Motivational Interviewing, or MI, is like a guiding compass for you when you’re navigating the challenging process of change. Have you ever felt the struggle of trying to make a significant shift in your life, knowing deep down its importance for your mental health and well-being, yet finding it tough to turn that knowledge into action?
That’s where this evidence-based counseling approach steps in–helping you tap into your intrinsic motivation, empowering you to make positive changes in your life, whether it’s in health, behavior, or breaking free from addictive patterns.
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What are the origins of motivational interviewing?
Developed by William R. Miller and Stephen Rollnick in the ’80s, MI emerged as a beacon of hope in the realm of transformative counseling practices. Miller and Rollnick originally wanted to address issues like substance misuse.
Since then, MI has evolved to touch various aspects of life, from supporting adolescents in behavioral health to helping people change and aiding individuals in their journey towards freedom from addictive behaviors.
Picture MI as a nurturing space where you can explore your ambivalence, discover your own reasons for change, and collaboratively pave the way to a more empowered and fulfilling life journey.
When is motivational interviewing used?
Motivational Interviewing is a versatile approach that supports and expresses empathy for individuals, groups, and families in making positive behavior changes. It is commonly used across diverse populations, and conditions where it is commonly used include: substance use disorder (SUD), alcohol use disorder (AUD), unsafe sex practices, and risky behavioral reduction.
Motivational interviewing is also used in combination with CBT for anxiety treatment, including generalized anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and anxiety caused by traumatic brain injuries.
How does motivational interviewing work?
In MI, the focus is on understanding your feelings, thoughts, and goals related to change and to support self-efficacy. By discussing your motivations and exploring the benefits and risks of change — as well as the benefits and risks of not changing — you can start to build your own pathway towards a healthier and more fulfilling lifestyle.
Although motivational interviewing is a therapeutic technique employed by licensed professionals, it’s meant to feel like you’re having a supportive chat with a friend. The other person — in this case, a therapist — helps you explore your reasons for wanting to make a behavior change. The therapist doesn’t necessarily see change as the goal; they’re more like a sounding board who asks insightful questions to help you uncover the right next steps for you.
Four main principles make up the spirit of motivational interviewing. They are:
Partnership – A therapeutic collaboration between you and your therapist. Instead of telling you what to do, the therapist guides you to find your own desires and confidence to make positive changes in your life.
Acceptance – Respecting your individual needs and autonomy
Compassion – Respecting, promoting, and acknowledging your needs and feelings
Evocation – Creating space to explore motivations, strengths, and values that you already possess to drive change
In addition, motivational therapy involves four processes during therapy:
Engagement – Empathetic, client-centered listening
Focusing – Naming of a target goal for change
Evoking – Supporting your own intrinsic motivation
Planning – Using your own knowledge and expertise to generate life changes
A main goal of motivational interviewing is to assess where you are in the “stage of change.” Many therapists use Prochaska and DiClemente’s transtheoretical model “stages of change” theory to assess their clients. The five stages of change, according to the transtheoretical model are:
Precontemplation stage
Contemplation stage
Preparation stage
Action stage
Maintenance stage
What is motivational interviewing like?
When you begin MI, you can expect a collaborative and conversational style of therapy where your therapist will work with you to explore and resolve ambivalence towards change you’re considering making. The spirit of motivational interviewing is person-centered, using a counseling style that maintains a gentle, collaborative tone throughout, allowing you to voice your reasons and motivations for change rather than being directed.
Your therapist may ask you questions like “Can you tell me more?”, “What does that mean to you?”, or “How do you feel about that?” In MI, sessions may involve reflective listening, exploring your motivations, values, and goals, as well as discussing potential strategies for change. After sessions, you may be encouraged to reflect on your thoughts, feelings, and actions, possibly through homework assignments or journaling activities tailored to support your progress.
Is motivational interviewing the same as regular therapy?
Is motivational interviewing the same as regular therapy?
Motivational interviewing is a specific counseling style and technique, not a standalone therapy modality in the way that CBT or DBT are. In practice, most licensed therapists who use MI integrate it into their broader clinical work — so a session might combine MI with CBT, trauma-focused therapy, or another evidence-based approach.
How long does motivational interviewing take?
The number of sessions needed can vary depending on your goals and progress. This typically ranges from a few sessions to several months, with a frequency that suits your needs and schedule as agreed upon by you and your therapist. Initially, your therapist may ask you open-ended questions to understand your perspective on change, your goals, and any barriers you may face.
Looking for a therapist who practices M1?Browse by specialty and insurance here
Is motivational interviewing effective?
