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Co-Occurring Schizophrenia and Substance Dependence/Abuse

Motivational Interviewing
Substance Dependence
Substance Abuse
Assessment of Co-occurring Disorders
Motivational Interviewing
Applying MI: Express Empathy
Applying MI: Develop Discrepancy
Applying MI: Avoid Argument
Applying MI: Roll With Resistance
Applying MI: Support Self-Efficacy
Evidence Based for Motivational Interviewing
Future Research and Barriers to Service
Web sites of Interest


“Motivation can be understood not as something that one has but rather as something one does.  It involves recognizing a problem, searching for a way to change and then beginning and sticking with that change strategy.  There are, it turns out, many ways to help people move toward such recognition and action” 

                                                                                    Miller, 1995



Motivation is redefined as purposeful, intentional, and positive—directed toward the best interests of the self.  It is the probability that a person will enter into, continue, and adhere to a specific change strategy.  This framework for linking individual change to motivation stems from phenomenological theory of psychology; most familiarly expressed in the writings of Carl Rogers.  In this humanistic view, an individual’s experience of the core inner self is the most important element or personal change and growth—a process of self-actualization that prompts goal-directed behavior for enhancing this self.


The motivational approaches described are based on the following assumptions about the nature of motivation:


           Motivation is a key to change.

           Motivation is multidimensional.

           Motivation is dynamic and fluctuating.

           Motivation is influenced by social interactions.

           Motivation can be modified.

           Motivation is influenced by the clinician’s style. 

           The clinician’s task is to elicit and enhance motivation.


Five Principles of Motivational Interviewing:


1.         Express Empathy through reflective listening

2.         Develop discrepancy between client’s goals or values and their current


3.         Avoid argument and direct confrontation.

4.         Adjust to client resistance rather than opposing it directly.

5.         Support self-efficacy and optimism.



Nicole & Colleen