Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-24T14:44:09.659Z Has data issue: false hasContentIssue false

Motivational Interviewing with Problem Drinkers

Published online by Cambridge University Press:  16 June 2009

William R. Miller
University of New Mexico


Motivational interviewing is an approach based upon principles of experimental social psychology, applying processes such as attribution, cognitive dissonance, and self-efficacy. Motivation is conceptualized not as a personality trait but as an interpersonal process. The model deemphasizes labeling and places heavy emphasis on individual responsibility and internal attribution of change. Cognitive dissonance is created by contrasting the ongoing problem behavior with salient awareness of the behavior's negative consequences. Empathic processes from the methods of Carl Rogers, social psychological principles of motivation, and objective assessment feedback are employed to channel this dissonance toward a behavior change solution, avoiding the “short circuits” of low self-esteem, low self-efficacy, and denial. This motivational process is understood within a larger developmental model of change in which contemplation and determination are important early steps which can be influenced by therapist interventions. A schematic diagram of the motivational process and a six-step sequence for implementing motivational interviewing are suggested.

Clinical Section
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1983

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review 84, 191215.CrossRefGoogle Scholar
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist 37, 122147.CrossRefGoogle Scholar
Cummings, C., Gordon, J. R. and Marlatt, G. A. (1980). Relapse: prevention and prediction. In The Addictive Behaviors: Treatment of Alcoholism. Drug Abuse, Smoking, and Obesity. Miller, W. R. (Ed.), Oxford: Pergamon Press.Google Scholar
Gordon, T. (1970). Parent Effectiveness Training. New York: Wyden.Google Scholar
Heather, N. and Robertson, I. (1981). Controlled Drinking. London: Methuen.Google Scholar
Hodgson, R. J., Rankin, H. J. and Stockwell, T. R. (1979). Alcohol dependence and the priming effect. Behaviour Research and Therapy 17, 379387.CrossRefGoogle ScholarPubMed
Kopel, S. and Arkowitz, H. (1975). The role of attribution and self-perception in behavior change: implications for behavior therapy. Genetic Psychology Monographs 92, 175212.Google ScholarPubMed
Marlatt, G. A. and Gordon, J. R. (in press). Relapse Prevention: Self-Control Strategies for Addictive Behaviors. New York: Guilford.Google Scholar
Matthews, D. B. and Miller, W. R. (1979). Estimating blood alcohol concentration: two computer programs and their applications in therapy and research. Addictive Behaviors 4, 5560.CrossRefGoogle Scholar
Miller, P. M. and Nirenberg, T. D. (Eds) (in press). Prevention of Alcohol Abuse: Current Issues and Future Directions. New York: Plenum Press.Google Scholar
Miller, W. R. (1976). Alcoholism scales and objective assessment methods: a review. Psychological Bulletin 83, 649674.CrossRefGoogle ScholarPubMed
Miller, W. R. (1978). Behavioral treatment of problem drinkers: a comparative outcome study of three controlled drinking therapies. Journal of Consulting and Clinical Psychology 46, 7486.CrossRefGoogle ScholarPubMed
Miller, W. R. and Baca, L. M. (1983). Two-year follow-up of bibliotherapy and therapist-directed controlled drinking training for problem drinkers. Behavior Therapy 14.CrossRefGoogle Scholar
Miller, W. R. and Hester, R. K. (1980). Treating the problem drinker: modern approaches. In The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking, and Obesity. Miller, W. R. (Ed.), Oxford: Pergamon Press.Google Scholar
Miller, W. R. and Joyce, M. A. (1979). Prediction of abstinence, controlled drinking, and heavy drinking outcomes following behavioral self-control training. Journal of Consulting and Clinical Psychology 47, 773775.CrossRefGoogle ScholarPubMed
Miller, W. R. and Munoz, R. F. (1982). How to Control your Drinking. (Revised edition). Albuquerque: University of New Mexico Press.Google Scholar
Miller, W. R., Crawford, V. L. and Taylor, C. A. (1979). Significant others as corroborative sources for problem drinkers. Addictive Behaviors 4, 6770.CrossRefGoogle ScholarPubMed
Miller, W. R., Taylor, C. A. and West, J. C. (1980). Focused versus broad-spectrum behavior therapy for problem drinkers. Journal of Consulting and Clinical Psychology 48, 590601.CrossRefGoogle ScholarPubMed
Polich, J. M., Armor, D. J. and Braiker, H. B. (1981). The Course of Alcoholism Four years after Treatment. New York: Wiley.Google Scholar
Prochaska, J. O. and DiClemente, C. C. (in press, a). Stages and processes of self change of smoking: toward an integrative model of change.Google Scholar
Prochaska, J. O. and DiClemente, C. C. (in press, b). Transtheoretical therapy: toward a more integrative model of change.Google Scholar
Sobell, M. B., Sobell, L. C. and Samuels, F. H. (1974). Validity of self-reports of alcohol-related arrests by alcoholics. Quarterly Journal of Studies on Alcohol 35, 276280.CrossRefGoogle ScholarPubMed
Submit a response


No Comments have been published for this article.