Reviewed by Amanda Jernigan, LCSW, Director of Clinical Services and Internship Program
At Gaudenzia, we believe in the power of evidence-based approaches to support lasting change. One of our core treatment techniques is Motivational Interviewing (MI), a collaborative style of communication that has transformed how we help individuals work through challenging life changes.
Recent research, including a comprehensive 2025 meta-analysis, confirms what we’ve long observed in our work: MI is remarkably effective at helping people tap into their own motivation for change. This approach has shown impressive results across many areas, from addressing substance abuse and co-occurring disorders to improving outcomes for justice-involved individuals. What makes MI particularly powerful is its ability to meet people where they are, helping them resolve their ambivalence about change while strengthening their internal motivation to take positive steps forward.
The evidence shows MI’s effectiveness goes beyond traditional addiction treatment. Whether someone is managing a chronic illness, working to maintain medication adherence, or processing trauma, MI provides a proven framework that increases engagement and reduces dropout rates, key factors in achieving lasting positive outcomes.
Looking for “rehab facilities near me” that use Motivational Interviewing? If you or someone you love needs help with substance use and co-occurring disorders, please call our Treatment and Referral HelpLine at 833.976.HELP (4357) or email HelpLine@gaudenzia.org
How Does Motivational Interviewing Work?
Developed by William R. Miller and Stephen Rollnick in the 1980’s, MI has two primary goals — to strengthen an individual’s internal motivation to change and to elicit an external commitment to making the change. The spirit of MI naturally creates an equal partnership between a client and their counselor by making the following distinctions:
- Collaboration vs. Confrontation — An MI approach focuses on the perspective and experiences of the client. Rather than confronting an individual about their behavior, this collaborative style of communication helps foster an understanding of what drives a client’s behaviors and what barriers to change they encounter. This intentional letting go of the “expert” role helps to create an equal partnership where both parties are seen as equally bringing something to the counseling intervention.
- Evocation vs. Education — A primary goal of MI is to elicit or evoke an individual’s own internal motivation, rather than imposing threats or ultimatums in attempts to force change. Evocation allows the counselor to see the reasons to make a change are already inside the client. By evoking change talk from the client, as opposed to educating clients about why they should make changes, the counselor helps create a space for the client to experience shifts towards change.
- Autonomy vs. Authority — MI emphasizes the power and autonomy an individual has over their own life, rather than placing a counselor in an authoritative hierarchy above the individual. Supporting self-autonomy and emphasizing personal control helps clients take ownership of their decision regarding change.
- Compassion vs. Self-Interest —The spirit of MI includes a focus on compassion for the client and a constant attention towards their individual reasons for and against change, without the distraction of the interests of other systems.
An underlying principle of MI is that a person’s motivation to change should come from within, rather than an external source, such as a counselor, family member, or court system.
Motivational Interviewing and Substance Use Disorder
MI recognizes the complexity of making significant life changes, particularly when dealing with behaviors that once served as survival mechanisms. Recent studies have shown that MI, especially when combined with Cognitive Behavioral Therapy (CBT), is particularly effective in addressing substance use disorders. While MI helps build motivation and resolve ambivalence about change, CBT provides practical tools and strategies for maintaining that change, making them powerful complementary approaches.
As an example, an individual with a co-occurring anxiety disorder may turn to drugs or alcohol to calm their nerves before a stressful event. While this behavior seems to help the individual cope during the event, it is not a healthy or sustainable coping mechanism. With repetition, this learned behavior becomes destructive, putting the individual at risk of developing or exacerbating substance use disorder.
Even when the harmful effects of drug and alcohol use are apparent, the individual may still feel ambivalent about changing their behavior, as it is the only way they know how to cope with their anxiety. MI provides a safe, nonjudgmental context for the individual to explore their ambivalence and take part in the process of finding alternate, healthier solutions.
Motivational Interviewing and The Stages of Change
Ambivalence, or feeling conflicted about making a change, is a common barrier to change. An MI treatment approach can help individuals navigate the process of making significant life changes. The process of change is outlined by Dr. James Prochaska and Dr. Carlo DiClemente’s transtheoretical model of behavior change, commonly known as the Stages of Change.
The Stages of Change model illustrates the incremental stages an individual may encounter as they confront destructive behaviors and set out to make lasting changes.
The Five Stages of Change are outlined as follows:
- Precontemplation — At this stage, an individual may be unaware that a problem exists and/or has no intention to change their behavior.
- Contemplation — An individual is aware that a problem exists and is exploring both sides of the ambivalence about making a change but has not yet committed to it.
- Preparation — During the preparation stage, an individual has made a commitment to change and intends on acting soon.
- Action — During the action stage of change, the individual modifies their behavior and/or circumstances with the intention of overcoming their problems.
- Maintenance — During the maintenance stage, individuals work to prevent returning to old, unhelpful thought patterns and behaviors and focus on sustaining long-term change.
Some professionals consider a “relapse” stage as part of the change cycle and view it as an opportunity to learn and make adjustments that support long-term success.
Counselors can tailor Motivational interviewing techniques to the stage of change an individual is in, helping them process their ambivalence and build the necessary confidence levels to progress to the next stage.
Motivational Interviewing at Gaudenzia
At Gaudenzia, we integrate Motivational Interviewing with Cognitive Behavioral Therapy and Relapse Prevention Therapy to create a comprehensive treatment experience. This evidence-based approach combines MI’s power to build motivation with CBT’s practical strategies, addressing both the “why” and “how” of lasting change. All our care is delivered through a gender-responsive, trauma-informed, and culturally responsive lens.
If you or someone you love needs help with substance use and co-occurring disorders, please call our Treatment and Referral HelpLine at 833.976.HELP (4357) or email HelpLine@gaudenzia.org today.
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