A systematic review of reviews from 2018 in the UK looked at over 5,000 records, and over 100 reviews, including close to 40 meta-analyses, to gauge the effectiveness of motivational interviewing. The researchers found that motivational interviewing therapy is overall effective, but the degree of efficacy depends on the issue you’re trying to address.
For example, according to the researchers, motivational interviewing is most effective at managing and preventing behaviors like binge drinking, decreasing drinking frequency, smoking, and substance abuse. But, it seems to be less effective for people with gambling issues. Not surprisingly, MI appears to be less effective for people who do not have a desire to change.
Other studies have shown that MI is more effective in a one-on-one format than in groups, and one of the benefits of MI is that it works well in combination with other types of therapy. One 2016 randomized clinical trial found that combining MI with CBT was particularly effective at treating severe generalized anxiety disorder. Clients who received MI + CBT were approximately five times more likely to no longer meet diagnostic criteria at 12 months compared to those who received CBT alone.
Did you know?
A 2018 systematic review of over 100 reviews and nearly 40 meta-analyses found the strongest evidence for motivational interviewing in reducing binge drinking, alcohol consumption frequency, and substance abuse — and research consistently shows it works particularly well when integrated with other evidence-based approaches like CBT.
How to find a clinician who practices motivational interviewing
If you think motivational interviewing therapy might be right for you, it’s important to speak with a licensed and experienced clinician trained in this model. Since MI can involve digging deep to look at motivations and breaking old patterns, you’ll want a therapist who is not only compassionate and patient but also experienced in creating a supportive environment. Don’t hesitate to ask about their background to make sure their clinical practice is the right fit for your specific needs.
There are many types of mental health care providers who practice MI, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more.
On top of finding someone specializing in MI, you want to make sure they meet your other needs. For example, if you’re struggling with a specific behavioral addiction, like sex addiction, you’ll want to find a therapist who can practice MI and also has experience treating sex addiction. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.
You can find a therapist who accepts your insurance and specializes in motivational interviewing by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Motivational Interviewing” from the “Treatment methods” drop-down.
Is motivational interviewing covered by insurance?
Is motivational interviewing covered by insurance?
Since MI is delivered by licensed mental health professionals and billed as standard therapy, it is typically covered by insurance the same way as any other licensed therapy session. Coverage depends on your specific plan and whether your therapist is in-network.
On Grow Therapy, you can filter by “Motivational Interviewing” under Treatment methods and by your insurance to find clinicians who are both trained in MI and covered by your plan.
Final thoughts
Motivational interviewing works because it starts where you actually are — not where someone else thinks you should be. Rather than pushing you toward a predetermined outcome, it creates space for you to examine your own ambivalence, understand your own reasons for change, and build the confidence to act on them. For people who’ve struggled with external pressure to change, or who’ve tried other approaches that felt prescriptive or judgmental, MI can feel like a genuinely different experience.
Finding the right clinician matters as much as finding the right approach. You want someone trained in MI who can also meet your specific needs — whether that’s experience with substance use, anxiety, behavioral patterns, or something else. On Grow Therapy, you can filter by “Motivational Interviewing” under Treatment methods, check who takes your insurance, and read provider profiles before booking. Most clients are in their first session within two days.
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Frequently asked questions
What’s the difference between motivational interviewing and CBT?
What’s the difference between motivational interviewing and CBT?
CBT focuses on identifying and changing unhelpful thought patterns and behaviors through structured exercises and homework. Motivational interviewing focuses on exploring ambivalence and building intrinsic motivation to change — it’s less about skills and more about helping you clarify your own reasons for wanting to do things differently. The two approaches are frequently combined: MI can help a client become ready for change, and CBT can help them implement it.
Can motivational interviewing help with anxiety?
Can motivational interviewing help with anxiety?
Yes — research shows that MI used in combination with CBT is particularly effective for generalized anxiety disorder. MI helps address the ambivalence many people with anxiety feel about change, while CBT provides structured tools for managing anxious thoughts and behaviors. If anxiety is your primary concern, look for a therapist who is trained in both approaches.
How is motivational interviewing different from regular talk therapy?
How is motivational interviewing different from regular talk therapy?
Traditional talk therapy often involves the therapist offering insight, interpretation, or guidance. Motivational interviewing is more deliberately non-directive — the therapist’s role is to ask questions that help you arrive at your own conclusions, rather than to tell you what to do or how to change. It’s particularly useful when ambivalence about change is part of what’s getting in the way.
Do I have to be ready to change to benefit from motivational interviewing?
Do I have to be ready to change to benefit from motivational interviewing?
No — in fact, MI is specifically designed for people who are ambivalent or uncertain about change. The transtheoretical model (stages of change) that MI therapists often use recognizes that people enter therapy at different levels of readiness, from precontemplation through maintenance. A good MI therapist meets you wherever you are without judgment.
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