What is Motivational Interviewing?

Motivational Interviewing (MI) is a research-based approach to instigating behavioral changes in individuals, particularly those who may struggle to commit to or effectively implement their personal goals. This is achieved through using language focused on increasing a person’s motivation to change their old self-limiting habits and beliefs.

Furthermore, the MI process helps individuals to build confidence in their personal strengths, and believe in their own capacity to practice autonomy. Some of the key qualities prioritized in the Motivational Interviewing approach are:

  • A guiding style of communication, flexing between a practitioner’s following of clients (good listening) and directing them (providing information, feedback, and advice).
  • A design focused on empowering clients to change by allowing them to explore and establish their own meaning and importance of change, as well as define their personal capacity to achieve this growth.
  • An established system based on respectful and curious ways of being with people that allows for the natural process of behavior change to occur, while still prioritizing client autonomy.

Using Motivational Interviewing for Addiction Treatment

When it comes to addiction, it can be incredibly difficult for individuals to overcome this condition, even in the face of the various tolls it can have on them and others. This is largely due to the fact that consistently abusing substances will gradually change the chemical makeup of an individual’s body over time.

This developed dependency on a specific substance can significantly diminish the individual’s motivation to change their habits on their own. In these cases, professional addiction treatment may be necessary for successful rehabilitation and positive change to occur.

Thus, Motivational Interviewing can be a particularly beneficial technique for addicted individuals to explore in their journey to sobriety. After all, it is specifically designed to target and reform the factors holding a person back from changing.

In fact, research has found that, particularly in the early stages of change, MI techniques are essential in an individual’s ability to achieve long-term sobriety.

 

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The Spirit of Motivational Interviewing

Motivational Interviewing prioritizes the incorporation of an established way of being with people. This “spirit of being” serves as the foundation for all MI work, and creates a safe and supportive environment through enforcing several conditions, including:

  • MI prioritizes collaboration and incorporates practitioners that are experts in working with their clients in achieving effective and long-lasting change. Furthermore, this process recognizes and supports the idea that these clients are the experts in their own lives.
  • The MI process pays particular attention to the idea that people have all of the skills and tools they need for change already within them. MI simply helps them to build motivation for change through evoking these priorities, values, and inner wisdom, allowing clients to explore this possibility and believe it themselves.
  • An MI practitioner is expected to maintain a nonjudgmental stance, instead prioritizing understanding their client’s perspectives and experiences, practicing empathy, acknowledging the individual’s personal strengths, and respecting their ability and right to choose whether or not they wish to change.
  • MI practitioners also must practice empathy, and actively promote and prioritize their clients’ welfare through establishing a relationship based on compassionate communication and mutual respect. Furthermore, practitioners must aid their client’s journey to behavior change in an unbiased and selfless manner.

The Motivational Interview Process

Motivational Interviewing instigates change talk by adhering to a set MI process, helping people change through effective communication and understanding. This process entails four steps, which are as follows:

  • Through building confidence with their clients, using open-ended questions, uncovering their values and hopes, and offering compassionate reflections, Motivational Interviewing practitioners are able to maintain interest in and form concise understandings of their client and their goals.
  • By consistently bringing the conversation back to the topic at hand and paying particular attention to their client’s personal concerns (such as the severity and relevance of health concerns or wellness factors that may affect their motivation for change) practitioners can better lead individuals in exploring effectives means of growth and goal progression.
  • Through exploring an individual’s reasons for and against change, practitioners can help their clients in elaborating on and developing further reasons for change. This may be achieved through acknowledging pros and cons, practicing double-sided reflections, gauging readiness rulers, and recommending wellness strategies and benefits.
  • By collaborating on finding ways of achieving change, MI practitioners and clients work together to set attainable goals, and establish a willingness to commit to improved thinking and healthier habits.

O.A.R.S: The Basic Skills of Motivational Interviewing

Matrix Model

When it comes to Motivational Interviewing skills, there are four major techniques utilized within the MI spirit of being. These are referred to as the O.A.R.S of Motivational Interviewing, and include Open-Ended Questions, Affirmations, Reflections, and Summaries.

Open-Ended Questions

When asking open-ended questions, practitioners are seeking to elicit complex and personal responses from their clients. This allows them to gain insight about the individual’s life experiences, thoughts, and thinking habits, as well as their personal values, goals, and strengths.

Furthermore, it provides clients with a chance to experience the acceptance of their self-limiting behaviors and beliefs as they are, with the intent of opening up the possibility of beginning the stages of change.

