1. Motivation and Intervention for Substance Abuse Problems
Chapter 9
Motivation and Intervention for Substance Abuse Problems

2. Chapter Objectives
Describe the dimensions of motivational interviewing.
Define the six stages of change in motivational interviewing.
Describe effective motivational strategies and the ingredients of effective brief counseling.
Describe the eight common defense components of resistance to change.
Describe interventions at each stage of alcohol/drug use.

3. Chapter Objectives
In intervening, describe the do’s and don’ts of emotional reaction, communication, trust in actions – not words, avoidance of distractions.
Describe some obstacles to reaching families and parents of alcoholics/addicts.
Outline and describe the four basic stages of a formal intervention.
Describe the kind of information to be elicited at the assessment stage of a formal intervention.

4. Chapter Objectives
Describe the need for and importance of caring, behavior-specific communication, as well as the avoidance of generalized and blaming statements.
Outline the script format and tasks of the preintervention phase.
Explain the bottom-line script.
Explain why there is the need for a postintervention session for the family.

5. Motivational Interviewing
Overview
Stages of changes and therapist tasks
Client-Centered Motivational Strategies
The counselor’s top priority is to elicit and understand the client’s view.

6. Motivational Interviewing
Effective Motivational Strategies
Giving advice.
Remove barriers.
Providing choice.
Decreasing desirability.
Practicing empathy.
Providing feedback.
Clarifying goals.
Helping active.

7. Motivational Interviewing
Active Ingredients of Effective Brief Counseling
Express empathy.
Develop discrepancy.
Avoid argumentation.
Roll with resistance.
Support self-efficacy.

8. Intervention Common Defense Components of Resistance to Change Denial
Minimization
Projection
Rationalization
Compliance
Conflict avoidance
Obsessive focusing
Acting out

9. Intervention
Interventions at Various Stages of the Alcohol/Drug Use Continuum
Stage 1 – Nonuse Interventions
Stage 2 – Initial Contact Interventions
Stage 3 – Experimentation Interventions
Stage 4 – Interventions at the Integrated Stage
Stage 5 and 6– Interventions at the Excessive Use and Addiction Stages

10. Obstacles to Intervention
Denial of family dysfunction/imbalance.
Skepticism about alcohol/drug messages that don’t fit parents’ own experience.
Assumption by parents that children’s alcohol/drug use will be O.K.
Distorted, depressed view of life by dysfunctional families.
Fear of loss of confidentiality.
Narcissism of parents.
Lack of insurance resource for parenting/counseling services.

11. Obstacles to Intervention
Lack of energy/time by parents.
Distrust of the system.
Lack of credible message sources for minorities.
Lack of concern/respect for experts’ opinions.
Lack of awareness of community resources.
Overwhelming need for services for basic survival.
Cultural mores.

12. Intervention Services
Alcohol/drug intervention is a process that prevents, alters, or interrupts progression of the disease.
Intervention services are offered by most chemical dependency inpatient and residential treatment centers.
A trained interventionist with an expertise in chemical dependency treatment must lead or facilitate the intervention.

13. Goals of Intervention
Provide an opportunity to express concern about the impact the alcoholic/addict’s behavior has had on them.
Provide information on addiction and family patterns of interaction.
Promote the development of a healthy family system and provide resource information.

14. Stages of Formal Intervention
Assessment
Preintervention
Intervention
Postintervention