Motivational Interviewing (MI)

Motivational Interviewing (MI) is a client-centered, directive approach designed to enhance motivation for change by helping individuals resolve ambivalence. Developed by William R. Miller and Stephen Rollnick, MI is rooted in empathy, collaboration, and respect for the client's autonomy. It is particularly effective in addressing substance use disorders (SUDs) by empowering individuals to identify and pursue their personal goals for recovery.

At its core, MI is built on four key principles: expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. By creating a nonjudgmental, supportive environment, the therapist helps clients explore the gap between their current behaviors and desired values or goals (developing discrepancy). Resistance to change is not confronted directly but explored with curiosity and acceptance (rolling with resistance), while self-efficacy is bolstered by highlighting the client’s strengths and past successes.

MI uses open-ended questions, reflective listening, affirmations, and summaries to evoke "change talk," where clients express their own reasons, desire, ability, and need for change. This intrinsic motivation is seen as the most enduring foundation for lasting behavioral changes.

MI as a Treatment for Substance Use Disorder (SUD)

For individuals with SUDs, ambivalence about change is common. MI is highly effective in these situations, as it focuses on understanding the individual's unique relationship with substances and their readiness to change. The therapist collaborates with the client to identify their goals, clarify their values, and explore how substance use aligns—or conflicts—with these aspirations.

MI is often integrated into broader treatment programs, such as cognitive-behavioral therapy (CBT) or 12-step models. It is particularly useful in engaging clients who are initially resistant or unsure about recovery. Research shows that MI can increase treatment retention, reduce substance use, and improve outcomes across various settings, including outpatient programs, primary care, and criminal justice systems.

By fostering a compassionate, client-driven approach, MI helps individuals build motivation and confidence to make meaningful, lasting changes in their lives.