Some of these questions may include:

  • Inquiries about significant or emotional situations, and what it was like for the client to experience these.
  • Asking clients how they were able to cope with difficult circumstances (whether during or after their occurrence).
  • Requesting more details about the individual’s personal life and how certain experiences may have shaped their current willingness and ability to initiate change with confidence.
  • Asking for further clarification and/or confirmation on the practitioner’s understanding of a client’s response.
  • Asking clients for their thoughts on how their personal experiences and environments may have influenced or are currently influencing their ability to effectively instigate behavior change.

The Importance of Using Your Own Words

Because the Motivational Interviewing process relies so heavily on the use of open-ended questions, there is no one-size-fits-all answer sheet to this therapeutic service. This need for complete authenticity and openness can be intimidating, especially for individuals overcoming addiction.

However, an MI space is meant to be safe, confidential, and supportive to all individuals who choose to participate in this process. While perhaps initially off-putting, this authenticity-based approach may actually prove to be quite liberating, as it allows clients to express themselves without fear of judgment or repercussions.

Affirmations

Once individuals have successfully answered initial questions as openly as possible, practitioners will then begin the affirmation process. Affirmations generally involve giving clients compliments or making statements of appreciation towards their values and goals.

These are primarily used to highlight their client’s personal strengths and further encourage positive actions towards establishing effective change. These affirmations may include the following examples:

  • Acknowledging a client for their continued efforts to show up and make an effort for their Motivational Interviewing sessions, and commending them for their time management skills.
  • Pointing out a client’s progress in adjusting the language they use regarding change talk, and congratulating them for developing a more positive mindset towards self-growth.

Reflections

Reflections are statements that allow an MI practitioner to provide their interpretation of what their clients are attempting to communicate while answering open questions, or during a more casual conversation.

These not only allow a client and their practitioner to develop a relationship of mutual respect and understanding but helps a client to build and exercise healthy communication skills. This can lead to their development of healthier personal relationships as they learn how to more clearly express themselves and understand others.

Furthermore, when using reflective listening and thinking skills, both the client and their therapist can find greater depth within a seemingly simple problem. As both parties talk about a specific issue in further detail, a person may be able to become more aware of underlying feelings or circumstances that may be limiting their ability to initiate self-growth and change.

Successfully Demonstrating Reflective Listening

Reflections require a great deal of commitment from both the therapist and the client. After all, these statements will demonstrate the MI practitioner’s reflective listening skills and may indicate to their client their true level of interest in helping them.

Clear communication is a key factor in any form of therapy, but it is particularly prevalent in the Motivational Interviewing process. Of course, any social interaction will generally require a level of back-and-forth before both individuals are effectively able to speak each other’s language.

Thus, if a therapist’s description of a conversation with their client does not quite match up to what the person is trying to communicate, it is important that they try not to respond negatively. Rather, both parties should continue to talk and provide clarification on a specific topic. Ultimately, this can further improve each of their reflective listening skills and techniques.

Summaries

Summaries, or summary statements, are used to combine all of the ideas discussed during a Motivational Interviewing session, as a means of understanding them as a whole.

As demonstrated through the reflective listening stage, change talk can often become extremely deep. Thus, being able to narrow down the most important details and feelings surrounding a specific issue into a singular summary statement is crucial in establishing a plan of action for evoking change.

When using Motivational Interviewing as a means of addressing addiction, for example, this may involve helping a person to explore the underlying causes of their substance use during the reflection stage. Once these have been identified, a summary statement can then be formed identifying key contributing factors to and triggers for their substance abuse.

Only once this has been accomplished, can the client and their practitioner begin developing a plan for how the individual will target and overcome their addiction. This step is particularly important when working with ambivalent clients.

The Need to Resolve Ambivalence

For many individuals who are struggling with addiction, experiencing conflicted feelings towards seeking out professional treatment is not uncommon. In other words, these individuals are ambivalent towards getting help.

These opposing ideas may include the following examples:

  • A desire to seek out treatment, but feeling held back by financial, social, environmental, or other restrictions.
  • Wanting to overcome an addiction, but lacking the self-confidence or will-power to do so.
  • Not wanting to overcome an addiction, but feeling obligated or forced to do so for the sake of loved ones.

Of course, the Motivational Interviewing process was designed with these mixed emotions and their limitations strongly in mind, as seen in its implementation of reflective listening and summarization skills.

Once a practitioner and their client have gotten to the root of their limiting behaviors through the use of summary statements, they can then begin to resolve ambivalence in these individuals. This not only allows the client to exercise autonomy in their recovery process, but to further explore their strengths and motivation for change.

