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Non-participation in outpatient dual diagnosis services presents a challenge for providers assisting clients in their recovery. To better understand factors that facilitate participation, the purpose of this paper is to examine positive recovery states – hope, meaning, and empowerment – as they relate to motivational interviewing (MI) and service use.

Six dually diagnosed adults completed four baseline assessments, four MI sessions, a post-MI tape-assisted recall interview, and one-month follow-up measures. Simulation modeling analysis of phone survey responses, comparisons of baseline and intervention phase data, and grounded theory analysis of interviews were conducted to determine MI's relationship to the dependent variables.

MI was associated with modest improvement in levels of participation, hope, empowerment, and with greater change in life purpose. Key recovery themes were: positive sense of self, increased self-efficacy, and improved relationships. Feelings of safety and trust were tied to greater self-disclosure while more active emotions were more closely linked to the discussion of recovery progress.

The paper's finding are limited by small sample size and phone survey response sets.

To better help dually diagnosed clients sustain treatment involvement, MI practitioners should pay special attention to recovery accomplishments, values, abilities, and self-esteem, while linking these attributes to service participation where appropriate and creating a safe, valuing atmosphere conducive to self-disclosure.

This is the first paper to measure key recovery constructs within MI process, and to explore the role of positive emotions related to MI, recovery, and service participation.