Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness.
Abstract
Motivation is a well-established predictor of recovery for addictive behaviors. Treatments aimed at changing substance use and gambling frequently employ motivational enhancing strategies, based in the principles of Motivational Interviewing (MI). Evidence for these approaches across addictive behaviors does not always paint a clear picture. The purpose of this review was to examine existing reviews of motivational-based interventions for various substances of abuse and gambling in the last decade to gain a deeper understanding of the current evidence and implications for future research and clinical practice. Literature searches were conducted to identify review articles from January 1, 2007 to January 30, 2017 for motivational enhancing interventions for alcohol, tobacco, drugs, marijuana, cocaine, opioids, methamphetamines, and gambling. Of the 144 articles assessed we included a total of 34 review articles in our review, including 6 Cochrane reviews. This review supports use of motivationally enhancing interventions across addictive behaviors with strongest evidence supporting use in alcohol and tobacco, with brief interventions showing strong efficacy. There is strong support for MI with marijuana and some support for gambling. Insufficient evidence is available for methamphetamine or opiate use. There are important caveats. In most cases, MI is more effective than no treatment and as effective (but not necessarily more effective) than other active treatments. Findings for effectiveness of more intensive motivational interventions or combinations are mixed. Treatment fidelity assessments, limited subpopulation analyses, and differences in dose, outcomes, and protocol specification continue to pose significant problems for reviews. (PsycINFO Database Record
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A brief intervention incorporates motivational interviewing to provide individual-centered counseling for people with alcohol use disorder.
“A brief intervention (BI) is an important tool that incorporates motivational interviewing to provide individual-centered counseling for people with AUD [8,9].”
Early responsiveness to SUD treatment is predictive of long-term outcomes, and brief addiction treatments are efficacious.
“Early responsiveness to SUD treatment is predictive of long-term outcomes [36], and brief addiction treatments are efficacious [37].”
From A Therapeutic Relational Agent for Reducing Problematic Substance Use (Woebot): Development and Usability Study (2021) · cites this paper as [37]
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Newman, P. A., Chakrapani, V., Williams, C. C., Massaquoi, N., Tepjan, S., Roungprakhon, S., Akkakanjanasupar, P., Logie, C. H., & Rawat, S. M. (2021) · JMIR Research Protocols · doi:10.2196/34381 · Cited by 27 · see citing works
“We use a 3-session peer-delivered MI-based brief counseling (45 minutes to 1 hour) format with weekly individual sessions, which has previously demonstrated effectiveness in interventions for alcohol, tobacco, and marijuana use, and HIV prevention [79,104-107].”
MethodGoldstein, S. P., Zhang, F., Klasnja, P., Hoover, A., Wing, R. R., & Thomas, J. G. (2021) · JMIR Research Protocols · doi:10.2196/33568 · Cited by 26 · see citing works
“A library of 4 independent modules was created based on principles from motivational interviewing (MI) and acceptance and commitment therapy (ACT) [42,43].”
Motivational Interviewing With Couples
Starks, T. J. (2022) · doi:10.1093/med-psych/9780197549643.001.0001 · Cited by 26 · see citing works
Lenton, S. R., Frank, V. A., Barratt, M. J., Potter, G., & Decorte, T. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.07.040 · Cited by 25 · see citing works
“This is particularly relevant in the context of motivational interviewing (Diclemente et al., 2017).”
BackgroundPollak, K. I., Gao, X., Arnold, R. M., Arnett, K., Felton, S., Fairclough, D. L., & Kutner, J. S. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.11.010 · Cited by 24 · see citing works
Chen, H., Lee, H.-L., Yang, F.-C., Chiu, Y.-W., & Chao, S. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17082755 · Cited by 24 · see citing works
“MI can enhance the intrinsic motivation of stroke patients, and it might be helpful for improving their activities of daily living in specific ways [17,21].”
