Motivational Interviewing (MI)

There’s a reason that up to 90% of people with substance use disorders (SUD) relapse. It’s hard to change even if you want to, and it’s near impossible to change if you don’t want to.

You may resist change for a variety of reasons. Maybe it’s more comfortable to avoid change, and maybe you lack the motivation to make it happen. Whatever the reason, motivational interviewing (MI) can help you uncover new reasons to change.

During MI treatment, you will go through stages of MI where you:

• Accept the gap between your current life and where you want to be
• Discuss ways that your life might improve if you embraced change
• Identify the obstacles that keep you resisting change

During MI treatment, you will go through stages of MI where you:

• Supportive
• Nonjudgmental
• Empathetic

MI helps you remember what’s possible and gives you the drive to build a better life in recovery. It’s not a magic pill by any means, but you’d be surprised how much you can benefit from a therapeutic environment that’s trusting and open like MI.

What’s the Difference Between Motivational Enhancement Therapy vs. Motivational Interviewing?

Motivational enhancement therapy (MET) isn’t exactly the same as MI, but it is a form of the treatment.

MI is a treatment approach that’s tailored to your needs, while MET is its own structured form of MI. Most MET courses don’t last longer than 4 sessions, and MI can last a single session in some cases.

What Happens In Motivational Interviewing?

During an MI session, you’ll talk about what needs to change in your life and why you want to make those changes.

In the first session, your therapist may use a motivational interviewing questionnaire to get a history and background on you. But most of the time, the MI conversation is tailored, so a motivational interviewing template isn’t necessary.

Your therapist will practice reflective listening by speaking your thoughts back to you. Hearing your reasoning and motivation expressed back to you can help you clarify what you’re thinking and feeling.

With this kind of therapy, the therapist exists mostly to serve as an empathic listener and a sounding board. The therapist doesn’t usually set goals for short-term therapy, but instead, they’ll guide a conversation that:

• Increases your motivation
• Helps you make the commitment to change

Research shows that committing to change out loud improves your ability to follow through on that change.

What Is The Theory Behind Motivational Interviewing?

Motivational interviewing theory is based on the idea that people who want to change will change, and people who are told that they won’t change don’t bother. It’s also person-centered, which means it meets you where you are with acceptance and encourages, rather than demands, change.

Growing beyond addiction requires a treatment environment that lets you share openly with unconditional acceptance. The motivation therapy techniques used in MI help you develop positive regard with your therapist, so you feel like you can share anything without being judged.

What Are The Origins Of Motivational Interviewing?

Motivational interviewing is based on two therapy models that came before it. Those include person-centered psychotherapy as Carl Rogers practiced it, and the Stages of Change.

What is Person-Centered Psychotherapy?

Carl Rogers built the person-centered model of psychotherapy. In this type of therapy, there are 3 core conditions that guide the session, including:

• Congruence: This is the therapist’s willingness to relate to the client like a human being, rather than a professional.
• Unconditional positive regard: The therapist must accept and value the client’s feelings and be able to listen without interrupting, judging, or giving advice.
• Empathy: The therapist must make it clear that they’re there to understand the client’s point of view.

During motivational interviewing, therapists take a similar approach to each session.

What is the Stages of Change Model?

Motivational interviewing and the Stages of Change are closely linked.

The Stages of Change model is a methodology that can help you make changes in the transition to recovery. Originally, the stages were developed as an aid for quitting smoking. But today, the Stages of Change are used in all kinds of behavioral health interventions.

There are 5 stages of motivation or change, which are:

• Pre-contemplation: The idea of change hasn’t entered your mind yet.
• Contemplation: You’re thinking about the possibility of change.
• Preparation: You’re planning how you’ll take action toward change.
• Action: You’re executing your plan to achieve change.
• Maintenance: You’re working to maintain the change that you’ve worked toward.

Relapse is a sixth, optional stage of change, which sends you back into pre-contemplation. But it’s possible to stay in maintenance indefinitely, which is the goal.

In motivational interviewing, Stages of Change play a big role in tracking where you are and where you could be. Some therapists work with a modified MI Stages of Change. However, the Stages of Change can be used with or without motivation therapy.

Key Elements of Motivational Interviewing

The motivational interviewing model is based on a set of key concepts, principles, and strategies, which are called the Spirit of MI. Those elements include:

The Spirit of Motivational Interviewing

Every MI session is done in a person-first style that’s called a “spirit” in MI language. The spirit of MI includes 7 ideas that guide every MI session:

1. The motivation to change comes from the client, not from outside influence.
2. It’s the client’s duty to work through his lack of motivation, not the therapist’s.
3. You can’t persuade someone out of being unmotivated.
4. Good counseling is quiet and elicits more information with the right questions.
5. Good counseling directs the client to examine their own motivation.
6. Clients can want change even if they’ve never wanted it before.
7. A good therapeutic relationship is similar to a partnership.

The 4 Steps of Motivational Interviewing

There are 4 steps that your therapist will take during every conversation with you. These steps include:

1. Express empathy: Your therapist will connect with you and show that they understand your experience.
2. Develop discrepancy: Your therapist will help you see the gap between where you are and where you could be.
3. Roll with resistance: It’s natural to want to avoid change, but a good therapist will roll with it and let you come back to it when you’re comfortable.
4. Support self-efficacy: Your therapist is there to provide you with the tools that you need to help yourself and move forward with confidence.

Evidence For Motivational Interviewing Therapy

There’s plenty of evidence that motivational interviewing works. A review of recent studies found that:

• MI reduced frequency and volume of alcohol consumption in people with alcohol use disorder
• MI reduced binge drinking, consumption frequency and quantity, and peak blood alcohol concentration in people aged 25 and younger
• MI reduced relapse in people with substance use disorder
• MI reduced short-term cannabis use in young adults

Integrating Motivational Interventions Into Recovery

It’s important to integrate MI into your life beyond treatment. You’ll be managing addiction as a chronic disease for the rest of your life, so MI needs to become part of your life too.

Remember, most people only attend MI for a few sessions. Integrating what you learn into your daily life can help ensure that the benefit follows you for months or years after.

Your therapist will help you come up with a plan to integrate MI into your recovery. It might include:

• Keeping a gratitude journal to remind you why you chose recovery
• Attending group therapy to connect with other people, which can be powerfully motivating in recovery
• Choosing reminders of your reasons for recovery, like a mantra or symbol that you can take solace in
• Enjoying life again, which can keep you reminded that there’s beauty beyond the rough edges

Call Bedrock Recovery Center today to learn how we can help you recover from addiction! Our Canton, Massachusetts facility offers Motivational Interviewing as part of our residential inpatient facility, where you’ll learn to stop and appreciate the beauty in life while getting state-of-the-art care.