Motivational interviewing (MI) is a counseling approach in which motivation is used to help clients change their behaviors. This treatment was first described by Professor William R. Miller, Ph.D., in a 1983 issue of Behavioral Psychotherapy. Motivational interviewing for substance abuse is effective for many clients because a lack of motivation to quit drugs or alcohol can be one of the greatest challenges for people with addictions, even despite health, financial, social, and legal problems. The idea behind using motivational interviewing in addiction treatment is to help the individual understand the negative consequences of their drug use and help them reach a stage of readiness when it comes to changing their behavior and getting sober.

Objectives of Motivational Interviewing for Substance Use Disorders

There are seven key points to motivational interviewing for substance abuse treatment:

  • Motivation comes from the client, not from outside sources.
  • Clients are responsible for resolving ambivalence (uncertainty,) not the counselor.
  • Uncertainty cannot be resolved through direct persuasion by the counselor.
  • The counselor quietly elicits information from the client.
  • The counselor guides the client in recognizing and resolving uncertainty.
  • Readiness to change is a fluctuating result of interpersonal interaction, not a character trait.
  • The client-counselor relationship should resemble a partnership.

With these guidelines in mind, MI therapists at our Massachusetts treatment center utilize the following steps to help clients:

  • Engaging: Engaging the client about issues, concerns, and hopes and establishing a trusting relationship with them.
  • Focusing: Centering the conversation on the patterns and habits the individual wants to change.
  • Evoking: Gently eliciting client motivation for change by explaining the importance of change, confidence that change can occur, and readiness for change.
  • Planning: Developing a set of practical steps the client can use to implement the desired changes discussed during treatment.

Motivational interviewing substance abuse treatment is a client-centered form of counseling that focuses on figuring out what clients need and want rather than what the counselor thinks is best. This requires high levels of empathy, reflective listening, and the ability to form strong bonds with clients as well as openness, vulnerability, and willingness to change from clients.

Common Motivational Interviewing Questions for Substance Abuse

Encouraging clients to discuss their addiction and their need for treatment is often a matter of asking the right question. It’s important to note that there aren’t any wrong answers.

Motivational interviewing in addiction treatment is all about empowering the individual to take responsibility for their actions and help them decide that getting sober is the right thing to do. Therapists at our Massachusetts inpatient drug rehab want clients to talk about their concerns, feelings, ideas, and plans rather than have someone else decide what’s best for them.

Common questions used in motivational interviewing to make this possible include:

  • Tell me about your concerns or challenges related to your drug or alcohol use.
  • What do you like most about the drugs or alcohol you use?
  • What are the positives about these substances for you? And what are the negatives?
  • What are your worries about your drug or alcohol use?
  • Tell me what you’ve noticed about your drug or alcohol use. How has it changed over time?
  • What things have you noticed that concern you that might become problems?
  • What have other people told you about your drug use?
  • What do you think other people are worried about regarding your drug or alcohol use?
  • Tell me what concerns you about your drug or alcohol use. Tell me what it has cost you.
  • What makes you think that you need to change your drug or alcohol use?
  • What do you think would be the most likely consequences if you continue to use drugs or alcohol?
  • What might be the positives of giving up drugs or alcohol?
  • What might be the negatives of giving up drugs or alcohol?

The last question, in particular, will help the individual realize what they fear about getting sober. Rather than invalidating clients’ fears about sobriety, we want to identify these concerns and help them realize that the pros of sobriety far outweigh any cons.

Motivational Interviewing & Substance Abuse Treatment

The purpose of motivational interviewing for substance abuse is to help clients overcome their internal battles about wanting to quit. Even though there are many clear reasons to quit drug or alcohol abuse, for a person with a substance use disorder, there are also several reasons not to quit. As a result, many addicts will go back and forth on the “pros and cons” of quitting, delaying their progress or preventing it entirely.

In one study, students addicted to tobacco who received motivational interviewing treatment were four times more likely to attempt to quit or cut down on their use of tobacco than others who did not receive MI.1 Motivational interviewing aims to lay out the pros and cons of quitting based on what the client believes is important. Once the individual overcomes denial and develops their conclusions about the pros and cons of quitting, their desire to change, what change means, and how they want to apply that change, it becomes a lot easier for them to change.

By taking these steps with clients to develop their personal desire to change and understand why it’s necessary for their lives, clients won’t feel forced to give something up. Instead, they’re pursuing the better and healthier lifestyle that they’ve chosen.


Addiction and Mental Health Support in MA

Motivational interviewing for addiction and mental illness is just one of the various psychotherapy programs offered at Clearbrook Treatment Centers Massachusetts. By offering various modalities of treatment, our team can help more people in varying stages of recovery.


For more information about MI or our other Massachusetts drug rehab programs, contact Clearbrook today.



  1. National Library of Medicine – The Effectiveness of Motivational Interviewing Delivered by Youth Workers in Reducing Drinking, Cigarette, and Cannabis Smoking Among Young People: Quasi-Experimental Pilot Study


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