Motivational Interviewing for Substance Abuse

Motivational Interviewing (MI) is a counseling method that helps people find genuine internal motivation to solve and address problems in their life. In the context of substance abuse treatment, MI is mainly used as a supplement or precursor to treatment.

Motivational interviewing can support addicts who are stuck in their ways by helping them find the motivation to seek the treatment they need. It also helps addicts address their fear, ambivalence or unwillingness to change so that they can get help on their own terms.

How Motivational Interviewing Works

Motivational interviewing is not meant as a stand-alone treatment for substance abuse. Other therapies address the addiction and the underlying causes of it. MI, on the other hand, is used only for addressing a person’s motivation to get better.

Motivational interviewing works under the assumption the people abusing drugs or alcohol know that their addiction is hurting them. The focus, then, shifts to why they are not trying to stop. The goal of MI is simply to start a conversation about change and commitment to seeking help.

To achieve this, the counselor’s job is mostly to listen in a supportive way and guide the conversation in the right direction. There are two main parts to Motivational interviewing:

  • Increase motivation: The first phase of MI is to help a person gain genuine motivation to stop using drugs or alcohol. This might be achieved by talking about how the substance abuse is getting in the way of what the client wants. Many patients find that just saying how their behavior is hurting them out loud can be a big motivator to seek help.
  • Make a commitment: The second phase and overall goal of MI is for the client to make a genuine commitment to change. Making this commitment is different than simply stating a desire or need to change. A commitment is a promise the person is making to themselves (and their counselor) to take specific steps towards getting better.

Usually, Motivational interviewing lasts for just one or two sessions. In some cases, however, it may be needed for a longer period of time. MI is used in conjunction and as a precursor to other common substance abuse treatments. These may include other therapies, medication, and group meetings.

Benefits of Motivational Interviewing

Motivational interviewing can be very helpful for people with substance use disorders. Addictions are unique disorders because they are often self-motivating. This means that the ‘high’ that users feel motivates them to keep abusing drugs and alcohol. For this reason, many addicts lack the motivation to change.

Still, most people with substance use disorders know, on some level, that they are hurting themselves. Without bringing this knowledge to the surface, it is unlikely that an addict will have the motivation needed to seek out treatment and have a successful recovery.

The main benefit of MI for substance abuse is that it helps addicts to come to treatment ‘on their own terms’. As any addiction expert will tell you, treatment is much smoother and more effective when a patient genuinely wants to recover.

Effectiveness of Motivational Interviewing for Substance Abuse

Several studies and trials have backed up this theory to show that MI is effective for helping to treat substance abuse. Both the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) recognize MI as an effective aid to treatment.

A review of 11 clinical trials that involved Motivational interviewing to address substance abuse found that the therapy was effective. In 9 out of 11 trials, the review found that treatment involving MI was more effective than:

  • No treatment
  • Standard treatment
  • Extended treatment

Further studies and reviews have continued to show that MI helps people who suffer from substance abuse to achieve better short and long-term results. This therapy is a great starting point for people who are unsure about treatment or who have a loved one who is resistant to seeking help.

Usually, Motivational Interviewing takes place before someone starts formal treatment. Sometimes, a person is admitted to a treatment center and it becomes clear that they need MI as a supplement to the treatment they are receiving. This usually happens when someone is resistant to wanting to help themselves.

Anyone suffering from drug or alcohol addiction can benefit from Motivational Interviewing. Gaining the genuine motivation to change is an invaluable resource that can continue to serve you throughout your entire recovery journey.


Written by
Northeast Addition Editorial Team

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This page does not provide medical advice.

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