Coping With Mental Health: Motivational Interviewing

People with substance abuse disorder are often unable to stop using harmful substances. The disease affects the brain and behavior, leading to an inability to control the use of drugs and/or medicine. Substance abuse disorder can include both legal and illegal substances, from nicotine to illicit drugs, such as heroin or cocaine.1

Treatment for substance abuse disorder usually involves a combination of:2

  • Detox therapy
  • Relapse prevention
  • Rehabilitation counseling
  • Behavioral treatment
  • Individual or group psychotherapy, or “talk therapy”

One type of psychotherapy that has shown to be useful in treating substance abuse disorder is motivational interviewing.3

What is motivational interviewing?

Motivational interviewing is centered around the idea of a therapist interacting with his or her patient and being accepting of them and their uncertainty that may be preventing necessary healing. The focus of motivational interviewing is on the idea that people must exercise free choice and that they can heal through a process of motivation for self-realization. Motivational interviewing uses strategies such as reflective listening, shared decision-making, and encouraging change through discussion. This style of talk therapy is based on four assumptions:3,4

  1. It is normal for a person to be ambivalent, or unsure, about changing his or her behavior. This is an important motivational obstacle for recovery.
  2. This ambivalence can be solved by working with a patient’s personal natural motivation and values
  3. The relationship between the therapist and the patient is a partnership
  4. An empathetic, supportive, and directive approach is critical for success

How does motivational interviewing work?

The strategic approach to motivational interviewing involves 3 key techniques:3

  • Reflection – Content reflection and feeling reflection. Content reflection can help the therapist get background on the patient and build a trusting relationship with them. This is when the therapist listens to what the patient says and repeats it back without adding judgment or opinion. Feeling reflection is when the therapist hears what the patient is saying and translates it back in terms of feelings and cause of feelings. For example, you are feeling that way because of this action.
  • Rolling with resistance – Rather than arguing with a person's arguments or justification for their behavior, the therapist acknowledges the difficulty and resistance to change
  • Change talk – Motivational interviewing relies on the belief that a person is more likely to make changes in his or her behavior if those changes are his or her own idea. Patients are encouraged to voice their own ideas on what changes they might make, what might work, and what might not work. The therapist may also make suggestions on new ways of thinking and behaving.

Does motivational interviewing work?

Motivational interviewing has been proven to be very effective in treating substance abuse disorder. It has also been increasingly used in other healthcare settings. Some areas where motivational interviewing has been proven effective include:3,5,6

  • Weight loss
  • HIV risk reduction
  • Cholesterol level control
  • Diabetes
  • Cardiovascular conditions
  • Asthma

The methods of motivational interviewing used to treat substance abuse disorder and other disease management can also be applied to everyday health interactions. These methods may help people make changes in behavior that lead to improved health outcomes.6

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