cognitive Behavioral Therapy (CBT). A lack of motivation can make changing one’s thoughts and behavior patterns difficult, so addicted individuals experiencing ambivalence about quitting may need to go through MI first. MI is also better than CBT for individuals who need a lot of support, validation of their feelings, and a close relationship with their counselors and feel that CBT does not provide this.
Motivational Interviewing Drug Addiction
The main point of MI is overcoming the internal battle over whether one wants to quit. Even though there are many reasons to stop abusing drugs or get severe treatment for an addiction to an addicted individual, there are also many reasons not to. Clients may go back and forth many times, feeling motivated to quit after encountering health or legal consequences of drug abuse or a conversation with a loved one but losing that motivation the following day.
In one study, students addicted to tobacco who received this treatment were four times more likely than those in the control group to either attempt quitting or cutting down.
MI aims to lay out the pros and cons of quitting based on what the client feels is necessary. Once clients overcome denial and conclude the pros and cons of drug abuse, their desire to change, what that change looks like, and how they want to implement it, it becomes much easier for that change to occur. Clients don’t feel forced to give up something they love. Instead, they’re pursuing a life change that they have chosen.
Motivational Interviewing in the Treatment of Anxiety and Depression
When it comes to anxiety and depression, motivation is everything. If you’re not motivated to seek treatment and change your lifestyle, it’s unlikely that any progress will be made. Motivational interviewing is a technique that therapists use to help their patients overcome this hurdle. It’s based on the premise that people are more likely to change their behavior when given intrinsic rather than external motivation.
In other words, people are more likely to stick with treatment if they do it for themselves rather than someone else. This doesn’t mean that therapists don’t provide support and guidance. But ultimately, it’s up to the individual to find the motivation to make the necessary changes.
Reclaim Your Life From Addiction With Motivational Interviewing
Individuals addicted to drugs or alcohol don’t think their substance abuse problem is as severe as it is. They don’t want to give up the positive sensations associated with their drug use. They fear the consequences of ceasing substance use, including withdrawal symptoms and cravings. Many addicted persons go through stages of grief after giving up their drug of choice.
Substance abuse disorder is a condition that can cause significant health, social, and economic problems that should not be taken lightly. We Level Up treatment, rehab, and detox center can provide you, or someone you love, motivational interviewing with professional and safe care. Feel free to call us to speak with one of our counselors. We can help you explore treatment resources and options.
Motivational Interviewing For Alcohol Abuse
MI treats alcohol use disorder by helping individuals overcome their ambivalence about changing their drinking behaviors. At the beginning of treatment, MI may help individuals identify their reasons for wanting to make changes and increase their motivation to implement and engage in treatment.
MI is usually very effective in the beginning stages of change, especially for individuals who don’t want to be criticized or lectured about the need to stop drinking. However, MI can also be used throughout alcohol treatment to help strengthen or re-establish your commitment to achieving your goals while helping you actively re-engage in your treatment plan.
According to the National Institute on Drug Abuse (NIDA), research has shown that the effectiveness of MI can vary based on the substance of abuse. However, MI has been demonstrated to be very effective for people who have an alcohol use disorder because it helps them engage in treatment and reduce problem drinking.
One study showed that participants who received MI at the beginning of treatment-experienced double the total abstinence rate at 3–6 months after inpatient or outpatient treatment. In addition, different meta-analyses have shown that MI is better than or equal to cognitive-behavioral treatments or pharmacotherapy (medication) for helping people decrease alcohol use.
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Frequently Ask Questions
Motivational interviewing (MI) is a collaborative approach that helps clients explore and resolve ambivalence about change. It empowers them to make positive life decisions aligned with their values and goals.
What Is the Primary Goal of Motivational Interviewing?
The primary goal of MI is to build a foundation of intrinsic motivation for change. It aims to help people identify their own reasons for making positive life changes, rather than having those reasons imposed upon them by others. MI guides people in exploring their ambivalence, clarifying their values, and developing a plan for change that aligns with their personal goals and desires.
What Is Motivational Interviewing Therapy?
Motivational interviewing therapy is a collaborative, goal-oriented counseling approach that helps clients resolve ambivalence and make positive changes in their lives. It’s based on the principles of expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. In MI therapy, the therapist serves as a supportive guide, using open-ended questions, reflective listening, and affirmations to help people explore their motivations, values, and goals.
What Differentiates Motivational Interviewing From Person-Centered Therapy?
While both MI and person-centered therapy emphasize a non-judgmental, empathetic approach, there are some key differences. Person-centered therapy focuses primarily on creating a supportive, accepting environment for clients to explore their feelings and experiences. In contrast, MI adds a goal-oriented component, actively guiding clients toward positive change. MI also places greater emphasis on exploring and resolving ambivalence, helping people develop discrepancy between their current behaviors and desired goals.
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Sources
[1] Stein LA, Lebeau-Craven R. Motivational Interviewing and Relapse Prevention for DWI: A Pilot Study. J Drug Issues. 2002 Fall;32(4):1051-1070. doi 10.1177/002204260203200403. PMID: 20485471; PMCID: PMC2871705.
[2] Trends & Statistics – National Institute on Drug Abuse (NIDA)
[3] Bischof G, Bischof A, Rumpf HJ. Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice. Dtsch Arztebl Int. 2021 Feb 19;118(7):109-115. doi 10.3238/arztebl.m2021.0014. PMID: 33835006; PMCID: PMC8200683.
[4] Empowering Change: Motivational Interviewing – Substance Abuse and Mental Health Services Administration (SAMHSA)
[5] USING MOTIVATIONAL INTERVIEWING IN – Advisory 35 – Substance Abuse and Mental Health Services Administration (SAMHSA)
[6] Motivational Interviewing Strategies to Engage Patients – Agency for Healthcare Research and Quality (.gov)
[7] Motivational Interviewing for the Prevention of Alcohol Misuse in Young Adults – https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/motivational-interviewing-prevention-alcohol-misuse-young-adults
[8] Motivational Interviewing and Managing Homelessness – Veterans Affairs (.gov) https://www.va.gov/HOMELESS/nchav/docs/3m_MI.pdf
[9] Motivational Interviewing, the Transtheoretical Model of Change – Department of Education (.gov)
