Motivational Interviewing for Substance Use Disorder

Motivational interviewing (MI) is one of several tools used in drug or alcohol rehab. Here, you can find out what it is, how it works, and why it is used for addiction treatment.

What Is Motivational Interviewing?

Motivational interviewing is a type of therapy that recognizes how hard it is to change learned behaviors and helps you develop the inner drive, strength, and confidence to accomplish a change in the face of ambivalence.1 In the case of addiction, motivational interviewing can help you overcome your compulsive use of drugs and alcohol.

How Does Motivational Interviewing Work?

Motivational interviewing works not by imposing changes on individuals, but by putting individuals in charge of their change. Instead of having the practitioner come up with next steps, you work together to develop achievable goals that keep you on the path to recovery.1

For example, a person may know that they need to exercise to lower their blood pressure. But change is difficult, and if a person can’t get motivated to change anything, they won’t start exercising, even if it will help them to lower their blood pressure. Instead of telling the person what to do and triggering resistance, the doctor might use OARS—the 4 steps of motivational interviewing—to help the person come up with their own goal.

OARS is a set of principles that stands for open-ended questions, affirmations, reflective listening, and summarizing.2

Open-ended questions

Avoiding “yes” and “no” questions helps you respond with whatever you feel is important. This alleviates the fear of having the wrong answer and opens a conversation.2 For example:

Therapist: “What kinds of exercise do you enjoy?” or “What is stopping you from exercising?”


Empathizing with difficulties and celebrating achievements is an important part of a partnership. If you and the interviewer feel like you have the same understanding of something, it is easier to find a solution.2 For example:

Patient: “I don’t have the athletic ability.” or “There’s no time all day, and then I’m just so tired at the end of the day.”

Therapist: “Exercise feels like something you have to be good at to do,” or, “Exercising takes too much time and energy.”

Reflective listening (RL)

This technique helps you realize that you already have the answers. The interviewer captures the essence of what you say with a conversational direction in mind.2 So, they help guide you without ever telling you what to do. For example:

Patient: “Running is just so hard. I’ve never liked it.”

Therapist: “You have difficulty running as exercise.”

Patient: “I remember having a problem with it even as a kid in P.E. class. I would always end up walking the warm-up laps and the mile run.”

Therapist: “Walking allowed you to finish the exercise at a manageable pace.”

Patient: “Yeah, I actually don’t mind walking long distances.”


In the end, they pick out the main parts of the conversation and summarize what you discussed.2 Then you can correct any misunderstandings and choose a goal to get started on.

Therapist: “Walking a long distance is good exercise and sounds like something you might enjoy. What do you think about walking a mile every other day?”

Having a conversation where a therapist uses motivational interviewing helps you to find the confidence and light the fire within you to begin your own change.2 It is your job (not your physician’s or therapist’s) to desire recovery enough to change.2 Motivational interviewing allows you to work through your own thoughts with guidance from others.2 It also makes your relationship with your therapist or physician more of a partnership than a hierarchy.2

Motivational Interviewing for Addiction Treatment

Support group in session

Motivational interviewing can be practiced in several types of addiction treatment settings. Treatment for substance use disorder can integrate motivational interviewing within the following areas, with a range of potential benefits and impacts that include the following:

  • Getting started – You can’t change if you don’t want to, but motivational interviewing can help you find the inner drive to cut back or take the next step.
  • Giving clarity in assessment – Counselors use motivational interviewing during the initial assessment given when you enroll in rehab. This helps them get a better picture of where you are on your recovery journey and gets you thinking about the next step from the start.
  • One-on-one counseling – This type of psychotherapy facilitates personalized guidance in a session focused solely on your barriers and abilities toward recovery.4
  • Group therapy – By working with people who are on the same path, you can encourage one another while enhancing mutual accountability.4
  • Telehealth – The convenience of a telehealth visit by telephone or video chat allows you to check in with your counselor quickly. This eliminates the need to travel and takes less time, both of which can be barriers to treatment.4

At Desert Hope, motivational interviewing is just the start of many therapies used in addiction treatment. Being evidence-based, our interventions offer you a realistic chance at recovery. We utilize motivational interviewing in our inpatient treatment programs and outpatient treatment programs.

MI and Addiction Treatment in Las Vegas

Recovery from substance use disorders can often feel out of reach. If you are seeking help or helping a loved one with addiction, motivational interviewing can help get you there. Treating your addiction could be the biggest way to turn your life in the direction you want to go.

It is easy to check if you have insurance that covers rehab, and there are other ways to pay for rehab if you are uninsured. Start the treatment admissions process today by calling and filling out our secure online

Do not compromise the quality or effectiveness of your treatment. Contact our inpatient addiction treatment facility in Las Vegas right now to learn more about our programming, including our medical detox and sober living programs, as well as other types of addiction treatment we offer, to get started on your recovery.

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