Using motivational interviewing techniques to talk with clients about their alcohol use

Abstract

Dramatic changes over the past 3 decades have significantly affected the way clinical services for alcohol problems are conceptualized and provided. An important trend is toward delivering services outside of specialized alcohol programs. Expansion of services to primary health care and mental health settings is likely to reach greater numbers of individuals than can be reached in specialized alcohol treatment programs. An important aspect of the change has been the introduction of motivational interviewing (MI) techniques. Although motivation was once viewed as a trait to explain both poor outcomes as well as why people drop out of treatment, today motivation is conceptualized as a state that can be influenced by therapists. MI is a nonconfrontational way of talking and interacting with clients that involves delivering messages in a manner that avoids eliciting resistance (e.g., not using labels such as “alcoholic”). MI has been shown to increase compliance, reduce resistance, decrease dropouts, and result in better treatment outcomes with all types of alcohol abusers, from those who are mildly dependent to those who are severely dependent on alcohol. This article also provides a table of major MI do's and don'ts and examples of what to say and what not to say to clients.