BackgroundMethodFoldal, V. S., Standal, M. I., Aasdahl, L., Hagen, R., Bagøien, G., Fors, E. A., Johnsen, R., & Solbjør, M. (2020) · BMC Public Health · doi:10.1186/s12889-020-8382-9 · Cited by 24 · see citing works
Chapter 25. Motivational Enhancement
Shulman, M., Pruzan, K., & Carpenter, K. M. (2021) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615373970.kb25 · Cited by 23 · see citing works
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Bottel, L., Brand, M., Dieris-Hirche, J., Herpertz, S., Timmesfeld, N., & Wildt, B. T. T. (2021) · Journal of Behavioral Addictions · doi:10.1556/2006.2021.00071 · Cited by 24 · see citing works
Wood, A. G., Mack, R., & Turner, M. J. (2020) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-020-00351-6 · Cited by 21 · see citing works
Bruguera, P., Barrio, P., Manthey, J., Oliveras, C., López‐Pelayo, H., Nuño, L., Miquel, L., López-Lazcano, A., Blithikioti, C., Caballería, E., et al. (2021) · European Journal of Emergency Medicine · doi:10.1097/mej.0000000000000810 · Cited by 20 · see citing works
GPs’ experiences of phosphatidylethanol in treatment of hypertension: a qualitative study
Thurfjell, Å., Sandlund, C., Adami, J., Hasselström, J., Hagströmer, M., & Lundh, L. (2023) · BJGP Open · doi:10.3399/bjgpo.2023.0037 · Cited by 20 · see citing works
“52,53 When the GPs talked about alcohol based on PEth, they employed a variety of Motivational Interviewing components 54 including the following: cooperating with the patient; respecting the patient’s autonomy; showing empathy; avoiding dissonance; asking for permission to raise the subject; using…”
MethodSiconolfi, D. E., Tucker, J. S., Pedersen, E. R., Perez, L. G., Dunbar, M. S., Davis, J. P., Rodriguez, A., Seelam, R., & D’Amico, E. J. (2023) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.23-00137 · Cited by 20 · see citing works
Gagneur, A., Gosselin, V., Bergeron, J., Farrands, A., & Baron, G. (2019) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2019.1586030 · Cited by 20 · see citing works
Expanding Current Approaches to Solve the Opioid Crisis
Blanco, C., Wall, M. M., & Olfson, M. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.3136 · Cited by 20 · see citing works
Pudalov, L. R., Swogger, M. T., & Wittink, M. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1552125 · Cited by 18 · see citing works
Pellemans, M., Salmi, S., Mérelle, S. Y. M., Janssen, W. C., & van der Mei, R. (2024) · Journal of Medical Internet Research · doi:10.2196/53562 · Cited by 19 · see citing works
“Moreover, MI adherence and fidelity demonstrated considerable variation across different settings and application domains [20-22].”
BackgroundImplementation and evaluation of SBIRT training in a Community Health nursing course
Bremner, M. N., Maguire, M. B. R., Keen, D. L., Blake, B. J., Santa, H., & Nowalk, A. (2019) · Public Health Nursing · doi:10.1111/phn.12696 · Cited by 19 · see citing works
Addiction and COVID: Issues, Challenges, and New Telehealth Approaches
Edinoff, A. N., Kaufman, S. E., Chauncy, T. M., Erwin, A. P., Russo, K. M., Nelson, M. E., Cornett, E. M., Shah-Bruce, M., Kaye, A. M., & Kaye, A. D. (2022) · Psychiatry International · doi:10.3390/psychiatryint3020014 · Cited by 19 · see citing works
“This is an important consideration for health care providers, as about 36% of individuals who are experiencing homelessness are also suffering from an SUD [23].”
BackgroundInfluentialChen, T., Chen, L., Li, S., Du, J., Su, H., Jiang, H., Wu, Q., Zhang, L., Bao, J., & Zhao, M. (2023) · JMIR mhealth and uhealth · doi:10.2196/40373 · Cited by 19 · see citing works
“Psychotherapy is one of the most important treatment methods for drug dependence currently, including cognitive behavioral therapy (CBT), meditation, motivational enhancement therapy (MET) [5,6].”
Rentsch, C. T., Fiellin, D. A., BRYANT, K. J., Justice, A. C., & Tate, J. P. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.13953 · Cited by 18 · see citing works
Dieris-Hirche, J., Bottel, L., Basten, J., Pape, M., Timmesfeld, N., Wildt, B. T. T., Geisler, B. L., Wölfling, K., Henningsen, P., Beutel, M. E., et al. (2023) · EClinicalMedicine · doi:10.1016/j.eclinm.2023.102216 · Cited by 17 · see citing works
Ondersma, S. J., Beatty, J. R., Puder, K. S., Janisse, J. J., & Svikis, D. S. (2019) · Journal of Women s Health · doi:10.1089/jwh.2018.7169 · Cited by 17 · see citing works
Motives, Frequency, and Consequences of Cannabis Use Among College Students
Espinosa, A., Ruglass, L. M., Conway, F. N., Jackson, K. M., & WHITE, H. R. (2022) · Journal of Drug Issues · doi:10.1177/00220426221093608 · Cited by 17 · see citing works
“Motivational interviewing and motivational enhancement strategies continue to gain empirical support in the treatment of problematic cannabis use (Diclemente et al., 2017) and may serve as a useful entry point when working with college students whose cannabis use has not yet escalated to…”
BackgroundGarrison, A., Fressard, L., Mitilian, E., Gosselin, V., Berthiaume, P., Casanova, L., Gagneur, A., & Verger, P. (2023) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2022.2163809 · Cited by 17 · see citing works
Vogel, E. A., Ly, K., Ramo, D. E., & Satterfield, J. M. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.108065 · Cited by 17 · see citing works
“First, motivational approaches are known to promote change in substance use behaviors (DiClemente et al., 2017) and may seem likely to improve treatment utilization as well.”
