Helping a friend or family member who struggles with addiction can be a balancing act between your desires for their recovery achievements and what they desire to achieve for themselves. It is common for this balancing act to be evident during interventions. When we are finally able to speak with the person about the destructiveness of their drug use and persuade them to embrace recovery,  it is easy to let our emotions and our desires to get the best of us. This may be therapeutic for us, but can be detrimental to the person we are hoping will choose recovery. Recovery always has to come from the person. Although we may present the evidence, if addiction is not something they acknowledge on their own, the message of recovery will not be absorbed. Motivational interviewing (MI) helps address this fundamental roadblock by motivating addicts and alcoholics to change their own position on recovery rather than being persuaded by outside influences.

Motivational Interviewing was developed to treat problematic drinkers by William R. Miller in the 1980s and its use continues to gain support. MI has become an evidence-based approach for substance use treatment. The thought process behind MI is that by exploring and resolving ambivalence, individuals can become motivated to change based on their own desires. Often times, this change occurs through collaboration with a clinician (counselor, therapist, etc.) through a series of open ended questions, but always remains centered on the individual. Four key concepts related to MI include: expressing empathy, supporting self-efficacy, rolling with resistance and developing discrepancy. Expressing empathy refers to thinking about the situation from the perspective of the individual through acknowledgement of where they are coming from. Supporting self-efficacy relies on assessing the strengths of the individual so that they know they possess the power to make a change in their behavior. Rolling with resistance is a technique utilized when the views of the individual seem to be in conflict with the desired outcome. The motivational component of MI occurs with the final concept: developing discrepancy. When developing discrepancy it is important to highlight how the substance abuse and associated behaviors are in conflict with the goals and values of the individual. For best results, the discrepancies need to be developed by the individual rather than pointing out what you feel is wrong with their choices.

When utilized by a qualified professional, MI can be helpful during interventions because it influences the addict / alcoholic to acknowledge their own desire to embrace recovery. It is imperative that the desire to recover comes from the person on their own terms, thus MI allows for the individual to find their own motivation to change. Qualified addiction professionals will ask open ended questions, acknowledge the strengths of the individual, and provide reinforcement through summaries of the discussion. Whether you’re a professional looking to incorporate MI into your treatment plan, or if you’re just a concerned family member, understanding that you have to inspire a person to embrace recovery is far more valuable than simply telling them about it.


Motivational MI Definitions Principles and Approach

SAMHSA National Registry of Evidenced by Programs and Practices: Motivational Interviewing