Motivational Interviewing for Substance Use Treatment

As a compassionate behavioral and mental health care provider, you incorporate many modalities to treat your clients. For those clients seeking recovery from addiction or substance use, one lesser-known, relatively new model is Motivational Interviewing (MI). Developed in the early 1980s, MI requires an approach based on collaboration, understanding, and empathy. 

What is Motivational Interviewing?
Motivational Interviewing (MI) is a technique commonly used in the treatment of clients with addiction or substance use. This style of treatment can be thought of as an evidence-based conversation that truly encourages behavior change from within and guides clients toward a specific end goal (in this case recovery from addition). 

Motivational Interviewing is highly collaborative. Through approachable dialogue, the client is encouraged to explore their desire for change, receiving kindness, compassion, and acceptance both from their counselor and from themselves. 

This style of treatment is not meant to manipulate, coerce, or “get people to change” as in an intervention. Motivational Interviewing is an on-going conversation between clinician and client that takes time, practice, and the client’s own self-awareness.

Essential Processes of Motivational Interviewing
There are four main processes to successful Motivational Interviewing or “keeping the conversation going.” During the “conversation” (Motivational Interviewing treatment), the clinician must always be: 

  • Engaging. The foundation to MI: actively listening, reflecting on, and affirming a client’s experience and perspective. 
  • Focusing. Steering dialogue toward the end goal of positive change.
  • Evoking. Helping clients build on their “why.”
  • Planning. The “how” to the process of change for a client.

Signs Motivational Interviewing May Benefit a Client 
Although not an exhaustive list, a client may benefit from MI if the following is present:

  • Ambivalence: having mixed feelings about change
  • Low confidence: doubting their ability to change
  • Apathy: low desire or uncertain if they want to change 

Is this tool aligned with my treatment style and will it be beneficial to my clients?
Be honest with yourself if this tool may be right for you, your clients, and your practice. Not every clinician or behavioral health provider is a good fit for motivational interviewing, just like not every client will be a good fit for this type of treatment.

The following are important characteristics in clinicians for the success of Motivational Interviewing:

  • Partnership and collaboration. Clinicians guide toward change, not force it.
  • Acceptance. Clinicians are non-judgmental and actively seek to understand their client’s perspective and life experiences. 
  • Compassion. Clinicians express unending empathy and promote their client’s wellbeing in a selfless way.
  • Patience and understanding. Clinicians actively listen, ask meaningful questions, and provide affirmations to build up client confidence

Behavioral and mental health providers should consider if Motivational Interviewing would be an impactful approach for those clients who are willing and wanting to change. It is proven to be a successful, client-centered approach to encouraging change, promoting resilience, and building confidence particularly in those seeking recovery. 

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