BackgroundMinian, N., Lingam, M., Moineddin, R., Thorpe, K. E., Veldhuizen, S., Dragonetti, R., Zawertailo, L. A., Taylor, V. H., Hahn, M., deRuiter, W. K., et al. (2020) · JMIR Research Protocols · doi:10.2196/19157 · Cited by 15 · see citing works
“There are established evidence-based methods for identifying and addressing modifiable risk factors as part of a clinical appointment [27-30].”
MethodFoldal, V. S., Solbjør, M., Standal, M. I., Fors, E. A., Hagen, R., Bagøien, G., Johnsen, R., Hara, K. W., Fossen, H., Løchting, I., et al. (2021) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-021-09964-9 · Cited by 15 · see citing works
Screening, brief intervention, and referral to treatment (SBIRT) for cannabis: A scoping review
Gette, J. A., Regan, T., & Schumacher, J. A. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.208957 · Cited by 15 · see citing works
Newhouse, R. P., Janney, M. A., Gilbert, A., Agley, J. D., Bakoyannis, G., Ferren, M. D., Mullins, C. D., Johantgen, M., Schwindt, R. G., & Thoele, K. (2018) · Addiction Science & Clinical Practice · doi:10.1186/s13722-018-0130-4 · Cited by 15 · see citing works
Motivational interviewing with individuals at risk of sex trafficking
Gerassi, L. B., & Esbensen, K. (2020) · Journal of Social Work · doi:10.1177/1468017320919856 · Cited by 15 · see citing works
“There is strong support (including Cochrane reviews and multiple meta-analyses) for using motivational interviewing to successfully reduce substance use and sexual risk (Diclemente et al., 2017).”
BackgroundGuerrin, C. G. J., Tesselaar, D. R. M., Booij, J., Schellekens, A., & Homberg, J. R. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106311 · Cited by 15 · see citing works
“…motivational therapies that redirect reward-seeking behavior toward non-substance-related goals could benefit “ reward ” subtype patients, while those with high alcohol cue reactivity might respond better to cue exposure therapies (DiClemente et al., 2017; Vollst ¨ adt--Klein et al., 2011).”
Gaume, J., Magill, M., Gmel, G. E., & Daeppen, J. (2021) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000666 · Cited by 14 · see citing works
Aanesen, F., Grotle, M., Rysstad, T. L., Tveter, A. T., Tingulstad, A., Løchting, I., Småstuen, M. C., van Tulder, M. W., Berg, R. C., Foster, N. E., et al. (2022) · Occupational and Environmental Medicine · doi:10.1136/oemed-2022-108637 · Cited by 14 · see citing works
Analysis of Behavior Classification in Motivational Interviewing
Tavabi, L., Tran, T., Stefanov, K., Borsari, B. E., Woolley, J. D., Scherer, S. J., & Soleymani, M. (2021) · Workshop on Computational Linguistics and Clinical Psychology (CLPsych) · doi:10.18653/v1/2021.clpsych-1.13 · Cited by 13 · see citing works
“These codes have shown to be effective means of assessing the quality of the session, training therapists, and estimating clients’ behavioral outcomes (Lundahl et al., 2010; Diclemente et al., 2017; Magill et al., 2018).”
BackgroundExpósito-Álvarez, C., Roldán-Pardo, M., Gilchrist, G., & Lila, M. (2024) · Psychosocial Intervention · doi:10.5093/pi2024a13 · Cited by 14 · see citing works
“This person-centered, non-confrontational approach fosters a strong therapeutic alliance and focuses on exploring and overcoming ambivalence about change (DiClemente et al., 2017).”
