Motivational Interviewing

Empowering Change in Substance Use Disorder Treatment

Substance use disorder (SUD) is a complex and challenging condition that affects millions of individuals and their families worldwide. The journey to recovery from addiction is often fraught with obstacles and setbacks, making it crucial to have effective therapeutic approaches that can guide individuals toward lasting change. One such approach that has gained recognition and prominence in SUD treatment is Motivational Interviewing (MI).

Motivational Interviewing is a psychotherapeutic approach that places the individual at the center of their recovery journey, empowering them to explore their motivations, set goals, and make informed choices regarding their substance use. With its roots in Rogerian client-centered therapy and cognitive dissonance theory, MI offers a compassionate and collaborative framework for addressing ambivalence and fostering intrinsic motivation to change.

The Essence of Motivational Interviewing

At its core, Motivational Interviewing recognizes that individuals with SUD often harbor mixed feelings about change. On one hand, they may acknowledge the negative consequences of their substance use, while on the other hand, they may be reluctant or unsure about the prospect of giving up the substance. MI meets individuals where they are in this ambivalent state and aims to resolve this internal conflict by facilitating self-discovery and empowerment.

The central principles of Motivational Interviewing are:

Express Empathy

MI practitioners demonstrate empathy by actively listening to individuals, showing understanding, and validating their feelings and experiences. This empathetic connection creates a safe and non-judgmental space where individuals feel heard and respected.

Develop Discrepancy

MI helps individuals recognize the discrepancy between their current behavior (substance use) and their values, goals, and aspirations. By highlighting this incongruence, individuals are motivated to resolve it and move towards change.

Roll with Resistance

Instead of confronting resistance with confrontation or argumentation, MI practitioners “roll with” it. This means acknowledging resistance and exploring it in a non-confrontational manner, allowing individuals to express their concerns without feeling pressured.

Support Self-Efficacy

MI enhances individuals’ belief in their ability to change by reinforcing their past successes and strengths. It fosters self-efficacy, helping individuals build confidence in their capacity to make positive changes.

The Stages of Motivational Interviewing

Motivational Interviewing is typically conducted in four sequential stages:

  • Engagement: In this initial stage, the MI practitioner establishes rapport and builds a trusting therapeutic relationship with the individual. This phase sets the foundation for open and honest communication.
  • Focus: The focus stage involves identifying the individual’s goals and concerns related to their substance use. It helps clarify what is most important to the person and what they hope to achieve.
  • Evoke: During this stage, MI practitioners use empathetic and open-ended questions to elicit the individual’s thoughts and feelings about their substance use. It encourages self-exploration and the expression of ambivalence.
  • Plan: The final stage centers on developing a change plan. Together, the individual and the MI practitioner collaborate to create a roadmap for achieving the identified goals and addressing any obstacles that may arise.

The Efficacy of Motivational Interviewing in SUD Treatment

Numerous studies have demonstrated the effectiveness of Motivational Interviewing in substance use disorder treatment. MI has been shown to increase treatment engagement, improve treatment retention, and enhance treatment outcomes. It is particularly valuable in situations where individuals may initially be resistant or hesitant to change.

One of the key strengths of MI is its adaptability to various stages of change. Whether an individual is in the pre-contemplation stage (not yet considering change), the contemplation stage (considering change but ambivalent), or the preparation stage (ready to take action), MI can be tailored to meet them where they are in their recovery journey.

Furthermore, MI aligns with the principles of person-centered care, recognizing that individuals are the experts in their own lives and have the capacity to make choices that best serve their well-being. This approach empowers individuals to take ownership of their recovery, fostering a sense of autonomy and self-efficacy.

Incorporating Motivational Interviewing into SUD Treatment

Motivational Interviewing is a versatile approach that can be integrated into various modalities of substance use disorder treatment. It is commonly used in individual therapy sessions, group therapy settings, and even as part of family therapy. MI techniques can also be applied in medical and psychiatric consultations to address the complex relationship between SUD and co-occurring mental health conditions.
MI is particularly effective in enhancing the readiness for change, which is often a critical precursor to entering formal treatment programs such as detoxification, residential treatment, or outpatient therapy. By helping individuals resolve ambivalence and bolstering their motivation, MI acts as a bridge to accessing these vital resources.


Motivational Interviewing represents a transformative and compassionate approach to substance use disorder treatment. Its emphasis on empathy, collaboration, and respect empowers individuals to explore their motivations, confront ambivalence, and make meaningful changes in their lives. As a person-centered approach, MI aligns with the individual’s values and aspirations, making it a powerful tool for enhancing engagement, retention, and outcomes in SUD treatment.

At Mulligan Recovery Centers, we recognize the profound impact of Motivational Interviewing in supporting individuals on their path to recovery. Our dedicated professionals are trained in MI techniques and are committed to providing compassionate and effective care that empowers individuals to achieve lasting change in their substance use and overall well-being.