Motivational interviewing

What is motivational interviewing?

Motivational interviewing is a way of talking with a trained worker or therapist that helps you sort out your own feelings about changing something — most often drinking, drug use, smoking or another habit. Instead of telling you what to do, the worker listens carefully, asks open questions, and helps you weigh up the good and not-so-good parts of how things are now.

The idea is that change sticks better when the reasons come from you, not from someone else's lecture. So the conversation is calm, respectful and free of blame. You stay in charge. The worker is on your side, even if you feel unsure or are not ready to stop yet.

Motivational interviewing is often a starting point or a part of treatment, not the whole of it. It can be used on its own for a short time, or alongside other support such as group work, key-working, medicines or other talking therapies. It can help you decide whether to change, and build your confidence to begin.

It is not a test, and there is no pass or fail. It will not force you to do anything, and it cannot promise that you will stop or cut down — but it can help you feel clearer and more in control of the decision.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your programme

• You do not need to have decided to stop or cut down — being unsure is completely normal and is exactly what this approach is designed for.
• It can help to think about what matters to you in life, as the conversation often links change to your own goals and values.
• Bring an honest sense of how things are now if you can; nothing you say is used to judge or punish you.
• Note any other support you already have (GP, key worker, family, groups) so it can be joined up.
• Tell the worker about any other health or mental-health problems, and any medicines you take.
• Think about practical things that affect you — housing, work, money, children — as these often matter to motivation and safety.
• If you feel at risk or in crisis, say so at the start, so the right urgent support can be arranged.

What happens

A session is usually a relaxed, private conversation with one trained worker or therapist, lasting around 30 to 60 minutes. There is no examination and no equipment. The worker will explain that you are in charge and that they will not push you.

They will ask open questions and listen more than they talk. You might explore what you like and dislike about your habit, what worries you, what you would want instead, and how confident you feel about change. The worker reflects back what they hear, which can help you notice your own thoughts more clearly.

You might look together at the next small step — which could simply be thinking it over, or trying a change, or taking up other support. Any plan is yours, and you can change your mind. Often this is one of several sessions, with the pace set by you.

Is this programme right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main limitation is that motivational interviewing builds readiness and confidence, but does not by itself manage physical dependence or withdrawal. If you are physically dependent on alcohol or other drugs, stopping suddenly can be dangerous, so ask what medical support and safe withdrawal options are available alongside the talking work.

Published figures to discuss

Motivational interviewing is a conversation, so it does not carry the physical risks of a procedure. Its effect on whether people cut down or stop varies a lot between studies and depends on the person, the problem, the skill of the worker and what other support is in place. Reliable single 'success rates' are not meaningful, so none are given here.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. Afterwards, some people feel lighter or clearer, others feel stirred up by what was discussed — both are normal. Any change you decide on then happens over the following weeks and months.

• Feeling more aware of your habit and its place in your life.
• Mixed feelings — wanting to change and not wanting to, at the same time.
• Motivation that goes up and down rather than in a straight line.
• Realising you would like more practical or medical support as well.

Aftercare

• Be kind to yourself; thinking about change is itself a step, even if nothing has changed yet.
• Follow up any support you agreed to look into, such as a key worker, group or GP.
• If you are dependent on alcohol or drugs, get medical advice before stopping suddenly.
• Keep any further sessions, as motivation often grows over a short course.
• Tell someone you trust if you are struggling, and use crisis support if you feel unsafe.
• Notice and credit small changes, not just complete stopping.

• A note of what matters to you and why change might help.
• Contact details for your drug/alcohol service or GP.
• The names of any groups or apps you were told about.
• A trusted person you can talk to between sessions.
• Crisis numbers saved (999; Samaritans 116 123; FRANK 0300 123 6600).
• Any medicines list, if other treatment is being considered.

