Keeping Going: Maintaining Motivation and Momentum in Drug and Alcohol Recovery

Introduction

Deciding to look at your drinking or drug use is rarely a single moment of clarity. More often, it is a series of starts, pauses and second thoughts. One week you may feel certain that something needs to change; the next, the urgency fades, old routines pull you back, or doubts creep in about whether treatment is really for you.

If that sounds familiar, it may help to know that fluctuating motivation is a normal part of the change process, not a sign of weakness or failure. Decades of research and clinical experience suggest that motivation is not a fixed trait that people either have or lack. It rises and falls in response to circumstances, relationships, emotions and, importantly, the way conversations about change are held (Miller and Rollnick, 2023).

This article looks at why motivation wavers when people begin exploring recovery and treatment, and what can help keep momentum going. It draws on motivational interviewing (MI), a well-researched approach used widely in UK drug and alcohol services and reflected in national clinical guidance (Department of Health, 2017).

Why motivation comes and goes

At the heart of most hesitation about change is ambivalence: wanting two conflicting things at the same time. You might want to drink less because of your health, sleep or relationships, while also valuing the relief, confidence or sense of connection that alcohol or drugs seem to provide. Miller and Rollnick (2023) describe ambivalence as a normal and expected part of the road to change, rather than as denial or resistance. People often stay stuck not because they do not care, but because both sides of the argument feel true.

The transtheoretical model, or ‘stages of change’, offers another useful lens (Prochaska and DiClemente, 1983; Prochaska, DiClemente and Norcross, 1992). It describes people moving from precontemplation and contemplation through preparation and action to maintenance. The model has been criticised, and people rarely move through the stages in a tidy line (West, 2005). However, it captures something important: someone still weighing things up needs different support from someone who has decided and wants a plan.

This matters for momentum. If you are pushed towards action before you feel ready, motivation can quickly collapse. Equally, if you wait for a perfect moment of certainty, it may never arrive. Recognising where you are right now, without judging yourself for it, is often the first step towards moving forward.

It can also help to break motivation down into its parts. MI describes readiness for change as resting on three related elements, sometimes summarised as being ‘ready, willing and able’ (Miller and Rollnick, 2023):

• Willing (importance) – how much the change matters to you

  
  

• Able (confidence) – how much you believe you could make the change

  
  

• Ready (priority) – where the change sits among everything else going on in your life right now

  
  

Many people feel change is very important but have little confidence, often after previous attempts that did not go to plan. Knowing which element feels weakest can point towards what is most likely to help.

What motivational interviewing offers

Motivational interviewing is a collaborative, person-centred way of talking about change. It was first described by William Miller in work with people experiencing problems with alcohol (Miller, 1983) and later developed with Stephen Rollnick. Rather than persuading, lecturing or confronting, an MI practitioner helps a person explore and strengthen their own reasons for change (Miller and Rollnick, 2023).

When people feel pressured or judged, they often defend the status quo; when they feel heard and respected, they are more likely to think openly about change.

The spirit of MI

MI is underpinned by a particular attitude, often described as its ‘spirit’. In the most recent edition of their text, Miller and Rollnick (2023) describe four elements:

• Partnership – working alongside you rather than doing things to you, recognising that you are the expert on your own life

  
  

• Acceptance – respecting your worth, your autonomy and your right to make your own choices

  
  

• Compassion – actively prioritising your welfare and wellbeing

  
  

• Empowerment – helping you recognise and use your own strengths, ideas and resources (earlier editions used the term ‘evocation’)

  
  

Four overlapping tasks

MI conversations tend to move through four overlapping tasks: engaging (building a trusting working relationship), focusing (agreeing what to talk about), evoking (drawing out your own motivation for change) and planning (developing a commitment and a concrete plan when you are ready). These are not rigid steps, and returning to an earlier task when circumstances change is part of the process rather than a step backwards.

Change talk

A central idea in MI is that the words people use about change carry weight. ‘Change talk’ is anything you say that favours change, such as “I want to feel healthier” or “I could stop on weeknights”. ‘Sustain talk’ is language that favours staying the same, such as “It’s the only way I can relax”. Both are normal and both deserve to be heard.

