Motivational Interviewing For Alcohol Use Disorder

Fear of judgement is a powerful deterrent to treatment for individuals struggling with a substance use disorder of any sort, including alcohol. Some who have already tried to overcome their substance use – whether on their own, in support groups, rehab, or elsewhere – may have encountered frustration, perceived failure, and criticism from others.

Enter motivational interviewing (MI). This highly effective therapy is designed to remove all semblance of judgment from therapy sessions, making room for empathy and self-empowerment instead. The goal of motivational interviewing is to strengthen the client’s inherent motivation to change, and find the resources for change within themselves. This, in turn, sets the stage for healing to begin.

Here’s how motivational interviewing for alcohol use disorder works, as well as what to expect in a therapy session, and what to look for in a motivational interviewing therapist.

How motivational interviewing for alcohol use disorder works

Motivational interviewing focuses on developing internal motivation, not skills

Providers use motivational interviewing skills to assist clients in motivating themselves to commit to change.

Of particular interest is having clients:

1. Reduce their ambivalence about the behavior they want to/need to change.

2. Increase the client’s discrepancy between their behavior and their goals and values.

Motivational interviewing is a gentle, interventional conversation

In a nutshell, motivational interviewing should feel less like an accusation, and more like a conversation about change. Releasing the pressure that other types of substance use treatments often embrace allows the client to decide for themselves their own reasons for overcoming their struggle with alcohol.

Because of its nuanced nature, it can take place in one session, or in every session.

Motivational interviewing is helpful for overcoming relapses, too

If a person relapses, motivational interviewing can be very helpful in resuming the change process. Meta-analysis showed that motivational interviewing had a significant and clinically relevant effect in approximately three out of four studies, with an equal effect on physiological (72%) and psychological (75%) diseases. [1]

Motivational interviewing can help those with a substance use disorder who are not prepared for change, or not committed

For individuals who are deeply enmeshed in their alcohol use – and are blocked by all that quitting or overcoming it entails, such as frustration, and anger – motivational interviewing can help them lay the groundwork for healing.

In fact, for those who are already committed to overcoming their substance use disorder, motivational interviewing might not be as helpful, since its main purpose is to identify deep-rooted motivation for change. However, motivation often fluctuates over time and Motivational Interviewing can help to maintain consistent motivation throughout treatment.

You don’t have to “admit” to having a substance use disorder to benefit from motivational interviewing

When a person is starting to think about making a change in their drinking habits – even if it is before they have made a decision about change – motivational interviewing can be helpful.

It is through the dynamics of this specific type of conversation that clients can find within themselves the desire, need, reasons, and ability to change.

Even short-term motivational interviewing can be effective for treating alcohol use disorders

In a meta-analysis of motivational interviewing research, where interventions provided brief motivational interviewing (i.e., motivational interviewing for only 15 minutes), 64% of the interventions showed a significant effect.1

When asked how much time it takes to “do” motivational interviewing, Bill Miller – one of the ‘founding fathers’ of motivational interviewing – compared the MI  approach to the enjoyment of  classical music. To paraphrase Dr. Miller, ‘MI is similar to a piece of classical music… having the time to listen to the whole piece will give people the most movement, but even just listening to some of it – the best parts of it –  will be able to move people.’

When searching for a motivational interviewing therapist for alcohol use disorder, look for someone who was trained by a “MINT” member  

Although different types of providers can be trained in motivational interviewing, there is no official certification in motivational interviewing. That said, the best certification to look for is MINT – the “Motivational Interviewing Network of Trainers.” If someone is a member of MINT, they are skilled in motivational interviewing and have remained active in the motivational interviewing world; also, providers who have been trained by a MINT trainer are believed to have been well trained in motivational interviewing.

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1.  Br J Gen Pract. 2005 Apr;55(513):305-12. Motivational interviewing: a systematic review and meta-analysis. Rubak, S., Sandbaek, A., Lauritzen, T., & Christensen, B.