Reviewed by Vinsent Franke, MBA, AMFT, CADC-II, RA, Founder of iRely Recovery. Updated September 2026.
Intro
Motivational Interviewing (MI) is an evidence-based counseling approach that helps people find their own reasons to change. Rather than telling clients what they should do, MI therapists guide conversations that draw out the client's own values, goals and internal motivation.
At iRely Recovery in Los Angeles, MI is a core part of how we work with every client, delivered by therapists trained in the research-validated model.
Key Points
- Draws out your own reasons to changeMI explores ambivalence instead of arguing for change.
- Built on OARSOpen questions, affirming, reflective listening and summarizing.
- One of the most studied approachesMore than 200 randomized trials support MI for substance use disorders.
- Insurance verificationWe verify benefits at no cost. Call 818-869-2112.
In Short
Motivational Interviewing at iRely Recovery helps you find your own reasons to change, using the OARS framework and four stages of engaging, focusing, evoking and planning. It is used alongside CBT, DBT and trauma-informed care. Most insurance is accepted. Call 818-869-2112 to speak with an admissions counselor.
What Is Motivational Interviewing?
Motivational Interviewing was developed by psychologists William R. Miller and Stephen Rollnick in the 1980s. It grew out of research showing that confrontational approaches to addiction treatment often produced resistance rather than change. MI takes a different stance: the therapist’s job is to explore ambivalence with the client, not to argue for change.
The approach rests on four guiding principles. Partnership treats the relationship as collaborative. Acceptance means the therapist respects the client’s autonomy and worth regardless of where they are in recovery. Compassion means the therapist actively promotes the client’s wellbeing. Evocation means drawing out the client’s own reasons for change rather than imposing external ones.
According to SAMHSA’s Treatment Improvement Protocol 35, MI is one of the most rigorously validated counseling approaches for substance use disorders, with more than 200 randomized controlled trials supporting its effectiveness for alcohol, opioids, stimulants and co-occurring conditions.
The OARS Framework
MI therapists use four core communication skills, known as OARS, in every session.
Open-Ended Questions
Questions that invite you to explore your own thoughts and feelings rather than yes or no answers, such as “What concerns you most about your drinking?” instead of “Are you ready to stop?”
Affirming
Acknowledging your strengths, efforts and past successes. Affirmations build confidence and reinforce that change is possible.
Reflective Listening
Reflecting back what you said, sometimes naming the feeling underneath the words, so you can hear your own ambivalence more clearly.
Summarizing
Pulling together key themes from the conversation to reinforce change talk and move between topics, so you feel heard and see patterns in your own thinking.
OARS are not techniques used mechanically. They express a genuine therapeutic stance, and our therapists are trained in MI fidelity, meaning the way they speak and listen is consistent with the research-validated model.
The 4 Stages of Motivational Interviewing
MI unfolds through four overlapping stages.
1. Engaging
Building a warm, trusting and non-judgmental therapeutic relationship. Without genuine trust, the other stages cannot happen, and this stage often takes more time than clients expect, by design.
2. Focusing
Collaboratively narrowing in on the specific behavior or area you want to work on. You, not the therapist, set the agenda.
3. Evoking
Drawing out your own arguments for change, called change talk. When you hear yourself say why you want to change and believe you can, motivation is built from the inside out.
4. Planning
Developing a concrete, client-generated action plan. Because the plan belongs to you, it is more likely to hold up when real-world obstacles arise.
MI vs. Traditional Confrontational Approaches
For decades, confrontational approaches dominated addiction treatment. Clients were told their addiction was a choice, that they needed to hit rock bottom, and that resistance was denial. Research has consistently found these approaches produce higher dropout and lower treatment completion.
MI produces the opposite result. When clients feel respected and heard, they stay in treatment longer and engage more deeply. A 2019 meta-analysis found MI-based interventions produced significantly better retention than confrontational models.
| Feature | Motivational Interviewing | Confrontational Approach |
|---|---|---|
| Therapist role | Guide and collaborator | Authority and instructor |
| Client role | Expert on their own experience | Passive recipient of advice |
| Change argument | The client generates their own reasons | The therapist argues for change |
| Response to resistance | Roll with resistance and explore ambivalence | Challenge and confront denial |
| Research base | More than 200 randomized trials, SAMHSA endorsed | Limited, and associated with higher dropout |
This does not mean MI avoids difficult conversations. It means those conversations are started by the client, not imposed by the therapist.
What to Expect in an MI Session at iRely
Sessions are conversational. Your therapist asks open-ended questions about your goals, your concerns and what matters most to you. You will not be lectured or told what you must do. At the same time, your therapist gently guides the conversation toward your own reasons for wanting to change.
Many clients describe MI as the first time in their treatment experience that they felt genuinely heard, and that experience of being heard is not just a pleasant feeling. It is the mechanism through which MI works.
MI for Co-Occurring Disorders
Many people who struggle with substance use also live with depression, anxiety, PTSD or other mental health conditions. MI suits co-occurring presentations well because it does not assume you have a single, simple problem to solve.
At iRely Recovery, MI is used alongside other evidence-based therapies we offer, including Cognitive Behavioral Therapy, Dialectical Behavior Therapy and trauma-informed approaches. The combination lets you build motivation through MI while developing coping skills through structured therapy.