Yaden, D. B., Berghella, A. P., Hendricks, P. S., Yaden, M. E., Levine, M., Rohde, J. S., Nayak, S. M., Johnson, M. W., & Garcia‐Romeu, A. (2023) · Pharmacological Research · doi:10.1016/j.phrs.2023.106998 · Cited by 13 · see citing works
Crutchfield, D. A., & Güss, C. D. (2018) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2018.1544058 · Cited by 13 · see citing works
Morse, A. K., Sercombe, J., Askovic, M., Fisher, A., Marel, C., Chatterton, M.-L., Kay-Lambkin, F., Barrett, E., Sunderland, M., Harvey, L., et al. (2023) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2022.108928 · Cited by 12 · see citing works
Beck, A. K., Baker, A., Britton, B., Lum, A., Pohlman, S., Forbes, E., Moore, L., Barnoth, D., Perkes, S. J., Oldmeadow, C. J., et al. (2023) · British Journal of Health Psychology · doi:10.1111/bjhp.12664 · Cited by 12 · see citing works
“Consistent with the current findings, the benefits may attenuate over time (Lundahl & Burke, 2009), and be larger for smoking and alcohol use relative to other health behaviours (DiClemente et al., 2017; Frost et al., 2018).”
BackgroundResultSarabia‐Cobo, C., Pérez, V. A. F., de Lorena, P., Sáenz‐Jalón, M., & Alconero‐Camarero, A. R. (2021) · International Journal of Older People Nursing · doi:10.1111/opn.12398 · Cited by 12 · see citing works
Professionally delivered interventions for gambling disorder
Abbott, M. (2019) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000516 · Cited by 12 · see citing works
Characterizing Symptoms of Cannabis Use Disorder in a Sample of College Students
Pellegrino, A. J., Duck, K. D., Kriescher, D. P. J., Shrake, M. E., Phillips, M. M., Lalonde, T. L., & Phillips, K. T. (2020) · Journal of Drug Issues · doi:10.1177/0022042620936655 · Cited by 12 · see citing works
“This approach, with its motivational underpinnings and nonconfrontational features, is effective in reducing cannabis use in young adults (DiClemente et al., 2017).”
BackgroundThe Feasibility and Impact of a Brief Internet Intervention for Pornography Reduction
Rodda, S. N., & Luoto, S. (2022) · Sexual Health & Compulsivity · doi:10.1080/26929953.2022.2153772 · Cited by 11 · see citing works
Variation in SBIRT delivery among acute care facilities
Keen, A., Thoele, K., & Newhouse, R. P. (2019) · Nursing Outlook · doi:10.1016/j.outlook.2019.09.001 · Cited by 12 · see citing works
McKelvey, K., Gaiha, S. M., Delucchi, K., & Halpern‐Felsher, B. L. (2021) · Humanities and Social Sciences Communications · doi:10.1057/s41599-021-00765-2 · Cited by 11 · see citing works
Park, J. J., King, D. L., Wilkinson‐Meyers, L., & Rodda, S. N. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-023-01010-4 · Cited by 10 · see citing works
“In other areas of addiction studies, motivational approaches are frequently delivered as brief interventions which have been shown to improve symptoms and increase treatment readiness (DiClemente et al., 2017).”
Expósito-Álvarez, C., Gilchrist, G., Gracia, E., & Lila, M. (2024) · Victims & Offenders · doi:10.1080/15564886.2024.2322960 · Cited by 10 · see citing works
“Our results could also help inform facilitators to encourage participants to set goals to help them reduce their hostility toward the intervention and increase retention (DiClemente et al., 2017), which is of particular relevance to reducing IPV recidivism rates.”
The Transdiagnostic Mechanisms of Behavioral Addictions and Their Treatment
Kim, H. S., & Hodgins, D. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_64 · Cited by 6 · see citing works
Cross-cultural adaptation of motivational interviewing for use in rural Nepal
Rimal, P., Khadka, S., Bogati, B., Chaudhury, J., Rawat, L. K., Bhat, K. C., Manandhar, P., Citrin, D., Maru, D., Ekstrand, M. L., et al. (2021) · BMC Psychology · doi:10.1186/s40359-021-00557-y · Cited by 10 · see citing works
“Briefly, the CHW training is structured in three forms: [1] pre-service training, [2] program-based training, and [3] continuing education to conduct home visits to collect health related data (e.”
