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Motivational Interviewing

What is Motivational Interviewing in Groups (MI)?

Motivational Interviewing (MI) is a counseling approach used 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.

This technique is often used for addiction as a lack of motivation to quit can be one of the greatest barriers for individuals struggling with addiction, even despite health issues and financial, social, and legal consequences.

The thought behind Motivational Interviewing is that all individuals dealing with addiction are at least partially aware of the negative consequences of drug abuse and addiction. Each individual is also currently in a certain stage of readiness when it comes to changing their behavior. The MI therapist facilitates the process of getting ready to change by overcoming ambivalence or a fear of change, increasing the client’s motivation.

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health, in 2009, there were 23.5 million Americans in need of treatment for addiction disorders. Many addicted individuals lack the motivation to change for three main reasons.

motivational interviewing in groups
Motivational Interviewing (MI) is a counseling approach used to motivate clients to change destructive behaviors.

Firstly, they don’t think that their substance abuse problem is as serious as it is. Secondly, they don’t want to give up the positive sensations associated with their drug use. Lastly, 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.

Motivational Interviewing is effective not only in clients who have voluntarily sought out treatment but also in those who have been given required addiction treatment as part of a legal settlement or pressured into it by loved ones.

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Motivational Interviewing (MI) Objectives

There are seven key points to MI that should be maintained across variations in MI techniques. These are:

  • Motivation comes from the client, not from outside sources.
  • The client is responsible for resolving ambivalence, not the counselor.
  • Ambivalence cannot be resolved through direct persuasion.
  • The counselor quietly elicits information from the client.
  • The counselor guides the client in recognizing and resolving ambivalence.
  • Readiness to change is a fluctuating result of interpersonal interaction, not a trait.
  • The client-counselor relationship should resemble a partnership.

The Four Processes Of Motivational Interviewing

Motivational Interviewing is a fairly simple process that can be completed in a small number of sessions. The typical steps are as follows:


Talking to the client about issues, concerns, and hopes, and establishing a trusting relationship.


Narrowing the conversation to the topic of patterns and habits the client desires to change.


Eliciting client motivation for change by increasing the sense of the importance of change, confidence that change can occur, and readiness for change.

motivational interviewing in groups
Motivational Interviewing is a fairly simple process that can be completed in a small number of sessions.


Developing a set of practical steps the client can use to implement the desired changes.

MI is a client-centered model of counseling, meaning that the focus is on figuring out what clients want, not what the counselor thinks is best for them. This requires high levels of empathy, reflective listening, and the ability to form a strong bond with the client in a short period.

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Benefits of MI

The following are 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
  • Normally delivered in 2-4 outpatient sessions
  • Triggers change in high-risk lifestyle behaviors
  • Large effects from brief motivational counseling have held up across a wide variety of real-life clinical settings
  • Mobilizes client’s resources for change
  • Invokes behavior change
  • Delivered within the context of a larger 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 that is 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 thought and behavior patterns very 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. 

MI may also be especially beneficial for those who have relapsed after attempting to get clean in the past. Ambivalence about the consequences of drug abuse can be a considerable factor in repeated relapse. Helping such a person navigate through this lack of motivation, and find their own inspiration to quit that isn’t based on guilt or pressure from loved ones and health professionals, can significantly reduce the chance of future relapse and lead to long-term health.

Motivational Interviewing Drug Addiction

The main point of MI is overcoming the internal battle over whether one really wants to quit or not. Even though there are clearly many reasons to stop abusing drugs or get serious 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 next morning.

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 clearly lay out the pros and cons of quitting based on what the client feels is important. Once clients overcome denial and come to their own conclusions about the pros and cons of drug abuse, their desire to change, what that change looks like, and how they want to implement that change, it becomes a lot easier for that change to take place. Clients don’t feel forced to give up something they love. Instead, they’re pursuing a life change that they themselves have chosen.

Motivational Interviewing For Alcohol Abuse

MI is typically used to treat 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 these changes 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 the course of 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 rate of total abstinence 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.

Motivational Interviewing in the Treatment of Anxiety

When it comes to anxiety, motivation is everything. If you’re not motivated to seek out treatment and make changes to 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 they are given intrinsic motivation rather than external motivation.

In other words, people are more likely to stick with treatment if they’re doing it for themselves rather than for 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 within themselves to make the necessary changes.

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Principles of Motivational Interviewing

The 4 key principles of motivational interviewing include:

Express Empathy: Empathy is the ability to imagine and feel what it’s like to be in another person’s shoes. The therapist uses reflective listening skills in order to develop a better understanding of your perspective and experiences by listening to you without judgment, criticism, or blame.

Develop Discrepancy: You are guided to think about the different ways your current behavior might impact your future goals. Together with your therapist, you are encouraged to consider how your substance abuse impacts your entire life and social roles, such as your role as a parent, partner, friend, employee, etc., and the pros and cons of changing your goals for the future.

Roll With Resistance: Resistance is often a part of the change process. It’s not always easy to accept the need for change, even if it’s clear that your current behaviors are negatively impacting your life and wellbeing. Your therapist will encourage you to try to see things from a new or different perspective, but you are also allowed to have your own opinion. Ultimately, the decision to change is up to you.

Support Self-Efficacy: Self-efficacy means that you believe you can make changes that have a positive impact on your life. People may believe that they cannot influence events in their lives or make behavioral changes, and they give up hope because they don’t think change is possible. Your therapist will help you develop a sense of hope and confidence to help you realize that it’s possible for you to change your drinking behaviors.

motivational interviewing in groups
This method of counseling appears to be especially effective for alcohol addiction, likely due to the fact that it’s easier to be ambivalent about the use of legal substances due to greater social acceptance than there is about the use of illicit drugs.

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Effectiveness of Motivational Interviewing

This method of counseling appears to be especially effective for alcohol addiction, likely due to the fact that it’s easier to be ambivalent about the use of legal substances due to greater social acceptance than there is about the use of illicit drugs. According to an analysis of studies published in the Journal of Clinical Psychology, MI is up to 20 percent more effective than other treatment methods for alcohol addiction.

The success of MI in treating substance addiction has resulted in it being tried for other types of addiction, mental illness, and behavioral issues. These include gambling addiction, eating disorders, low self-esteem, parenting practices, and increasing motivation for positive behaviors like healthy eating and exercise. Research into MI’s effectiveness in these areas is preliminary.

Reclaim Your Life From Addiction With Motivational Interviewing

Substance abuse disorder is a condition that can cause major health, social, and economic problems that should not be taken lightly. We Level Up treatment rehab & 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 inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.

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