Motivational Interviewing

What is Motivational Interviewing?

Motivational Interviewing is a type of therapy that focuses on helping individuals clarify their goals and make concrete behavioral changes. It honors client autonomy by supporting their self-motivational statements and facilitating behavior change.

These behaviors can vary widely, but they often include health-related behaviors, substance abuse, and other addictive behaviors. Its goals are to support individuals in working through the negative aspects of conflicting feelings, evaluating their options for action, and finding motivation to make desired change. Though Motivational Interviewing (MI) can be more directive than some forms of therapy, the therapist doesn’t tell you what changes you should make; rather, they support you in sorting through your thoughts and feelings as you decide what you genuinely want to change as a collaborative process.

Motivational Interviewing is often quite brief, with treatment sometimes lasting as few as one or two sessions. That said, it can also be used as a complement to or a component of longer-term treatment models.


How Motivational Interviewing works

Motivational Interviewing relies on the partnership between an empathetic, supportive therapist and an individual who is contemplating a meaningful change in their behavior. The philosophy behind it is often described as person-centered or humanistic, which in this case means that Motivational Interviewing (MI) assumes that the individual can and should be the one who decides to make change. Therapists are helping patients change behavior through their supportive actions and their ability to elicit change talk.

According to this philosophy, there are four key points. To begin, the therapist is there to engage with you, build rapport, and listen to your concerns and reasons for wanting change. Your therapist may express empathy while learning about your personal challenges.

The next steps involve focusing on the target behavior and evoking your specific goals for change. Your therapist may notice and point out your existing motivations, clarify your feelings, and reinforce your change talk while encouraging you to stay away from sustain talk or keep up with the unhealthy habits you want to change.

Finally, your therapist is there to aid you in planning the process of committing to making change. You may or may not commit to actually making a change, but in Motivational Interviewing, the choice belongs to you, and your therapist’s role is to support you in that choice.

What happens in a typical Motivational Interviewing session

Motivational Interviewing may look a lot like other forms of behavioral and cognitive psychotherapy, but one of its main differences is that it focuses on a specific area of change that the client is interested in working on.

The new desired behavior may be identified ahead of time, and your first session will likely start with your therapist asking you a series of questions about this area of change and your related thoughts, feelings, and behaviors. If, for example, you want to quit smoking, your therapist might ask about your history of smoking, how you feel about smoking, and what makes you wonder if you might want to quit.

From that point, you’ll continue to discuss the factors affecting your decision, with your therapist prompting you as needed to get a complete picture of the change you’re considering and the reasons you might choose different courses of action. Often, you’ll be asked to outline different decisions you might make and describe the pros and cons of each, along with your feelings about them. Your therapist might also offer you information about the situation you’re contemplating or ask clarifying questions to help you understand your options more clearly. These can be tough conversations about your future goals based on your current behavior.

Depending on the course of your treatment, you may come to a decision within a session or two. Your therapist may also work with you on your plan for committing to any change you’ve chosen and voicing your commitment aloud can be a critical aspect of treatment adherence. There is little room for resolve ambivalence when committing to make long-term positive changes.

What Motivational Interviewing can help with

Motivational Interviewing can help with challenges including, but not limited to:

  • Addictions (Smoking cessation, alcohol abuse, and other substance use disorders)
  • Anxiety
  • Depression
  • Any substantial behavioral changes (lose weight)

Motivational Interviewing techniques were designed for addiction medicine, specifically people struggling with substance abuse treatment. It is also used to treat other addictions including gambling, sex, and shopping.

It is also a common treatment in medical or health care settings, using motivational strategies to help individuals commit to behavioral changes necessary for medical reasons or physical health conditions (such as taking medication regularly or making dietary changes). More recently, it has become a treatment option for mental illness conditions like anxiety and depression as well.

Generally speaking, anyone considering making a substantial change in behavior might benefit from reflective listening of an empathetic ear and support for their self-efficacy.

Effectiveness of Motivational Interviewing

Research suggests that Motivational Interviewing can be an effective short-term treatment for various behavioral health issues as an evidence-based approach.

One review of a wide range of Motivational Interviewing studies found that although the degree of effectiveness varied depending on who was receiving treatment and what the target problems were, the treatment nonetheless had positive outcomes for many participants. [1]

Another study found that Motivational Interviewing can also help improve health-related behaviors in medical settings and is associated with better communication between patients and doctors. [2]

What to look for in a Motivational Interviewing therapist

Motivational Interviewing skills can be provided by a wide range of practitioners, including social workers, psychologists, and psychiatrists. There is no specific credential that all Motivational Interviewing therapists have, but you’ll want to make sure that your therapist has an up-to-date license, as well as experience or advanced training in using Motivational Interviewing.

You might ask potential therapists how long they’ve been practicing Motivational Interviewing, what kind of training they’ve received in this modality, and whether they have experience using it with individuals who are targeting the same kind of behavioral change that you’re interested in working on.

New to therapy? Learn about how to find a therapist here.