The impact of a brief motivational intervention at the start of an outpatient day programme for alcohol dependence

Motivational intervention, a strategy to increase motivation for change, was tested as an addition to treatment at the start of an outpatient programme for alcohol dependence. Admissions to the programme were randomly allocated to either a motivational or educational procedure. The three motivational constructs of the SOCRATES-8A Readiness to Change questionnaire (Ambivalence about change, Recognition of problems, Taking Steps to change) were used as measures of motivation for change. At one week post-intervention, motivational participants reported significantly greater levels of problem recognition. The motivational group's post-intervention scores were significantly higher on the Taking Steps scale and significantly lower on the Ambivalence scale. There was no difference on measures of engagement in treatment or drop-out from the outpatient treatment programme. For the population as a whole, a relatively low pre-intervention score on the Ambivalence scale was predictive of drop-out. Results support the efficacy of motivational intervention for decreasing self-reported levels of ambivalence about change and for increasing problem recognition and taking steps towards change. More detailed research with a longer follow-up period is needed to determine whether this has any impact on other vectors of motivation for change, including participation in treatment, outcome expectancy and drinking behaviour.