Motivational interviewing: A hammer looking for a nail?

In the field of substance misuse today, motivational interviewing is largely heralded as the definitive model for effecting behavioural change. However, like any model, it has its limitations. As the saying goes, when the only tool you have is a hammer, every problem appears to become a nail, and this may well be the case in the application of motivational interviewing to the treatment of substance misuse. In other words, the client and their situation may be made to fit the tool rather than the tool being adapted to suit the needs of the client. Whilst in theory it appears to be a tool applicable to all substance misusers in treatment, my clinical experience within a community drugs team has led me to question its suitability as a 'one-size-fits all' treatment, and to further determine whether there is a theory-practice gap that sets clients up to fail. (PsycINFO Database Record (c) 2010 APA, all rights reserved)