Substance Abuse, Motivational Interviewing Procedures

Motivational Interviewing Procedures and Techniques

Although motivational interviewing procedures are largely nondirective and nonconfrontational, conducting a substance related interview requires that the interviewer structure the interview around a number of substance use and abuse questions and issues. Rollnick and Bell recommend covering 10 different content areas.

Bring up the subject of substance use. Do this gently and openly. For example, following about 5 to 10 minutes of building rapport and establishing a minimal amount of trust, transition to the substance issue by using a summary statement and swing question: “We’ve been talking a while in general about how your life is going. It sounds like you’ve had a bit of stress lately. Would you mind if I asked you now about your use of alcohol?” Intake Interviewing and Report Writing 191In most cases, clients-even alcohol abusing clients-cooperate with a gentle effort to explore their drinking patterns. As you can see, this approach is tentative and gives clients a sense of control over the interview. From the motivational interviewing perspective, this approach allows the client to become engaged in a conversation. In contrast, the confrontation of denial approach tends to elicit denial and resistance by using more accusatory questions or only closed questions.

Ask about substance abuse in detail. Rollnick and Bell suggest questions such as, “What kind of a drinker are you?” or “Tell me about your use of marijuana; what effect does it tend to have on you?” . The purpose of these questions is to let clients talk about their view of their drinking. These questions can be followed up with more speci?c queries: “You said you like to have a few beers with your friends after work. What’s a

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