Who MI Is Best For
MI is effective across a wide range of substance use presentations, including:
- Alcohol use disorder
- Opioid dependence, including heroin and prescription opioids
- Stimulant use disorders, such as cocaine and methamphetamine
- Benzodiazepine dependence
- Cannabis use disorder
- Co-occurring substance use and mental health conditions
MI is especially valuable for clients who have had negative experiences with confrontational treatment, who feel ambivalent about change or who are in the early stages of considering recovery. It is not a sign of weakness to feel conflicted about change. MI is designed precisely for that moment.
Research and Evidence Base
Motivational Interviewing has one of the largest research bases of any counseling approach in addiction treatment.
SAMHSA TIP 35
Identifies MI as a core evidence-based practice for substance use disorders.
NIDA
The National Institute on Drug Abuse recognizes MI as an effective behavioral therapy for addiction treatment.
Cochrane Review (2010)
A review of 59 randomized controlled trials found MI effective in reducing substance use across multiple substances and settings.
Miller and Rollnick (2013)
Motivational Interviewing: Helping People Change is the definitive clinical reference for the approach.
Insurance Accepted for Motivational Interviewing in Los Angeles
Most major insurance plans cover Motivational Interviewing when it is delivered as part of a licensed substance abuse treatment program.
Call 818-869-2112 to verify your specific coverage before admission.
Getting Started
Ready to start a recovery that feels like your own? Motivational Interviewing begins with a conversation. Our admissions process and our clinical team are ready to walk you through what comes next.
Frequently Asked Questions About Motivational Interviewing
What is Motivational Interviewing for substance abuse?
Motivational Interviewing (MI) is an evidence-based, collaborative counseling approach that helps people find their own internal motivation to change substance use behaviors. Developed by William Miller and Stephen Rollnick, MI is built on four core skills known as OARS: open-ended questions, affirming strengths, reflective listening and summarizing. Unlike confrontational approaches, MI respects client autonomy and has been validated by decades of research.
What are the 4 stages of Motivational Interviewing?
The four stages are engaging, building a trusting, non-judgmental therapeutic relationship; focusing, collaboratively identifying the specific behavior change to work on; evoking, drawing out the client’s own reasons, values and motivations for change; and planning, developing a concrete, client-led plan for making the change. Each stage builds on the last and is paced to the individual client.
Is Motivational Interviewing evidence-based for addiction treatment?
Yes. Motivational Interviewing is one of the most extensively researched counseling approaches in addiction treatment. SAMHSA designates MI as an evidence-based practice in its Treatment Improvement Protocol 35, and more than 200 randomized controlled trials have shown its effectiveness for alcohol use disorder, opioid dependence, stimulant use and co-occurring mental health conditions.
How many Motivational Interviewing sessions are typically needed?
Research shows that even a few sessions of MI can produce measurable reductions in substance use. In a residential treatment setting like iRely Recovery, MI is integrated throughout the program rather than delivered as a fixed number of standalone sessions, and most clients engage in MI-informed conversations daily as part of their individualized treatment plan.
Does insurance cover Motivational Interviewing therapy?
Most major insurance plans cover Motivational Interviewing when it is delivered as part of a licensed substance abuse treatment program. iRely Recovery is DHCS licensed (License #191516AP) and works with many insurance providers. Call 818-869-2112 to verify your specific coverage before admission.
What is the OARS method in Motivational Interviewing?
OARS is the core skill set of Motivational Interviewing. Open-ended questions invite you to explore your own thoughts and feelings without yes or no answers. Affirming acknowledges your strengths and past successes. Reflective listening demonstrates understanding and helps you hear your own words reflected back. Summarizing pulls together themes and reinforces change talk. Together, OARS create a conversation where you feel safe to explore ambivalence about substance use.
What types of addiction does Motivational Interviewing treat?
Motivational Interviewing has been validated for a wide range of substance use disorders, including alcohol use disorder, opioid dependence, stimulant use such as cocaine and methamphetamine, benzodiazepine dependence and co-occurring substance use and mental health conditions. At iRely Recovery, MI is used across all substance types as part of an individualized treatment approach.
Sources
[1] Substance Abuse and Mental Health Services Administration. (2019). Motivational interviewing as a counseling style. In www.ncbi.nlm.nih.gov. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK571068/ on May 22, 2025
[2] Bischof, G., Bischof, A., & Rumpf, H.-J. (2021). Motivational interviewing: an evidence-based Approach for Use in Medical Practice. Deutsches Aerzteblatt Online, 118(7), 109 to 115. https://pmc.ncbi.nlm.nih.gov/articles/PMC8200683/ on May 22, 2025
[3] The University of Iowa. (n.d.). Motivational interviewing: Steps and core skills. https://sbirt.uiowa.edu/sites/sbirt.uiowa.edu/files/2020-02/sbirt_mi_part_2_-_2018_-_final.pdf on May 22, 2025
[4] SAMHSA. (2021). USING MOTIVATIONAL INTERVIEWING IN SUBSTANCE USE DISORDER TREATMENT. https://library.samhsa.gov/sites/default/files/PEP20-02-02-014.pdf on May 22, 2025
[+] Substance Abuse and Mental Health Services Administration. (1999). Enhancing Motivation for Change in Substance Use Disorder Treatment. Treatment Improvement Protocol (TIP) Series, No. 35.
[+] Miller, W. R., and Rollnick, S. (2013). Motivational Interviewing: Helping People Change (3rd ed.). Guilford Press.
Ready to Start a Recovery That Feels Like Your Own?
Motivational Interviewing begins with a conversation. Call iRely Recovery today at 818-869-2112 to speak with an admissions counselor about our MI-based residential treatment program in Los Angeles. We are at 17524 Napa St, Los Angeles, CA 91325, and DHCS Licensed #191516AP.