 

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The Principles of Motivational Interviewing

As a form of therapy, Motivational Interviewing, while established on a foundation prioritizing a set treatment process and spirit of being, is still a very personal experience. Thus, particularly when used as a form of substance abuse treatment, this technique emphasizes a need to adhere to certain principles in its approach to treating clients, including:

  • Expression of Empathy
  • Development of Discrepancy
  • Rolling with Discord
  • Support of Self-Efficacy

Expression of Empathy

Because change is often an intimidating and difficult process, MI practitioners are responsible for approaching clients and their goals with empathy and an open mind. Providing consistently compassionate support is considered to be an integral part of the MI process in effectively helping people change.

Furthermore, maintaining a constant level of empathy throughout this treatment process allows practitioners to build a stronger level of trust with their clients. Not only this, but in observing how it is possible to approach others openly and compassionately through their therapist, a person can also develop these skills for themselves.

Development of Discrepancy

Any therapeutic service will heavily prioritize a level of confidentiality between a service provider and their clients. This not only promotes a safe and supportive environment during sessions, but allows clients to feel secure in their relationship with their therapist.

This is particularly important in establishing an individual’s comfortability with honestly answering open-ended questions. After all, they are able to communicate how they are feeling and share any thoughts or beliefs without the fear of rejection or judgment.

Rolling with Discord

Disagreements between practitioners and their clients are not uncommon when it comes to Motivational Interviewing. Especially for individuals overcoming addiction, stopping usage of an abused substance can produce difficult emotions and physical side effects, which can result in confrontational behaviors.

In these cases, practitioners are expected to move through these periods with patience and open-mindedness. This not only demonstrates their reflective listening skills, but can serve to reassure their client that they matter and will be met with compassion when sharing their concerns and frustrations.

Support of Self-Efficacy

Ultimately, when it comes to establishing change, it is up to a client and their own autonomy and intrinsic motivation to achieve this goal. The practitioner simply serves as a means helping their clients with focusing, developing, and implementing their goals for change.

While the client is responsible for actually enacting change in their life, having a healthy form of interaction and external support can make this process significantly less difficult for them.

The Benefits of Motivational Interviewing in Treating Addiction

Benefits of Motivational Interviewing

There are several benefits associated with the use of Motivational Interviewing skills and services as a form of substance abuse treatment. While this is primarily found to be most effective when combined with other treatment methods, the MI approach has been found to be beneficial even on its own.

Some of these benefits may include:

  • Increased rates of individuals continuing or returning to addiction treatment programs.
  • Increased rates of individuals participating in and seeking out professional treatment programs.
  • Increased recovery success rates in individuals who seek out professional addiction treatment.
  • Increased rates of sustained abstinence and long-term recovery following initial treatment.
  • More effective managed care treatment options.
  • Increased success in intervention and stabilization efforts.
  • Successful application in a variety of clinical treatment settings related to addiction (i.e., mental health or psychiatric treatment services).
  • Reduced need for long-term client-therapist relationships, as MI is designed to produce long-lasting behavioral change.
  • Noticeable behavior change within the first session, through creating a safe and supportive space, and a mutually respectful client-therapist relationship.

Furthermore, Motivational Interviewing has even been found to be particularly effective for individuals who have been previously unsuccessful with Cognitive Behavioral Therapy (CBT) – a popular form of therapy in many approaches to addiction treatment.

This has primarily been found to be due to the fact that MI provides a level of support, validation, and intimacy between clients and their therapists that may not be available through CBT services. Furthermore, MI may also be particularly beneficial for individuals who have previously experienced or are at risk of a relapse.

Finding the Right Treatment Options for You

If you or a loved one is struggling with addiction and are ready to start seeking out professional treatment options, you may be feeling overwhelmed or unsure of where to start this process. Here at Find Addiction Rehabs, we know how difficult it can be to find support and resources for substance abuse; but that’s why we are here.

With our hotline available 24/7, our representatives are always ready to help connect you with rehab facilities and addiction treatment programs that are dedicated to meeting your personal care needs. Whether finding Motivational Interviewing services near you or helping you determine other treatment options that work for you, we are here to help.

Committing to the stages of change in overcoming addiction can feel impossible, but it does not have to. So put yourself first, and make the right choice. By calling us today, we can help you take the first step on a path to recovery, where you can discover the intrinsic motivation you need to successfully achieve lasting sobriety and inner peace!