Research suggests this matters. One study found that the strength of commitment language during MI sessions predicted later drug use outcomes (Amrhein et al., 2003). A later meta-analysis of MI process studies found support for the idea that MI-consistent practitioner skills are linked to more client change talk, and that the balance of change talk to sustain talk is associated with outcomes (Magill et al., 2018). More broadly, a meta-analysis of 25 years of MI research found that MI produced modest but statistically significant effects across a range of problems, including alcohol and drug use, and performed comparably to other active treatments (Lundahl et al., 2010). As with any approach, results vary from person to person.

MI practitioners use four core skills, often summarised as OARS: open questions, affirmations, reflections and summaries. These help people hear their own reasons for change spoken back to them, which can be surprisingly powerful.

Protection Motivation Theory: why knowing the risks is not enough

Many people assume that if someone fully understood the harms of alcohol or drugs, they would simply stop. Protection Motivation Theory (PMT) helps explain why this is rarely the case. Originally developed to understand how people respond to health warnings, it suggests that our motivation to protect ourselves depends on two separate processes (Rogers, 1975; Rogers, 1983).

The first is threat appraisal: how serious we believe a risk is, how vulnerable we feel to it, and the rewards we get from carrying on as we are. The second is coping appraisal: whether we believe a change would actually help (response efficacy), whether we believe we could make it (self-efficacy), and what we think it would cost us in effort, discomfort or loss (response costs).

Why this matters for recovery

PMT suggests that awareness of risk only leads to lasting change when it is matched by a belief that change is both possible and worthwhile. Meta-analyses have found that coping appraisal, particularly self-efficacy, tends to be a stronger predictor of protective intentions and behaviour than threat appraisal (Floyd, Prentice-Dunn and Rogers, 2000; Milne, Sheeran and Orbell, 2000). In other words, feeling capable of change matters at least as much as feeling worried.

This has several practical implications:

• Fear alone rarely sustains momentum. If you feel highly threatened but have little confidence, you may cope by avoiding the subject, minimising the risks or feeling hopeless, rather than taking action.

  
  

• The rewards of current use are real. PMT recognises that drinking or drug use often meets genuine needs, such as relief from stress or social ease. Acknowledging this honestly, rather than dismissing it, mirrors how MI treats sustain talk.

  
  

• Confidence can be built. Self-efficacy, response efficacy and response costs can all change with the right information, support and experience of small successes.

  
  

PMT and MI fit well together. MI avoids scare tactics and focuses instead on exploring your own concerns while strengthening your confidence and sense of choice. The strategies below are designed to support both sides of the picture: understanding what is at stake for you, and believing that change is within reach.

Practical ways to maintain motivation and momentum

These strategies draw on MI principles and wider psychological research. Many people find they work best when explored with a trained professional.

1. Reconnect with what matters to you

Motivation tends to last longer when it comes from your own values rather than from pressure, guilt or other people’s expectations. Self-determination theory distinguishes between motivation that feels self-chosen and motivation that feels imposed, and suggests that self-chosen motivation is more likely to be sustained (Ryan and Deci, 2000).

Try asking yourself: what kind of parent, partner, friend or colleague do I want to be? How does my current drinking or drug use fit with that picture? Gently exploring the gap between your values and your current situation is a key part of evoking motivation in MI (Miller and Rollnick, 2023).

2. Notice and record your own reasons

When motivation is high, write down your reasons for change in your own words. On harder days, reading them back can be more persuasive than anything another person could say.

3. Use a simple 0–10 scale

Ask yourself two questions: “On a scale of 0 to 10, how important is it for me to make this change?” and “How confident am I that I could do it?” Then ask a follow-up: “Why am I at this number and not a lower one?” This tends to bring out the reasons and strengths you already have. A second question – “What would help me move up one point?” – can point to a realistic next step (Miller and Rollnick, 2023).

