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Motivational Interviewing with Problem Drinkers

  • William R. Miller (a1)
  • DOI:
  • Published online: 01 June 2009

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.

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A. Bandura (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological Review 84, 191215.

A. Bandura (1982). Self-efficacy mechanism in human agency. American Psychologist 37, 122147.

R. J. Hodgson , H. J. Rankin and T. R. Stockwell (1979). Alcohol dependence and the priming effect. Behaviour Research and Therapy 17, 379387.

D. B. Matthews and W. R. Miller (1979). Estimating blood alcohol concentration: two computer programs and their applications in therapy and research. Addictive Behaviors 4, 5560.

W. R. Miller (1976). Alcoholism scales and objective assessment methods: a review. Psychological Bulletin 83, 649674.

W. R. Miller (1978). Behavioral treatment of problem drinkers: a comparative outcome study of three controlled drinking therapies. Journal of Consulting and Clinical Psychology 46, 7486.

W. R. Miller and L. M. Baca (1983). Two-year follow-up of bibliotherapy and therapist-directed controlled drinking training for problem drinkers. Behavior Therapy 14.

W. R. Miller and R. K. Hester (1980). Treating the problem drinker: modern approaches. In The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking, and Obesity. W. R. Miller (Ed.), Oxford: Pergamon Press.

W. R. Miller and M. A. Joyce (1979). Prediction of abstinence, controlled drinking, and heavy drinking outcomes following behavioral self-control training. Journal of Consulting and Clinical Psychology 47, 773775.

W. R. Miller , V. L. Crawford and C. A. Taylor (1979). Significant others as corroborative sources for problem drinkers. Addictive Behaviors 4, 6770.

W. R. Miller , C. A. Taylor and J. C. West (1980). Focused versus broad-spectrum behavior therapy for problem drinkers. Journal of Consulting and Clinical Psychology 48, 590601.

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Behavioural and Cognitive Psychotherapy
  • ISSN: 1352-4658
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  • URL: /core/journals/behavioural-and-cognitive-psychotherapy
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