What is Motivational Interviewing and What Role Does it Play in Mental Health Treatment?

Healing from mental illness or addiction requires making meaningful emotional and behavioral changes. However, many people feel ambivalent about making those changes and struggle to find the motivation to engage in transformation. Motivational interviewing can change that. So what is motivational interviewing? By understanding the techniques and spirit of motivational interviewing, you can come to see the value of integrating this unique modality in a comprehensive treatment plan.

When you’re struggling with mental illness or addiction, recovery depends not just on gaining insight into your condition, but on making emotional and behavioral changes to support recovery in concrete ways. However, making those changes can be hard, especially when you are still in the midst of psychological distress. Sometimes, finding the motivation to want to make those changes can be even harder, whether it’s truly ending substance use, improving your interpersonal relationships, or living a healthy lifestyle. While there are a multitude of therapeutic modalities geared toward helping you understand your experiences and develop the skills you need to move toward wellness, all depend on your desire to create meaningful change.

Wanting change, knowing how to change, and actually making a change are all very different things, and the greatest barriers to healing often live in the spaces between them. This is where motivational interviewing comes in. So what is motivational interviewing and why does it work? By understanding the logic behind this innovative approach, you can come to recognize why it plays a vital role in recovery.

What is Motivational Interviewing?


Originally developed by Drs. William R. Miller and Stephen Rollnick in the 1980s through their work with people struggling with alcohol use disorder, motivational interviewing (MI) is a person-centered, goal-oriented therapeutic approach designed to help resolve ambivalence and develop the motivation needed to make meaningful changes. Miller and Rollnick found that people in alcohol use disorder treatment simultaneously desired and resisted change. Furthermore, the desire to change could not be forced upon them; motivation had to come from within. As such, they designed MI to help harness “people’s capabilities for exercising free choice and changing through a process of self-actualization.” In more concrete terms, MI seeks to help people:

  • Explore their ambivalence about change
  • Foster their own desire for making change
  • Express their desire for change verbally
  • Develop a plan for creating change
  • Strengthen their confidence in making changes and emphasizing the significance of even small changes
  • Enhance their commitment to taking action

MI proved to be an effective strategy for people with alcohol use disorder and has since been applied to numerous other populations, including people with mental health disorders as well as physical health ailments that benefit from behavioral changes.

The Spirit of Motivational Interviewing


Motivational interviewing involves specific strategies, such as:

  • Exploring open-ended questions
  • Discussing pros and cons of change
  • Examining values
  • Receiving affirmation to strengthen self-understanding and resolve

However, MI is more than simply a set of questions to answer or techniques to try. As one writer explains, “it is characterized by a particular ‘spirit’ or clinical ‘way of being’” that sets the stage for the therapeutic relationship and the techniques employed. These include:

Collaboration (vs. Confrontation)

Many therapeutic relationships are structured with a hierarchal approach in which the therapist acts as the expert and may prioritize their view of what treatment should look like and what the outcomes should be. MI, on the other hand, works from an understanding of the therapeutic relationship as a partnership in which you are the expert on your own experiences and goals. You work with your therapist as a team to discover, explore, and create changes according to your own desire for particular outcomes.

Evocation (vs. Imposing Ideas)

MI is not about the therapist imposing their opinions on you, telling you what to do, or giving you reasons to change. Rather, the therapist acts as a guide, helping draw out your own thoughts and feelings and harness your inner resources to engage in change. This not only helps you conceptualize change, it also helps you create a deep and lasting commitment to it because it comes from you rather than someone else.

Autonomy (vs. Authority)

Some therapeutic approaches treat the therapist as the authority figure whose views take precedence over the client’s. MI, however, recognizes the autonomy and right to self-determination of the client while emphasizing that there is no one right way to change. This can be deeply empowering and helps you appreciate the ability you have to control your own life. At the same time, it also helps you stay accountable for your own behaviors.

In order to foster this spirit, your therapist must have a strong sense of empathy and support your self-efficacy. They must also help you navigate your own resistance to change by allowing you to define your own problems and develop your own solutions in a safe space. When your goals and behaviors conflict, they will work with you to examine the discrepancies and support you as you develop strategies to align what you do with what you want.

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Integrating Motivational Interviewing in Comprehensive Treatment


The broad applicability of motivational interviewing makes it ideally suited for anyone struggling with ambivalence, and it can be a core part of your healing process whether you are suffering from a mental health disorder, substance use disorder, or both. However, motivational interviewing alone is not enough for true recovery to take place, particularly when you are living with a severe psychological illness and/or struggling with any co-occurring disorders. Rather, it is best when integrated into a comprehensive curriculum of therapies.

By integrating motivational interviewing in a broad spectrum of therapies, you can use the skills you learn in each modality to complement your work in the others. For example, cognitive behavioral therapy (CBT) is often an essential part of the recovery process for many people struggling with mental health disorders and addiction, but it relies on implementing specific behavioral techniques in order to overcome damaging emotional and behavioral patterns. Motivational interviewing can help you develop your own goals and commit to making changes, making you more willing to engage in CBT strategies. Meanwhile, family therapy may give you increased insight into damaging dynamics within your interpersonal relationships, which can be used to help you discover your desire for change in motivational interviewing.

What the best treatment plan is and how motivational interviewing fits into that plan will vary from person to person. As such, it is essential that you seek out a treatment program that will tailor your plan to your individual situation. By working with compassionate clinicians who understand your unique needs and draw on your strengths, you can identify and create the transformation you want and need to live a fuller, richer, and more stable life.

Hanbleceya offers comprehensive, long-term residential treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned San Diego-based program and how we can help you or your loved one start the journey toward recovery.

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