Motivational Interviewing In Substance Abuse Treatment

Medically Reviewed by Johnelle Smith, M.D. on May 27, 2022

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 In Substance Abuse Treatment

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 you’ll find information on:

  • how motivational interviewing works
  • examples of motivational interviewing techniques
  • benefits of motivational interviewing
  • where to find motivational interviewing for addiction
Ohio Recovery Center


Plymouth, Massachusetts

How Motivational Interviewing Works

Motivational interviewing is a form of talk therapy that is focused, goal-oriented, and non-coercive, aiming to support, rather than force, positive changes in a person’s life.

Through counseling sessions, or “interviews,” a counselor works with patients to identify goals for recovery that are achievable and personalized to align with the person’s values and concerns.

There are four steps in the motivational interviewing process:

  • Engaging: This first step focuses on engaging patients and beginning to build that initial rapport within the counseling relationship.
  • Focusing: This step involves identifying patterns of behavior that the patient would like to change, and goal-setting.
  • Evocation: The evoking step involves encouraging patients to open up about their own motivations for behavior change (“change talk), or their own reasons for resistance.
  • Planning: This step involves planning how to change behaviors and strengthen personal commitment to change to support their recovery.

Motivational Interviewing Adaptations

Since the beginning of motivational interviewing (1991), the therapy has also become the basis for several adaptations that can better meet some patients’ or providers’ needs.

Adaptations of motivational interviewing include:

  • motivational enhancement therapy (a time-limited adaptation)
  • motivational interviewing groups (i.e. group-based MI)
  • behavior change counseling
  • technology-assisted motivational interview (TAMI)

Principles Of Motivational Interviewing

Motivational interviewing has several key principles that guide the counseling process of change between the patient and their clinician.

Key focuses and principles of motivational interviewing include:

  • building rapport in the early stages of a therapeutic relationship
  • strengthening motivation for recovery and commitment to change
  • addressing ambivalence about recovery (if applicable)
  • facilitating a treatment process that is person-centered
  • identifying steps for achieving goals outlined in counseling sessions
  • emphasizing the autonomy of the patient
  • actively listening to the patient and resisting the “righting reflex” (i.e. attempting to correct or challenge a patient’s negative thoughts)
  • preparing people for change

Motivational Interviewing Techniques

Counselors that practice motivational interviewing (MI) may utilize a number of therapeutic techniques that align with the goals and elements of MI.

Some motivational interviewing techniques include:

  • asking open-ended questions to engage and begin identifying goals
  • affirming the strengths of the patient
  • encouraging personal reflection to help people understand their motivations more fully
  • expressing empathy for the patient, including their concerns and reasons for resistance to change
  • summarizing key points discussed during interviews
  • checking in with patients regularly to ensure both the counselor and patient are in agreement on key takeaways from their interviews
  • demonstrating a commitment to patients’ perspectives by listening rather than telling patients what to do (i.e. reflective listening)

Unlike therapies that take on a more paternalistic approach, motivational interviewing places the patient at the center of the therapeutic process—and actively encourages their participation and input.

In this respect, motivational interviewing is considered an empowering modality. It respects the agency of the person with addiction and the integral role they have within their own healing process.

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.

Decades of research on motivational interviewing for a wide variety of issues, including medication adherence and smoking cessation, show that it can have a number of positive effects.

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 (e.g. stopping substance use)
  • promotes supportive coping strategies
  • can encourage positive decision-making
  • can demonstrate positive effects in a short period of time
  • can help to reduce substance use/promote abstinence
  • can increase treatment retention (i.e. the amount of time patients stay in treatment, as recommended by a treatment provider or treatment team)
  • increase likelihood of patients engaging in follow-up services

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:

  • medical detoxification (detox) services
  • cognitive behavioral therapy
  • group therapy
  • family therapy
  • medication-assisted treatment (MAT)
  • self-help groups
  • mental health counseling
  • relapse prevention planning
  • aftercare support

Treatment services offered for addiction can vary according to the type of treatment program a person begins, or whether they are solely seeking counseling, outside of a full rehab program.

Where To Find Motivational Interviewing Treatment

Motivational interviewing is offered by a number of different types of treatment providers, and may be found at all levels of care, from inpatient treatment to outpatient treatment settings.

For instance:

Motivational interviewing may also be found through an individual counselor, primary care provider, or counseling center.

Motivational Interviewing FAQs

Find answers here to common questions about motivational interviewing and its use for treating drug addiction.

Motivational interviewing may involve the use of several therapeutic techniques.

For instance, one example might include evoking discussion about a person’s motivation for change, as well as their hopes, concerns, and expectations for this process.

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.

Motivational interviewing is a short-term process. This may occur over the course of as few as one or two counseling sessions.

It may also serve as an intervention to supplement other long-term therapies, like cognitive psychotherapy.

Insurance coverage for drug counseling is commonly included within insurance plans that cover mental health and substance abuse treatment services.

Coverage for drug counseling may depend on your insurance provider, individual policy, the treatment provider, and other personal factors.

Find Motivational Interviewing At A Rehab Center

Motivational interviewing is an evidence-based treatment for addiction. If you’re looking for addiction treatment for yourself or a loved one, we may be able to help.

Call our helpline today to learn more about motivational interviewing or to find a treatment provider that offers motivational interviewing for addiction.

This page does not provide medical advice. See more

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These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on May 27, 2022

Canton, Massachusetts

Bedrock Recovery Center


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Payment Options: Insurance Accepted, Self Pay

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Plymouth, Massachusetts

Ohio Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

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Spring Hill Recovery Center


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