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Treating Addiction With Motivational Interviewing (MI) And Life Skills Therapy

David Hunter, MA.Ed, LPC

Medically reviewed by

David Hunter, MA.Ed, LPC

March 12, 2019

Addiction is a brain disease that affects a person’s emotions, thoughts, and behaviors. If you are looking into addiction treatment for a loved one, it is vitally important to seek treatments that include behavioral therapies to address the complicated internal struggles an addicted person suffers through, and that which contribute to and maintain the disease.

Drugs, The Brain, And Behavior

National Institute on Drug Abuse states that addiction has nothing to do with willpower or choice. As scientific research of drug addiction progresses, it is being confirmed that addiction is a disease that affects both the brain and someone’s behavior. Addiction changes the functions and responses of the brain that send signals, tells the person what they want, need, and what they need to do. In this way, addiction can be seen directly in the individual’s behavior and actions. And while behavior may seem like a voluntary action, addiction takes the power away from the person and into its own hands.

Drugs alter the different parts of the brain that are responsible for various abilities and behaviors. The cerebral cortex is responsible for our ability to see, hear, and taste. It also controls our ability to think, plan, make decisions, and solve problems. The limbic system is the reward center of the brain that responds to pleasure. This part of the brain motivates us to either continue or stop doing certain things, based on the pleasant sensation, and it controls emotions and mood as a result of them. The brain stem controls our most basic functions like breathing and heart rate.

The Importance Of Behavioral Therapy For Addiction Treatment

The National Institute on Drug Abuse states that the most successful treatments of addiction combine appropriate medications with behavioral therapy. Because addiction starts in the brain, it is the retraining of the brain that is most essential for recovery.

Behavioral therapies help to engage those suffering from addiction in their treatment and to help change their attitude and behaviors. These therapies also aim to improve the person’s life skills to better handle stressors and triggers that may cause a drug relapse, as well as improve the effectiveness of medications by motivating the person to maintain their treatments.

What Is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) was designed to help patients suffering from addiction to recognize, avoid, and handle the situations that may cause them to use drugs. CBT focuses on the idea that when someone learns how to deal with and accept an addiction, a patient can more successfully recover from addiction and prevent a relapse into unhealthy behavior. It typically involves individual and group therapy which may involve family therapy and motivational interviewing.

When a patient and therapist work together to address these issues, they can develop effective ways of thinking that lead to healthier beliefs and behaviors. CBT is then able to replace negative, harmful thoughts and actions with positive ones that reinforce change.

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What Is Motivational Interviewing (MI)?

According to studies led by the University of Massachusetts, Motivational Interviewing focuses on resolving ambivalence in patients and targets the development of motivation that progresses into positive change. It serves as an alternative to other methods that focus more on coercing the patient into change, which hasn’t been shown to be effective.

As a counseling method for those addicted to drugs or alcohol, MI works with these main assumptions in mind:

  • Ambivalence regarding substance abuse and the ability to change is normal and is one of the toughest obstacles to overcome in addiction treatment
  • Working with a patient’s own motivations and values can treat ambivalence
  • MI is meant to be a collaborative partnership between the therapist and patient
  • Empathy, support, and direct counseling lay the foundation for true change to occur

What Is Involved With These Therapies?

Cognitive Behavioral Therapy

According to the U.S. National Library of Medicine, Cognitive Behavioral Therapy (CBT) is applied to substance abuse based on the primary belief that drugs are powerful motivators of behavior. CBT is used to help a person suffering from addiction to mitigate the substantial reinforcing effects by increasing the experience associated with non-drug use, or by developing skills to help reduce the use of substances, and offering rewards for activities spent without the use of drugs. CBT for addiction treatment uses a variety of treatment types that focus on different aspects of the recovery process for those addicted to substances.

Contingency management is introduced at the beginning of treatment and encourages the patient to stay away from drugs by offering rewards when they abstain from drug use. Relapse prevention is designed to help the patient recognize and prevent high-risk situations which often lead to drug use. Goal setting involves the patient and therapist creating goals for the future and holds the patient accountable. Skills training is used to help the patient regulate their emotions, improve their tolerance for stress, and develop their coping skills to handle negative emotions and stressful situations better.

Motivational interviewing is also one component of CBT and addresses motivational barriers to change the patient’s mindset towards treatment.

Motivational Interviewing

According to the U.S. National Library of Medicine, MI is typically issued with individual therapy but may also include group therapy sessions. The therapy interviewer works with the person suffering from addiction with five main principles in mind: To express empathy through reflective listening; demonstrate the difference between the patient’s goals and their current behavior; avoid argumentation at all costs; adjust rather than oppose resistance from the patient, and encourage self-healing and positive thinking.

Motivational Interviewing is often characterized by the “spirit” of the treatment since it is the therapist-patient relationship that forms the foundation. MI is based on collaboration between the patient and the therapist, evocation, which is drawing out ideas from the patient themselves rather than imposing ideas on them, and autonomy, which is taking the authority stigma away from the therapist and acknowledging that the patient holds the true power for change.

Who Are These Treatments Best For?

Both CBT and MI can be effective for all types of substance use disorders and addictions because they focus on the need to inspire change and motivation for self-healing in the patient. The U.S. National Library of Medicine states that MI has been shown to trigger changes in high-risk lifestyle behaviors, evoking the desire to avoid risky situations. And CBT has been found to be helpful for alcohol and drug use disorders through numerous studies and trials.

Change Your Behavior. Change Your Future

The implementation of behavioral therapies has been found to be very successful on their own and in combination with other therapies for the treatment of addiction. Since addiction affects the brain, altering a person’s beliefs and behavior regarding drug use can help them develop an empowering sense of desire and motivation to quit using drugs. For more information about CBT and MI and to find a local treatment center near you that offers these therapies, contact us today at

National Institute on Drug Abuse - Enhancing Motivation for Change in Substance Abuse Treatment.

National Institute on Drug Abuse - Cognitive-Behavioral Therapy for Substance Use Disorders

UMass - A Definition of Motivational Interviewing

National Institute on Drug Abuse - The Science of Addiction

National Institute on Drug Abuse - How Science Has Revolutionized the Understanding of Drug Addiction

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