Motivational Interviewing Treatment Programs

Motivational Interviewing (MI), developed by psychologists William Miller and Stephen Rollnick, is a collaborative, person-centered counseling approach that helps individuals discover their own motivation for behavior change. MI is particularly valuable for addressing ambivalence about recovery and enhancing engagement in treatment.

The Spirit of MI

MI is guided by four key principles:

• Partnership: Collaborative relationship between counselor and client rather than expert-recipient dynamic
• Acceptance: Absolute worth, accurate empathy, autonomy support, and affirmation
• Compassion: Actively promoting client's welfare and prioritizing their needs
• Evocation: Drawing out client's own motivations, ideas, and solutions rather than imposing them

MI Techniques and Strategies

MI counselors use specific techniques including open-ended questions (exploring rather than yes/no), affirmations (recognizing strengths and efforts), reflective listening (understanding client's perspective), and summarizing (pulling together information). These OARS skills create environment where clients articulate their own reasons for change, increasing commitment and follow-through.

Change Talk and Sustain Talk

MI counselors listen for and strengthen "change talk" - client statements expressing desire, ability, reasons, need, and commitment to change. They also recognize "sustain talk" - arguments for maintaining status quo - and respond with reflective listening rather than confrontation. This approach reduces resistance and allows clients to work through ambivalence at their own pace.

Applications and Integration

MI is used as standalone brief intervention, preparation for intensive treatment, or integrated throughout recovery programs. It enhances effectiveness of other treatments like CBT by improving motivation and engagement. MI is effective across substances, populations, and settings from emergency departments to residential treatment to outpatient care.

MI training and resources:

• Motivational Interviewing Network of Trainers (MINT)
• SAMHSA Resources