Enhancing motivation for treatment and change

(from the chapter) Studies from the past 2 decades have pointed to new ways of thinking about clients' motivation for change. Persons with substance use disorders often terminate treatment early, continue to use substances during treatment, or are noncompliant with the stated requirements of the therapy, so that practitioners are led to label such clients as resistant, denying, and unmotivated. Provocative findings have challenged traditional notions that "denial" is a characteristic trait of people with substance use disorders, that it is the amount or intensity of treatment that determines how much change will occur, that motivation is a trait that individuals bring or do not bring to treatment, and that noncompliance is a function of the individual's character. Research has contributed some fascinating pieces of the puzzle, and it is a challenge to decide how to put them together. Topics discussed in this chapter include research on motivation (natural change, brief intervention, the Drinker's Check-Up, therapist effects, client compliance), measuring motivation (decisional balance, stages of change, motivational vectors, readiness), and enhancing motivation (FRAMES: six components of effective brief intervention), and motivational interviewing. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)