Motivational Interviewing in Treatment

Motivational interviewing (MI) is a client-centric counseling approach that focuses on motivating a client to change destructive tendencies and behaviors. Its principal proponent is William R. Miller, Ph.D. A lack of motivation is often one of the greatest barriers for individuals who are struggling with various forms of abuse and addiction.

Even when clients are confronted with health, financial, social, and legal issues, they often have an ingrained and deep-seated fear of change. This fear is known as ambivalence. Clients with addictions are often aware – even if only partially aware – of the negative effects of their addictions. They may realize that they need to change, but may still lack motivation to change.

Therapists who use the motivational interviewing approach work with their clients to overcome this ambivalence. They do so boosting the clients’ own motivation to make the necessary lifestyle changes needed to overcome addiction.

Why Do Drug Users Lack Motivation?

Many addicted individuals lack the self-motivation to change because they do not think that their substance abuse problem is as serious as it really is. Another reason is that they do not want to give up the positive sensations associated with their drug use. Finally, they fear the consequences of ending their drug use, such as experiencing withdrawal symptoms and cravings.

How Motivational Interviewing Works

The motivational interviewing approach is a short-term intervention that acknowledges that the process of overcoming addiction will be different and unique for each person. A central principle is that therapists need to establish trusting relationships with their clients. Consequently, motivational interviewing is critically dependent on the ability of the therapist to develop a trusting bond, which will ultimately determine the effectiveness of the approach.


At the heart of motivational interviewing is a therapist’s ability to appreciate and understand the client’s perspective without judging. This is known as empathy. Empathy does not mean that therapists need to agree with clients, but that therapists should seek to understand how their clients’ actions make sense to them (or how they made sense at the time). This creates a trust that is critical to effective counseling.

Overcoming the Fear of Change

A motivational interviewing approach recognizes that clients are often fearful and uncertain about whether they want to change. Many people became addicted as way to cope with life. They may feel that they do not have alternative options and do not want to give up their addictions.

Motivational interviewing helps clients determine how to move forward and overcome the fear of change. It helps clients examine the benefits and costs of different choices and actions. Therapists work with clients to develop action steps and achieve goals. They aim to create a trusting and collaborative atmosphere based on the clients’ own strengths, needs, and goals.

Supportive Encouragement

Therapists who practice motivational interviewing need to encourage their clients’ beliefs in their abilities to make changes. Often, therapists may have more confidence in the individuals than they have in themselves, but clients may gain confidence as they proceed.

Developing New Understanding

Practitioners of motivational interviewing recognize that change is difficult. It does not always come quickly or easily or just because clients want it. Clients may change their minds many times about whether they want to give up their addiction. They may waver about the course of the change needed and the direction it should take.

Rather than challenging or opposing clients, therapists who use motivational interviewing try to help clients reach new understandings of themselves and the implications of their addictions. They do this by re-framing and offering different interpretations of situations that arise during the change process. These new perspectives may increase the clients’ motivation to change. This process is based on the individuals’ own goals and values.

Limitations of Motivational Interviewing

While using the motivational interviewing approach has helped many clients find the motivation to find the path to recovery, the technique may not work for everyone. For some clients who have co-occurring mental illnesses, simple motivation may not be sufficient. Motivational interviewing is designed to occur in as little as four sessions. Clients with mental illness-related limitations may need a more in-depth method of counseling and possibly medication to build their motivation.

Success in motivational interviewing depends partly on the skill of the therapist. Motivational interviewing may be a difficult treatment to master and requires therapists to develop trusting relationships with many types of clients. Substantial understanding and patience are required, yet the process is designed to be quick and compact to keep it as accessible and affordable as possible. Effective therapists addresses may help clients who have had less success with other therapeutic methods.

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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