Motivational enhancement therapy is a form of treatment for individuals struggling with addiction and other mental health conditions. Learn how motivational enhancement therapy works.

Motivational enhancement therapy is a form of treatment for alcohol, nicotine or marijuana abuse, among other substances. When a person struggles with addiction, it can be hard to convince them that they have a problem or need help. 

Even if an individual is aware that they are addicted to one or more substances, figuring out how to change their behavior is challenging at best. Thus, the ultimate goal of motivational enhancement therapy is to encourage individuals to think differently about their addiction and consciously choose to change their motivations and behaviors about drug and alcohol use. 

Motivational enhancement therapy tends to work better for individuals already receiving treatment for addiction rather than for people who have not yet sought treatment. 

What Is Motivational Enhancement Therapy?

What exactly is motivational enhancement therapy? Typically, motivational enhancement therapy, also known as motivational interviewing, involves up to five therapy sessions between an individual and their therapist. 

According to the National Institute on Drug Abuse, the first session includes an initial assessment and an extensive discussion about the person’s substance use. Additionally, therapists will teach individuals self-motivational statements that help them think positively about stopping their drug or alcohol use. 

In subsequent sessions, therapists work with the person to develop effective coping strategies in the event of difficult situations where an individual is exposed to drugs and alcohol. A specific plan is made and tailored to the individual that aims to decrease or completely stop drug use. 

Over time, a therapist evaluates whether their patient’s condition has improved and makes suggestions.  

Development of Motivational Enhancement Therapy

The history of motivational enhancement therapy started in the early 1980s with two clinical psychologists, William Miller and Stephen Rollnick. Miller first outlined clinical motivational enhancement therapy in his 1983 paper entitled, “Motivational Interviewing with Problem Drinkers.” 

In the following years, motivational enhancement therapy was found to be more effective than regular advice-giving by therapists when it came to changing an individual’s motivations and behaviors. In the 1990s, Miller and Rollnick worked to modify motivational interviewing from an individual to a collaborative process between a person struggling with their behavior and a therapist.

Since the 1990s, motivational enhancement therapy has become extremely popular. In 1997,  the Motivational Interviewing Network of Trainers (MINT) was developed to create guidelines for all counselors, therapists and medical professionals who use motivational interviewing as a therapy. 

As of 2018, MINT includes trainers from 35 different countries. Motivational enhancement therapy can also be used to treat behavioral problems not including substance use, like improving older adults’ behavior when receiving primary care treatments.  

Motivational Enhancement Therapy Principles and Goals

In Miller and Rollnick’s 1991 book titled, “Motivational Interviewing: Preparing People To Change Addictive Behavior,” they discuss five main principles associated with motivational enhancement therapy. These are general guidelines that all counselors, therapists or medical professionals should follow when using this type of therapy. The five principles include: 

  • Expressing empathy: A therapist should actively listen to an individual and gently, rather than forcefully, persuade them to change their behaviors
  • Developing discrepancy: A therapist should help a person discover their ambivalence about an addiction or behavioral problem
  • Avoiding arguments: If an individual becomes argumentative or defensive, an alternative strategy should be devised by the therapist
  • Rolling with resistance: A therapist should openly discuss alternative or new strategies with the patient, allowing them to have agency or choice in their treatment
  • Supporting self-efficacy: A therapist should emphasize that an individual has the power to make changes, though there are multiple other strategies to affect behavior modification than motivational enhancement therapy alone

Thus, motivational enhancement therapy shows that the power of suggestion and creating a motivational environment can be extremely helpful for individuals struggling with addiction and other mental health conditions

Motivational Interviewing in Addiction and Mental Health Treatment

Most published studies involving addiction assess the efficacy of motivational enhancement therapy in treating alcohol dependence

In a literature review conducted in 2018, 31 different motivational interviewing studies were assessed for their effectiveness in treating substance misuse, with the majority involving alcohol misuse. Most of these studies recommend further research, or showed small, but positive effects associated with motivational enhancement therapy. 

This literature review suggests that overall, motivational enhancement therapy is a constructive and useful form of treatment for many individuals struggling with addiction. Nevertheless, more scientific studies must be carried out in the future to understand what specific behaviors or addictions motivational interviewing will be most effective at treating. 

If you or a loved one are struggling with addiction, motivational enhancement therapy may be a beneficial way to affect change on your road to recovery. The Recovery Village employs various addiction specialists that can tailor treatment options to your individual needs. Contact a representative today to learn about treating addiction and other co-occurring mental health conditions at The Recovery Village.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Dr. Bonnie Bullock, PHD
Bonnie is a medical communications specialist at Boston Strategic Partners, a global health industry consulting firm. Her recent work in mental health includes developing conference materials for clinical studies in mood disorders and copy-editing clinical manuscripts. Read more

Frost, Helen; Campbell, Pauline, et al. “Effectiveness of Motivational Interviewi[…]ic review of reviews.” PLoS One, October 18, 2018. Accessed June 12, 2019.

Miller, William. “Motivational Interviewing with Problem Drinkers.” Behavioural Psychotherapy, 1983. Accessed June 12, 2019.

The National Institute on Drug Abuse. “Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine).” January 2018. Accessed June 12, 2019.

Rubak, Sune. “Motivational interviewing: a systematic […]ew and meta-analysis.” British Journal of General Practice, April 2005. Accessed June 12, 2019.

Substance Abuse and Mental Health Services Administration. “Chapter 3—Motivational Interviewing as a Counseling Style.” NCBI Bookshelf, 1999. Accessed June 12, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.