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# Enhancing Motivation for Change in Substance Abuse Treatment

*Treatment Improvement Protocol (TIP) Series, No. 35*

Center for Substance Abuse Treatment.

Substance Abuse and Mental Health Services Administration (US)1999

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This TIP, *Enhancing Motivation for Change in Substance AbuseTreatment*, embraces a fundamentally different way to conceptualizemotivation. In this approach, motivation is viewed as a dynamic and changeablestate rather than a static trait. This TIP shows how clinicians can influencethis change process by developing a therapeutic relationship, one that respectsand builds on the client's autonomy and, at the same time, makes the treatmentcounselor a participant in the change process. The TIP also describes differentmotivational interventions that can be used at all stages of change, fromprecontemplation and preparation to action and maintenance. The goal of this TIPis to make readers aware of the research, results, and promise of motivationalinterventions in the hope that they will be used more widely in clinicalpractice and treatment programs across the United States.

## Contents

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                        - What Is a TIP?
                        - Editorial Advisory Board
                        - Consensus Panel
                        - Foreword
                        - Executive Summary and Recommendations
                        - Chapter 1-- Conceptualizing Motivation And Change                           - A New Look at Motivation
                          - Changing Perspectives on Addiction and Treatment
                          - Changes in the Addictions Field
                          - A Transtheoretical Model Of the Stages of Change
                          - To Whom DoesThis TIP Apply?
                          - Summary
                        - Chapter 2—Motivation and Intervention                           - Elements of Effective Motivational Interventions
                          - Motivational Intervention And the Stages of Change
                          - Special Applications of Motivational Interventions
                          - Brief Interventions
                        - Chapter 3—Motivational Interviewing as a Counseling Style                           - Ambivalence
                          - Five Principles of Motivational Interviewing
                          - Five Opening Strategies For Early Sessions
                          - Effectiveness of Motivational Interviewing
                          - Motivational Interviewing and Managed Care
                        - Chapter 4—From Precontemplation to Contemplation: Building Readiness                           - Raising the Topic
                          - Gentle Strategies To Use With the Precontemplator
                          - Assessment and Feedback Process
                          - Intervene Through Significant Others
                          - Motivational Enhancement and Coerced Clients: Special Considerations
                        - Chapter 5—From Contemplation to Preparation: Increasing Commitment                           - Changing Extrinsic to Intrinsic Motivation
                          - Tipping the Decisional Balance
                          - Emphasizing Personal Choice and Responsibility
                          - The Importance of Self-Efficacy
                        - Chapter 6—From Preparation to Action: Getting Started                           - Recognizing Readiness To Move Into Action
                          - Negotiating a Plan for Change
                          - Initiating the Plan
                        - Chapter 7—From Action to Maintenance: Stabilizing Change                           - Engaging and Retaining Clients in Treatment
                          - Planning for Stabilization
                          - Developing and Using Reinforcers
                        - Chapter 8—Measuring Components of Client Motivation                           - Self-Efficacy
                          - Readiness To Change
                          - Decisional Balancing
                          - Motivation for Using Substances
                          - Goals and Values
                        - Chapter 9—Integrating Motivational Approaches Into Treatment Programs                           - The Treatment Continuum and Stepped Care
                          - Applications of Motivational Approaches In Specific Treatment Settings
                        - Chapter 10—Directions for Future Research                           - Conclusion
                        - Appendix A -- Bibliography
                        - Appendix B—Screening and Assessment Instruments
                        - Appendix C—Ordering Information for Assessment Instruments
                        - Appendix D—Resource Panel
                        - Appendix E --Field Reviewers

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The opinions expressed herein are the views of the Consensus Panel members and donot reflect the official position of CSAT, SAMHSA, or the U.S. Department ofHealth and Human Services (DHHS). No official support or endorsement of CSAT,SAMHSA, or DHHS for these opinions or for particular instruments or softwarethat may be described in this document is intended or should be inferred. Theguidelines proffered in this document should not be considered as substitutesfor individualized client care and treatment decisions.

Copyright Notice

Bookshelf ID: NBK64967PMID: 22514841

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                    - Cite this Page Center for Substance Abuse Treatment. Enhancing Motivation for Change in Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 35.)
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                    - SAMHSA/CSAT Treatment Improvement Protocols
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