4. Build confidence through small, achievable steps

Confidence, or self-efficacy, grows through experience. Bandura (1977) proposed that one of its strongest sources is the experience of succeeding at something, even something small. Rather than aiming for an overnight transformation, choose a step that feels achievable this week, such as keeping a drinking diary, booking an appointment with your GP or speaking openly with one trusted person. Each completed step is evidence that change is possible.

5. Turn intentions into specific plans

Good intentions often fade when they meet real-life pressures. Research on ‘implementation intentions’ suggests that “if–then” plans can help people act on their goals (Gollwitzer, 1999). For example: “If I feel the urge to drink after work, then I will go for a walk and call my sister” or “If I am offered cocaine at the weekend, then I will say I’m driving and leave by 10pm.” Planning for specific high-risk situations in advance means you are not relying on willpower in the moment.

6. Keep your autonomy at the centre

It is your life and your decision. People are more likely to commit to changes they have chosen for themselves. You might decide on abstinence or want to explore reducing your use first, depending on your circumstances and any medical advice you receive. Revisiting your goals as things change can help motivation feel less like an obligation and more like a choice.

When momentum slips: setbacks, support and recovery capital

Lapses are not the end of the road

Few people change their relationship with alcohol or drugs without some setbacks along the way. Relapse prevention research distinguishes between a lapse (a single episode of use) and a relapse (a return to previous patterns). Marlatt and Gordon (1985) described how people who see a lapse as proof of personal failure – “I’ve blown it, so what’s the point?” – may be more likely to slide into a full relapse. Later work has emphasised that relapse is a dynamic process, influenced by many interacting factors such as stress, mood, confidence and coping skills (Witkiewitz and Marlatt, 2004).

If you do lapse, it can help to treat it as information rather than a verdict. What was happening beforehand? What were you thinking and feeling? What might you do differently next time? Approaching setbacks with curiosity and self-compassion, rather than harsh self-criticism, can help you get back on track more quickly.

Build your recovery capital

Motivation is easier to sustain when it is supported by the resources around you. Cloud and Granfield (2008) use the term ‘recovery capital’ to describe the personal, social, physical and community resources a person can draw on, such as supportive relationships, stable housing, meaningful activity, good health and access to services. Practical steps might include reconnecting with friends who do not drink or use drugs, returning to a hobby or exercise, improving your sleep or finding activities that give you a sense of purpose.

Do not go it alone

Many people find that support from others helps them keep going when their own motivation dips. This might come from family and friends, mutual aid groups or professional treatment services. Options, such as SMART Recovery can be useful to keep things going.

Staying safe and getting support

An important safety note

If you are physically dependent on alcohol, stopping suddenly can be dangerous and may cause serious withdrawal symptoms, including seizures. NICE guidance recommends that people who are dependent on alcohol are offered medically assisted withdrawal where appropriate (NICE, 2011). Similar caution applies to some other substances, including benzodiazepines (Department of Health, 2017). Please speak to your GP before cutting down or stopping. If you are unwell or in crisis, contact NHS 111, call 999 or attend A&E.

Free, confidential information and advice is also available from Drinkline on 0300 123 1110 and from FRANK on 0300 123 6600.

How Cheshire Sobriety Clinic can help

At Cheshire Sobriety Clinic, we provide private, confidential outpatient support for people experiencing difficulties with alcohol and drugs, from our consulting rooms in Altrincham and Alderley Edge and online across the UK. Our approach draws on established therapeutic methods, including the principles of motivational interviewing described in this article. We aim to meet you where you are, whether you are still weighing things up or ready to make a plan.

We do not provide medically managed detox or crisis care. If your circumstances mean your needs would be better met by another service, we will talk this through openly with you and help you explore alternatives. Everyone’s experience of treatment is different, and outcomes depend on many individual factors.

If you would like to talk things through, you can book a free, confidential 30-minute consultation, with no obligation to go ahead with treatment. You do not need to have everything figured out before you get in touch.

This article is for general information only and is not a substitute for personalised medical or professional advice.

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