Motivational interviewing is used to assess the motivation of addicts seeking treatment for substance abuse. It is innovative because rather than focusing on telling patients what they should do or highlighting the health risks of addiction, motivational interviewing focuses on what the patient is ready for in terms of treatment. It is less about what the doctor or therapist feels is important and more about what the patient wants. If the patient is motivated to seek treatment, they will speak that in the interview, and if they are not, it is an important step in identifying the problem.

The thought behind motivational interviewing is that it exposes difficulties people have in seeking treatment and maintaining abstinence and brings those issues out into the open where addicts can speak openly about them, which makes those barriers easier to overcome.1 People tend to respond negatively to conflict, and telling people to quit addictive substances is confrontational. It tends to make people defeated prior to beginning treatment.

In the past, treating patients with addiction problems has been challenging, as the addicted often have volatile emotions and are not ready to be motivated to change. “Hitting rock bottom” often motivates, but even in these cases, patients are likely to relapse due to the effects of their negative lifestyle choices on their friends and family. Their entire lives are filled with conflicts arising from their own internal conflicts or the attempted interventions of others during times that weren’t right for change. One thing is certain. The last thing an addict needs when seeking treatment is another conflict or intervention. That is why motivational interviewing has been an ongoing positive addition to treatment. It allows the patient to express how important it is in their life that they enact change, and it allows the patient to drive their own treatment rather than being told how to make decisions, as they’ve experienced unsuccessfully already.

Three decades of research and development have done in regard to the psychotherapy of motivational interviewing. Two primary areas of motivational interviewing were shown to be relevant: therapist effects and clinical style. Therapists’ empathy caused a major effect in successful motivational interviewing. Clinical style in therapists’ demeanor also proved important. Responding to the clients’ words allowed clients to argue against their own behavior. 2

Two different methods were studied when evaluating motivational interviewing (MI): They were MI combined with assessment feedback and MI added to active treatment. Two methods were used in combination rather that MI only because MI is not meant to be stand-alone treatment. It is meant to be a part of collaborative treatment.

Motivational interviewing combined with assessment feedback was the typical interviewing process assessing the addict’s motivation combined with details about health risks, normative data, and feedback in responses in general. There was feedback given from therapists or clinicians, and follow up proved this was successful in sustaining abstinence. 2

Interviewing was also combined with active treatment in facilities with therapists, drugs, and other methods. Regardless of the treatment, the inclusion of MI doubled the rate of success over three to six months. 2

The research of motivational interviewing was definitively shown as an improvement to treatment without MI. Some therapists have been shown to be more effective than others, and a certain amount of patients don’t respond at all to treatment regardless of whether or not MI is included. These negative results prove that MI is not fully understood and warrants further investigation and training of clinicians.

Ultimately, motivational interviewing is added to treatment prior to other methods of treatment and is meant to be used collaboratively to enhance the long-term results of substance abuse treatment. The results of motivational interviewing are promising, and further implementation of this clinical model is relevant in addiction therapy.