The Development and Evaluation of a Statewide Training Center for Home Visitors and Supervisors
Schultz, D. A., Schacht, R. L., Shanty, L. M., Dahlquist, L. M., Barry, R. A., Wiprovnick, A. E., Groth, E. C., Gaultney, W. M., Hunter, B. A., & DiClemente, C. C. (2019) · American Journal of Community Psychology · doi:10.1002/ajcp.12320 · Cited by 10 · see citing works
Self-citation(2021) · The Journal of Spinal Cord Medicine · doi:10.1080/10790268.2021.1863738 · Cited by 9 · see citing works
Navigating Evidence, Challenges, and Caution in the Treatment of Stimulant Use Disorders
Bahji, A., Danilewitz, M., & Crockford, D. (2023) · Brain Sciences · doi:10.3390/brainsci13101416 · Cited by 9 · see citing works
Maurage, P., Rolland, B., Pitel, A., & D’Hondt, F. (2023) · Neuropsychology Review · doi:10.1007/s11065-023-09623-1 · Cited by 9 · see citing works
A Self-Guided Internet-Based Intervention for the Reduction of Gambling Symptoms
Rolvien, L., Buddeberg, L., Gehlenborg, J., Borsutzky, S., & Moritz, S. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.17282 · Cited by 9 · see citing works
Berube, M., Dupuis, S., Leduc, S., Roy, I., Turcotte, V., Côté, C. L., Grzelak, S., Clairoux, S., Panic, S., & Lauzier, F. (2021) · Pain Management Nursing · doi:10.1016/j.pmn.2021.08.001 · Cited by 9 · see citing works
Forman, D. P., Moyers, T. B., & Houck, J. M. (2021) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2021.108642 · Cited by 9 · see citing works
May, A. C., Meyerhoff, D. J., & Durazzo, T. C. (2023) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.15169 · Cited by 9 · see citing works
Scharer, J. L., Arnold, R., Wald, R. L., Nichols, J., Medoff, D. R., Himelhoch, S. S., & Bennett, M. E. (2019) · AIDS and Behavior · doi:10.1007/s10461-019-02759-3 · Cited by 9 · see citing works
Alcohol Reduction to Reduce Relapse in Acute Alcoholic Pancreatitis—Missed Opportunities
Sissingh, N. J., Umans, D. S., Goudriaan, A. E., Sijbom, M., Verdonk, R. C., van Hooft, J. E., & for the Dutch Pancreatitis Study Group (2021) · Alcohol and Alcoholism · doi:10.1093/alcalc/agab014 · Cited by 9 · see citing works
“This results in leaving patients at risk of resuming drinking after discharge and further harm (DiClemente et al., 2017).”
BackgroundLawrence, S. A., Cicale, C., Wharton, T., Chapple, R. L., Stewart, C., & Burg, M. A. (2021) · Journal of Social Work Practice in the Addictions · doi:10.1080/1533256x.2021.1922038 · Cited by 9 · see citing works
“The effectiveness of MI in substance abuse treatment has been strongly supported in the literature (see for example: DiClemente et al., 2017), and it is a method that can be applied rapidly and fully in a brief time period.”
MethodStreet-Level Meta-Strategies: Evidence on Restorative Justice and Responsive Regulation
Braithwaite, J. B. (2021) · Annual Review of Law and Social Science · doi:10.1146/annurev-lawsocsci-111720-013149 · Cited by 9 · see citing works
“Meta-analyses of 119 studies, more than half of which were randomized controlled trials, show motivational interviewing’s effectiveness as a meta-strategy for selecting what to do about health objectives, such as conquering addiction (DiClemente et al. 2017; Lundahl et al. 2010, 2013).”
BackgroundNichol, B., Rodrigues, A., Wilson, R., & Haighton, C. (2024) · Health & Social Care in the Community · doi:10.1155/2024/6786899 · Cited by 8 · see citing works
- Authors
- DiClemente, C. C., Corno, C. M., Graydon, M. M., Wiprovnick, A. E., & Knoblach, D. J.
- Affiliations
- University of Maryland, Baltimore County (US)
- Venue
- Psychology of Addictive Behaviors
- Published
- 2017-12
- Volume
- 31
- Issue
- 8
- Pages
- 862-887
- ISSN
- 0893-164X (ISSN-L)
- 1939-1501
- OpenAlex
- W2772342693
- Cited by
- 294
- References
- 60
- Citations by year
- 2026: 20 · 2025: 35 · 2024: 39 · 2023: 43 · 2022: 33 · 2021: 50 · 2020: 35 · 2019: 29 · 2018: 10
- FWCI
- 15.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychology of Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- motivational interviewing, motivation enhancement, brief intervention, addictive behavior, substance use disorders, gambling, alcohol consumption, tobacco use, cannabis, cocaine, opioids, methamphetamine, treatment efficacy, treatment effectiveness, intervention fidelity
- MeSH terms
- Gambling, Humans, Review Literature as Topic, Behavior, Addictive, Treatment Outcome, Substance-Related Disorders, Motivational Interviewing
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