SAMHSA TIP 35 Enhancing Motivation for Change in Substance ...

Enhancing Motivation for Change in Substance Use Disorder Treatment

UPDATED 2019

TREATMENT IMPROVEMENT PROTOCOL

TIP 35

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TIP 35

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Contents

Foreword

viii

Executive Summary

ix

TIP Development Participants

xv

Publication Information

xxi

Chapter 1--A New Look at Motivation

1

Motivation and Behavior Change

4

Changing Perspectives on Addiction and Treatment

6

TTM of the SOC

13

Conclusion

16

Chapter 2--Motivational Counseling and Brief Intervention

17

Elements of Efective Motivational Counseling Approaches

17

Motivational Counseling and the SOC

23

Special Applications of Motivational Interventions

26

Brief Motivational Interventions

30

Screening, Brief Intervention, and Referral to Treatment

32

Conclusion

33

Chapter 3--Motivational Interviewing as a Counseling Style

35

Introduction to MI

35

What Is New in MI

37

Ambivalence

38

Core Skills of MI: OARS

41

Four Processes of MI

48

Benefts of MI in Treating SUDs

63

Conclusion

64

Chapter 4--From Precontemplation to Contemplation: Building Readiness 65

Develop Rapport and Build Trust

66

Raise Doubts and Concerns About the Client's Substance Use

71

Understand Special Motivational Counseling Considerations for Clients Mandated to

Treatment

77

Conclusion

81

Chapter 5--From Contemplation to Preparation: Increasing Commitment

83

Normalize and Resolve Ambivalence

84

Help Tip the Decisional Balance Toward Change

87

Conclusion

93

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