Motivational Interviewing (MI) for SUDs

Behavioral therapies are often an important component of treatment for substance use disorders (SUDs). Motivational interviewing (MI) is an evidence-based addiction therapy that can encourage people to make healthy changes in their lives.¹

Keep reading to learn more about motivational interviewing for substance use disorders and how it may help you or a loved one start and stay on the path to recovery.

What Is Motivational Interviewing (MI)?

Motivational interviewing is a short-term, person-centered counseling approach that helps people address and resolve their ambivalence about change.^1,2

MI is a collaborative style of therapy that involves an active partnership between the patient and therapist as a way to promote change. Therapists who provide MI urge their patients to think about the negative consequences of their behaviors and the positive effects of a healthier lifestyle by using non-confrontational, empathic techniques.^1,3

When used for addiction treatment, MI may help people stop or reduce drug and alcohol use by leading them to discover their motivations for stopping drug or alcohol use. The therapist encourages patients to engage in treatment by initiating a discussion about their substance use and the reasons behind their reluctance to change.^2,3

Motivational interviewing techniques can strengthen a person’s readiness for change, by helping them:^3,4

• Recognize they are suffering due to addiction.
• Realize they can develop healthier coping mechanisms instead of using drugs and alcohol.
• Understand the benefits of sobriety.
• Learn they have the power to break the cycle of addiction.
• Commit to behavioral change.

What Can Motivational Interviewing Treat?

Motivational interviewing therapy can be used to treat a variety of conditions and problems, such as:^3–6

• Substance use disorders, including addiction to alcohol, stimulants, and other drugs.
• Co-occurring mental health disorders like depression.
• Polysubstance use disorders.
• Smoking.
• Stress.
• Compulsive gambling.
• Sexual risk-taking.

How Does Motivational Interviewing Work?

MI works by using strategic conversational techniques that promote internally motivated change. It is a brief or short-term intervention that can be conducted in person, over the phone, or virtually through text messaging and other online platforms.^1,3,5

MI can take place in single or multiple sessions and may be combined with other evidence-based therapies to provide more effective outcomes.¹

An MI therapist relies on certain principles of person-centered counseling, which include:⁷

• Partnership—The therapist and patient are collaborators who work together to motivate change.
• Evocation—This is based on the idea that all people possess the needed resources and skills to change. An MI therapist will use techniques to help a patient explore their reasons for change and build motivation to make the desired changes.
• Acceptance—The therapist takes a nonjudgmental, respectful, and empathic approach that recognizes a patient’s personal experiences, strengths, and autonomy regarding change.
• Compassion—The therapist prioritizes and supports the patient’s health and well-being at all times.

In motivational interviewing for addiction, the therapist’s view is that ultimately it is up to the patient to decide whether they want to change their substance use and other related behaviors. The therapist can help them see the pros and cons of change and help motivate them to make changes, but it is the patient who is responsible for finding their internal motivation and making the commitment to change.³

The therapist can also help the patient see where they currently are and where they’d like to be, identify obstacles that might be in the way of achieving their goals, and prepare to make changes if they choose to do so.³

The Transtheoretical Model of Motivational Interviewing

MI is founded on the transtheoretical model, a five-stage process of change. The model involves the idea that change can produce ambivalence, and people may go back and forth between wanting to change and wanting to stay the same before they commit to making changes.^3,6

The transtheoretical model of the five stages of change are:³

1. Precontemplation is when the person is not considering change.
2. Contemplation is when the person starts to realize they need to make a change but remains ambivalent about changing their substance use and related behaviors.
3. Preparation is when the person starts to weigh the pros and cons of change and decides to commit to change.
4. Action is when the person successfully implements their plan to stop using substances and make other related behavior changes.
5. Maintenance is when the person remains actively involved in their recovery and maintaining changes.

OARS and the Four Processes of MI

OARS is an acronym for the core counseling skills used by MI practitioners to elicit change in their patients. These motivational interviewing techniques for substance abuse may include:^3,7

• Open-ended questions, or those that cannot be answered with a simple yes or no. This helps a patient reflect on their reasons for change, examines what the patient already knows about change, and gives the therapist an opportunity to gain a greater understanding of the patient’s experiences. This might include questions such as, “Can you tell me about the impact your substance use has had on your family life?”
• Affirmation, in which the therapist expresses positive regard for the patient’s strengths. This might include supportive statements such as, “Even though you felt tempted to drink last weekend, you stayed sober. I can see that you’re really working hard on your recovery.”
• Reflective listening, where the therapist repeats, rephrases, or offers their best understanding of what the patient has said. For example, the therapist may use statements such as, “If I understand you correctly…” or “It sounds like you’re saying…”
• Summarizing, which is a form of reflective listening where the therapist provides a brief statement or summary of the key points made by the patient during the session.

MI uses four key processes, which include:^3,8

• Engaging—Establishing a collaborative relationship between the therapist and patient.
• Focusing—This elicits the presenting problem and sets the stage for a plan to change.
• Evoking—The therapist helps the patient by using MI core skills and strategies, such as reflective listening, to encourage a goal-oriented plan.
• Planning—The patient develops a plan to make behavioral changes.

Benefits of Motivational Interviewing (MI)

Motivational interviewing for substance abuse may have various benefits for people who are struggling with addiction and those already on the path to recovery. Evidence shows that MI can also be effective for SUD treatment when combined with other therapies, such as group counseling, cognitive behavioral therapy (CBT), and recovery management checkups.¹

The benefits of MI for SUDs may include:^1,4,5

• Helping people find and develop their motivation to change.
• Preparing people to enter treatment.
• Increasing participation and involvement in treatment.
• Improving treatment retention and overall treatment outcomes.
• Decreasing substance use, especially alcohol, tobacco, and marijuana use.
• Reducing rates of relapse and encouraging a return to treatment should relapse occur.

Research suggests that MI may be especially effective for treating alcohol use disorder and can help improve a person’s engagement in treatment and reduce problem drinking.^1,4

Does Insurance Cover Motivational Interviewing?

Insurance coverage varies greatly from plan to plan. However, most insurance carriers cover substance use disorder treatment to some degree, and it is possible that your insurance plan could also cover motivational interviewing as a part of a comprehensive, evidence-based addiction treatment program.

To learn more about your specific benefits and insurance coverage options, contact your insurance provider directly or fill out this simple and secure .

At Greenhouse Treatment Center, we are in-network with many insurance companies, including:

• Blue Cross and Blue Shield of Texas (BCBSTX).
• Aetna.
• Humana.
• Ambetter.

MI and Addiction Treatment in Texas

If you or a loved one is struggling with addiction, professional treatment at our Dallas inpatient rehab facility can help. Greenhouse offers different types of rehab care and personalized treatment plans designed to meet the individual needs of each patient.

We also provide specialized programs for Veterans, first responders, the LGBTQ community, Christians, young adults, trauma survivors, and more.

Call to speak with one of our caring admissions navigators and learn more about motivational interviewing as a treatment for substance abuse. They can also answer any questions you may have about how to cover the cost of treatment and help you start the treatment admissions process when you’re ready.

It’s never too late to get the care you deserve. Contact us today.