Introduction

The Basics

What is Motivational Interviewing (MI)?

Motivational Interviewing is a collaborative, person-centered counseling approach designed to strengthen an individual’s motivation and commitment to change.

Goal

What is the goal of Motivational Interviewing?

The fundamental goal of Motivational Interviewing (MI) is to help people resolve ambivalence about change and strengthen their own motivation for positive behavior change. Think of it like helping someone tune into their own radio station of change – the signal is already there, but sometimes there’s interference that makes it hard to hear. MI aims to clear that interference so people can connect with their own reasons and capacity for change.

Uses

What does Motivational Interviewing treat?

Motivational Interviewing can benefit people dealing with various challenges including:

• Substance use disorders
• Health behavior changes
• Medication adherence
• Chronic disease management
• Weight management
• Exercise adoption
• Smoking cessation
• Treatment engagement
• Academic or work motivation

You might be best suited for Motivational Interviewing if you’re feeling stuck or uncertain about making a change and want a supportive space to explore your own goals and values.

Subtypes

Are there any subtypes of Motivational Interviewing?

There are several subtypes or adaptations of MI that have been developed for specific contexts and populations.

Subtypes of Motivational Interviewing include:

• Brief Motivational Interviewing (BMI): A condensed version designed for time-limited settings like emergency departments or primary care visits, typically lasting 15-30 minutes
• Motivational Enhancement Therapy (MET): A structured form of MI often used in substance use treatment that combines traditional MI with personalized feedback on assessment results
• Group Motivational Interviewing (GMI): Adapts MI principles for group settings, leveraging both facilitator guidance and peer support
• Blended approaches:
  • Motivational Interviewing with Cognitive Behavioral Therapy (MI-CBT)
  • Motivational Interviewing with Acceptance and Commitment Therapy (MI-ACT)
  • Motivational Interviewing with Solution-Focused Brief Therapy
• Population-specific adaptations:
  • Adolescent Motivational Interviewing: modified to address developmental considerations
  • Culturally adapted Motivational Interviewing: tailored for specific cultural contexts and perspectives

Effectiveness

Origins

Who developed Motivational Interviewing, and when?

William Miller and Stephen Rollnick developed Motivational Interviewing (MI) in the 1980s. The approach emerged from Miller’s work treating alcohol addiction in New Mexico, where he observed that empathetic listening and drawing out people’s own motivations for change were more effective than confrontational approaches.

Miller and Rollnick formally introduced Motivational Interviewing in 1991, refining the approach through several editions of their influential text.

Evidence Base

Is Motivational Interviewing evidence-based?

The evidence base for Motivational Interviewing (MI) is substantial and growing. Research has demonstrated its effectiveness across various behavioral changes, particularly in healthcare and addiction treatment. Research shows MI significantly improves engagement in treatment and outcomes for substance use, medication adherence, diet, exercise, and other health behaviors.

How It Works

Techniques Used

How does Motivational Interviewing work?

Motivational Interviewing (MI) works through four key processes that often overlap and recur:

1. Engaging: building a trusting, collaborative relationship
2. Focusing: identifying the specific direction for change
3. Evoking: drawing out the person’s own motivations for change
4. Planning: developing concrete steps for implementation

These processes are guided by the key elements of MI, which emphasize:

• Partnership: The therapist works alongside the client rather than as an authority figure, creating a collaborative relationship.
• Acceptance: The therapist demonstrates respect for the client’s autonomy, affirming their worth and potential.
• Compassion: The therapist prioritizes the client’s welfare and needs.
• Evocation: Rather than imposing motivation, the therapist draws out the client’s own motivations and resources for change.

Motivational Interviewing helps clients explore and resolve ambivalence about change by expressing empathy and avoiding judgment, developing discrepancy between current behavior and goals/values, rolling with resistance rather than confronting it, and supporting self-efficacy and confidence in ability to change.

What to Expect in a Session

What can I expect from a Motivational Interviewing session?

In a typical Motivational Interviewing session, the therapist creates a collaborative atmosphere where you can explore your thoughts and feelings about change without feeling judged or pressured.

The therapist will use specific techniques like open-ended questions, affirmations, reflective listening, and summarizing (OARS) to help people explore and strengthen their own arguments for change. Rather than telling you what to do, the therapist will help you discover your own path forward.

Treatment Length & Structure

How long does Motivational Interviewing take?

The effectiveness of Motivational Interviewing (MI) doesn’t necessarily correlate with duration; research suggests even brief MI interventions (1–2 sessions) can produce meaningful behavior change, though more complex issues may benefit from extended engagement.

The effectiveness depends more on the quality of the MI implementation and the client’s readiness for change rather than the number of sessions.

While there’s flexibility in structure, sessions typically follow a pattern of:

1. Exploring ambivalence
2. Developing discrepancy between current behavior and values
3. Strengthening commitment to change

Getting Care

Finding a Therapist

How do I find a therapist trained in Motivational Interviewing?

Alma’s directory has many therapists who are trained in Motivational Interviewing, including: