Motivational therapy (or MT) is a combination of humanistic treatment and enhanced cognitive-behavioral strategies, designed to treat substance use disorders.
A motivational therapist does not explicitly advocate change and tends to avoid directly contradicting their patient, but instead expresses empathy, rolls with resistance, and supports self-efficacy.
Others explain the frequent successes of motivational therapy by noting that the patient is the ultimate source of change, choosing to reduce their dependency on drugs.
In 1991, Miller and Stephen Rollnick expanded on the fundamental approaches and concepts, while making more detailed descriptions of procedures in the clinical setting.
He later defined it as a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.
Since Miller and Rollnick, other psychologists have introduced models and various techniques to try to implement within the Motivational Therapy realm to help with substance use.
It focuses on the understanding of what initiates change while utilizing a guiding philosophy, and fosters a balance of components that are both directed and client-centered.
Motivational problems are increasing in addiction treatment settings, as more patients are identified by early interventions, and are court-ordered, ambivalent, and unmotivated.
Version one of the model includes the family approach towards substance use; emphasizing four different principles: assessment, detoxification, relapse prevention, and rehabilitation.
Similar to MET, motivational interviewing finds 'change talk' very important and the clinician interacts with the patient through open-ended questions, affirmations, reflections, and summaries.
Evocation is expressed through the clinician's responsibility to "draw out" the opinions and commitment to change of the client, rather than suggesting or imposing ideas.