⚠ Get urgent help if…

• Thoughts of harming yourself or ending your life — get help now (call 999 or Samaritans on 116 123).
• Feeling unable to keep yourself or others safe.
• Severe withdrawal symptoms if you stop alcohol or drugs suddenly — shaking, sweating, confusion, fits.
• Fast-worsening low mood, panic or hopelessness.
• Drinking or using much more than usual to cope, or mixing substances dangerously.
• Feeling completely alone with no support — contact your service, GP or a helpline.
• Any medical emergency such as collapse, fits or unresponsiveness — call 999.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

A good outcome from motivational interviewing is usually that you feel clearer about your situation and more in control of the decision — whether that means deciding to change, taking up other support, or simply understanding yourself better. For some people it leads fairly soon to cutting down or stopping; for others it is one helpful step among several.

It cannot guarantee that you will change, and it does not, by itself, treat physical dependence. Feeling no different, or still unsure, after a session does not mean it has failed — readiness often builds gradually.

Motivation is not fixed — it naturally rises and falls. The thinking sparked by motivational interviewing can keep working for weeks, but most people benefit from ongoing support rather than relying on a one-off conversation. If your circumstances change, it is normal and sensible to revisit your plan with a worker or GP.

Related tests, treatments or support

Motivational interviewing is often combined with other support: key-working, group programmes, cognitive behavioural therapy, mutual-aid groups such as SMART Recovery or 12-step groups, and medicines where appropriate (for example for alcohol, opioid or nicotine dependence). For many people the combination works better than the conversation alone.

Follow-up & long-term care

Follow-up depends on the service. You may be offered further sessions, a key worker, or a referral into wider treatment. Ask who your point of contact is, how to get back in touch if motivation dips, and what to do in a crisis. Good services make it easy to return without judgement if you relapse.

• Keep in touch with your service or GP, especially when motivation feels low.
• Use mutual-aid groups or apps if they help you stay on track.
• Plan ahead for situations that tempt you, and have a step to take if you slip.
• Look after sleep, mood and other health, which all affect motivation.
• Return for more support if your circumstances change — relapse is common and is not a failure.

Repeat, follow-on and what comes next

• Motivation naturally rises and falls; needing to revisit the conversation is expected, not a failure.
• Relapse is common in addiction, and returning for more support is a normal part of recovery.
• If the approach is not helping, a different therapy or added medical support may be needed.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A named worker or clear point of contact you can return to without judgement.
• A plan that joins up talking work with medical and practical support.
• Clear crisis instructions, including what to do if you feel unsafe.
• Easy re-access if motivation dips or you relapse.
• Involvement of family or carers where you want it, with your consent.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether you use a free NHS or charity service rather than a private therapist.
• The number and length of sessions.
• Whether sessions are one-to-one, in a group, in person or online.
• The training and qualifications of the worker or therapist.
• Whether motivational work is part of a wider package with key-working or medicines.
• Any written reports or letters requested.

• The therapist's training and qualifications.
• The number of sessions included and the length of each.
• What happens if you need more sessions or other support.
• Whether the fee includes any reports, letters or liaison with your GP.
• The cancellation and missed-appointment policy.
• What to do, and who to contact, in a crisis or if you relapse.

On the NHS? Motivational interviewing is widely used in free NHS and charity drug and alcohol services; private therapy exists but is not needed to access good support.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Is motivational interviewing right for me, or would I also benefit from other support?
• How many sessions might I have, and who would I see?
• If I am dependent, what medical support is available so I can change safely?
• What happens if my motivation dips or I relapse — can I come back?
• How will this be joined up with my GP or any other treatment?
• What can I do between sessions, and who do I contact in a crisis?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my programme, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this programme not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for motivational interviewing

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Drug addiction: getting help NHS — Alcohol support Royal College of Psychiatrists — Alcohol, mental health and the brain NICE — Alcohol-use disorders: diagnosis and management (CG115) NICE — Drug misuse in over 16s: psychosocial interventions (CG51) FRANK — honest information about drugs (helpline 0300 123 6600)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.