How to Enhance Motivation for Change in Substance Abuse Treatment

Just a few years ago, mental health professionals thought there was little hope for people with a substance abuse problem who didn't want to change. The client was either motivated or not, and if the client was not motivated, no approach would help. In recent years, however, substance abuse treatment professionals have been rethinking this assumption. Instead of seeing motivation as a static either/or they now see it as a fluid process that may change by the week, the day or even the hour. They also believe that it is part of effective counselors' job to enhance their clients' motivation.

Things You'll Need

• Objective substance abuse screening tools such as the Michigan Alcohol Screening Test (MAST) or the Simple Screening Instrument for Substance Abuse (SSI-SA)
• Written information about substance abuse and treatment options

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Instructions

• 1

  Perform a thorough assessment on your client. Use objective screening measurements as well as empathetic, open-ended questions to discover the extent of your client's substance use and his attitude about it.

• 2

  Determine your client's motivation to change. (See the stages of change in "Tips.") Target your interventions to match your client's motivation; for instance, don't immediately start talking about treatment if your client isn't even convinced she has a problem.

• 3

  Offer objective feedback about the scores your client achieved on the substance abuse screening tools. Also offer positive feedback about your client's strengths and acknowledge the stage of his readiness to change.

• 4

  Explain to the client that any change in substance use is up to her. You will be supportive, but you will not try to force your client to stop drinking or using. Ask the client to summarize what has been said so far. Listen actively and draw your client's attention to self-motivational statements, which may indicate increased motivation.

• 5

  Ask your client's permission to offer advice and options. Be ready with written materials about how to cut back on or abstain from alcohol and drugs as well as a variety of substance abuse treatment programs in your area. Giving your client a range of suggestions and choices allows him to keep control over the final decision.

• 6

  Encourage the client to take the next step in the change process, whether that involves simply thinking about the trouble alcohol and drugs have caused for her (contemplation) or entering an inpatient treatment program (change).