Moving Forward With Motivational Interviewing Therapy

For many people contemplating entering treatment, experiencing some level of ambivalence is common. While they understand that using substances has caused them harm and might want to stop, they aren’t quite ready to give them up. This ambivalence isn’t a character flaw — it is a normal human aspect of the process of change. 

The most effective way to motivate someone to change is to help them access their own inner motivation, create their own plan for change, and enter recovery with the kind of conviction that lasts. At Forward Motion Health, motivational interviewing is foundational to how we engage with all the men who walk through our doors.

 

What is Motivational Interviewing?

Motivational Interviewing (MI) is a research-proven, patient-centered form of counseling designed to help people resolve ambivalence and move toward positive behavior change.[1] It is delivered by therapists, social workers, counselors, and health professionals in both one-on-one and group settings. 

MI may be used as a stand-alone, short-term intervention or incorporated into longer periods of treatment. Sessions are generally brief and conversational and focus more on establishing a therapeutic relationship that invites honest conversation. MI is appropriate for adults looking to address substance use issues, co-occurring mental health issues, medication adherence challenges, and many other health-related conditions that require behavior change.

At Forward Motion Health, MI is ingrained in our clinical work. Our staff uses MI principles to encourage patients to seek their own motivation for change and to build self-confidence and motivation for long-lasting recovery, rather than relying on external pressures that fade once they leave treatment.

How (and Why) Motivational Interviewing Works

MI was developed by William R. Miller in the late 1970s and early 1980s, with Stephen Rollnick joining soon afterward to enhance and extend the method.[2] Their landmark text, published by Guilford Press, defined MI as “a collaborative, goal-oriented style of communication” designed to strengthen someone’s motivation to change. Their work drew inspiration from Carl Rogers’ client-centered theory and also drew on Prochaska and DiClemente’s Stages of Change Model — pre-contemplation, contemplation, preparation, action, maintenance — so that clinicians could assess where their patients were along the continuum of change.[3]

MI rests on what Miller and Rollnick call the “spirit of motivational interviewing,” which is described in four key elements: partnership, acceptance, compassion, and evocation. From there, clinicians use techniques such as open-ended questions, affirmations, reflective listening, and summarizing (summarized by the acronym OARS) to help patients explore their ambivalence, identify their values, and explain their own internal reasons for change. The goal is to evoke “change talk,” which is the patient’s own reasons for change, instead of relying on outside motivation, which may not always be present.

At Forward Motion Health, our clinicians are trained in this modality and combine it with other evidence-based therapies such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and trauma-informed care. MI does not involve confrontation, nor does it involve passivity. Instead, MI is a well-defined, highly skilled dialogue process that helps patients transition from “I should change…” to “I want to change…”

Who is Motivational Interviewing Best For?

Motivational Interviewing can be an appropriate approach for nearly any client seeking to change behaviors. However, there are some scenarios where MI is particularly well suited. 

Some examples include:

• You are not sure if you’re ready to change or seek treatment.
• You were pressured into treatment by your family, employer, or the courts.
• You have previously attempted to stop using substances and felt that external accountability was ineffective.
• You struggle with co-occurring conditions such as depression or anxiety that tend to get in the way of motivation.
• You feel that previous treatments were either too direct or did not allow for enough input or autonomy.
• You’re having trouble adhering to medications or managing chronic illness in addition to addressing your substance use.

MI is frequently used early in treatment to establish rapport and encourage patients to stay engaged. MI can then be used alongside additional therapies as treatment progresses. Your therapist will assess the best combination of strategies for your needs.

 

Efficacy of Motivational Interviewing

MI is among the most researched behavioral therapies in addiction treatment, and randomized controlled studies and meta-analyses support its application.

Key findings include:

• Research across a variety of treatment settings suggests that MI may help reduce substance use and support positive health behavior change.[4]
• A meta-analysis published in the Journal of Consulting and Clinical Psychology found that MI was generally more effective than no treatment and produced outcomes comparable to other active treatment approaches.[5] 
• MI has been studied across numerous health-related behaviors, including smoking cessation, gambling disorders, medication adherence, and other behavioral change interventions.[6]
• For substance use disorders, MI has been studied and found effective as both a brief standalone intervention and as part of longer treatment programs, particularly during the early stages of behavior change.[7]

 

What to Expect from Motivational Interviewing

An MI session looks much different than what most people picture when they think of therapy. There is no lecturing, confrontation, or pressure to commit to a specific plan before you are ready.

During an average MI session, your clinician will:

• Ask you open-ended questions to invite reflection — questions like “What’s working well in your life right now?” or “What do you hope will be different for you a year from now?” 
• Listen closely and reflect back what they heard to help you hear your own thoughts more clearly.
• Reinforce the strengths and successes that have occurred throughout your history.
• Summarize what you said to help organize the conversation and identify the key points of discussion.
• Explore both sides of your ambivalence — the reasons you want to change and the reasons you don’t — without pushing you toward a decision you are not ready to make.
• Acknowledge and respect your autonomy and your ability to make your own decisions while providing support for your confidence and sense of competence.

Most patients report that MI allows them to experience a collaboration with their clinician in a way that doesn’t happen in traditional talk therapy.

Motivational Interviewing at Forward Motion Health

At Forward Motion Health, motivational interviewing is one of a wide range of evidence-based treatments we provide as part of a customized treatment program. 

Our clinical staff is trained in MI principles and applies them across the entire continuum of care — including admission, individual therapy, group therapy, and family work — because it respects clients’ autonomy and supports the kind of intrinsic motivation that supports recovery. 

We also use motivational interviewing along with CBT, DBT, trauma-informed care, medication management, and other treatment approaches to offer a comprehensive and clinically relevant level of care that respects each patient’s unique journey toward healing.