Motivational Interviewing (MI) for Substance Use

Motivational Interviewing (MI) is my “go-to” approach as a brief intervention to help clients take steps towards changing substance patterns.  Here’s why…

MI is a counseling approach that utilizes client’s strengths to better understand their situation and develop plans for changes.  Are you having mixed feelings about your substance use patterns?  Maybe you’re considering making some changes, but not sure what you want to do.  Maybe you know you need to make some changes, but they haven’t happened for whatever reason.  Perhaps you’ve even been considering starting a substance use treatment program, but you are on the fence.  If so, Motivational Interviewing (MI) may be a helpful intervention for you for the following reasons:

  • The collective research supporting MI as an intervention for substance use is extremely strong.  MI is an evidence based approach supported with hundreds of high quality, peer reviewed publications documenting its efficacy.
  • Equally important, MI is well liked by most clients.  This finding is not surprising because it is referred to as a “client-centered” approach, and emphasizes the importance of the client’s views, wants, and rights to make their own decisions. 
  • MI is a brief and practical option for clients in private practice settings like mine. In many cases, MI is conducted for a limited number of sessions.  At the time of writing this article, the average number of meetings in research studies was roughly 4 sessions.  So clients don’t have to commit to a “program” that they may be uncertain about.
  • MI can be a precursor to, or combined with, other interventions.  But because MI is not a theory driven approach, it is easily integrated with different models such as CBT, 12-Step, mindfulness, medication therapies, and so forth.  The client gets to decide which other strategies, if any, would be helpful based upon their preferences.
  • MI applies to a variety of types of substance use challenges.  MI can be a great approach to make changes to cannabis, alcohol, and nicotine use.  Although I would not recommend MI as a stand alone intervention for serious opioid use problems, it could be part of comprehensive approach or a stepping stone to sort through the options and make further plan for next steps.  I sometimes jokingly refer to MI as a “gateway intervention.”  🙂
  • MI supports any client goals related to improving health or reducing risks of harm.  Whether a client is hoping to stop using the substance altogether, cut down, and/or reduce the consequences of substance use, MI can be adapted to support the plan.


Author: Jim Carter Ph.D.,  Member of Motivational Interviewing Network of Trainers (MINT) since 2008. Dr. Carter offers MI for clients seeking brief interventions for substance use, or considering entering formal treatment programs for substance use or other challenges.  Note: This is NOT what is typically referred to as an “intervention” because the goals are client-centered (vs. goals of loved ones).


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