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A brighter future often dovetails recovery from drug and alcohol addiction. But making bold changes can be daunting: at least 40-60 percent of people slip back into substance use in their first year after rehab, according to the National Institute on Drug Abuse.

If you’re stuck in relapse — or on the fence about which way your life should go — an intervention known as Motivational Interviewing (MI) may help.

Motivational Interviewing is a non-confrontational type of counseling that taps your own abilities and intrinsic desire to improve yourself. There are no lectures from a therapist about the dangers of addiction, no set of recovery strategies that must be followed. Rather, Motivational Interviewing brings the therapist and client together as collaborators, moving through conversations that help you look inward.

As the therapist asks open-ended questions, you may examine your drug habits and how they impact your goals for the future. You might explore your readiness and willingness to change, and consider the pros and cons of changing vs. doing nothing.This supportive approach builds strength and confidence — inviting clients to explore the benefits of change (with no outside pressures), and call on their own skills and resources to reduce substance use.

An Evidence-Based Approach

Decades of research with over 200 clinical trials generally support the effectiveness of Motivational Interviewing. The counseling method has been shown to help people stop smoking, decrease alcohol use (even in non-alcoholics) and comply with taking medications to manage chronic disease.

According to recent studies, Motivational Interviewing can also help gamblers to significantly reduce their days and dollars spent gambling, and help diabetics achieve at least short-term improvement in monitoring their blood glucose levels. Studies also show that Motivational Interviewing is “teen friendly” and motivates young adults to resist drugs in the face of peer pressure or boredom.

Change Talk: A Q&A with the Co-Founder of Motivational Interviewing

Motivational Interviewing was developed by two clinical psychologists, William R. Miller and Stephen Rollnick.

Dr. Miller first described the technique in a 1983 article for the journal Behavioural Psychotherapy. He suggested that confrontation leads to resistance and denial; by contrast, Motivational Interviewing is empathic and supportive — and a more effective approach to eliciting positive change.

Here’s a Q&A with Dr. Miller, co-founder of Motivational Interviewing:

How does Motivational Interviewing (MI) strengthen a person’s desire to change destructive habits?

Dr. Miller: “The essence of MI is to help people find and explore their own internal motivation for change.  Telling people what’s wrong with them and what they should do just tends to increase defensiveness.  The best reasons for change are the person’s own motivations and concerns.  That’s what MI explores.”

How effective is Motivational Interviewing as a treatment for drug and alcohol addiction?

Dr. Miller: “Alcohol/drug problems is what MI was originally developed for, and that is where the largest number of clinical trials have been published.  MI is now widely recognized as an “evidence-based treatment” given the number of studies showing positive effects.”

Can Motivational Interviewing help problem drinkers?  What does the research show?

Dr. Miller: “The very first article on MI (1983) was entitled “Motivational interviewing for problem drinkers.”  We started out offering it for people who were clearly drinking too much for their own (or others’) good, but who might not fit the classic picture of alcoholism.  As it turned out, MI has been found to benefit people with alcohol problems whether mild or severe.”

Does Motivational Interviewing involve family members/loved ones in the treatment process?

Dr. Miller: “A spouse or significant other is often invited to participate, but MI can also be offered as individual or group therapy.”

Typically, how many counseling sessions are required?

Dr. Miller: “In clinical trials, the usual number of MI sessions has been one to four.  Often, though, MI is now combined with other treatment methods.”

How can I find a therapist who uses Motivational Interviewing?  Is this therapy typically covered by insurance plans?

Dr. Miller: “There is good information about MI on www.motivationalinterviewing.org including a list of trainers in each area who could be good sources of information about qualified providers of MI.  Insurance coverage depends on the provider’s qualifications and licensure, but generally MI would be a covered treatment.”

Are there any phone apps, consumer websites or others ways to learn more about Motivational Interviewing?

Dr. Miller: “Yes, MI can be provided via telephone or electronic media.  The most comprehensive website is www.motivationalinterviewing.org.

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