Mental health articles

motivational interviewing and substance abuse Motivational interviewing is a brief counseling technique that provides a
research-supported foundation for eff ective substance abuse treatment.
In their book Motivational Interviewing, Miller and Rollnick (1991) use
the acronym FRAMES to summarize the key elements of eff ective brief
counseling:
Feedback Communicating the fi ndings of assessment is necessary
so that the individual has clear awareness of the present situation
and the need for change. Feedback sets the stage for goal setting and
deciding what steps to take.
Responsibility In eff ective interventions, responsibility for change
is left with the individual.
Advice Th e clinician acts as a kind of coach who invites change,
a more active role than in traditional psychotherapy. Th e clinician
may clearly identify the problem or risk area, explain why change is
important, and advocate specifi c goals.
Menu Th e counselor discusses with the client a range of strategies
or goals for behavioral change.
Empathy An empathic counseling style is associated with lower
levels of client resistance and greater long-term behavior change.
Self-effi cacy Th e clinician encourages the client to make successful
changes in the problem area, expressing hope and optimism that the
client will be able to arrive at the appropriate outcome.
Building on Miller’s and Rollnick’s work, researchers at the University of
Washington designed a program called BASICS (Brief Alcohol Screening and
Intervention for College Students), a usually two-session intervention specifi –
cally for use with college students who drink heavily (Dimeff , Baer, Kivlahan,
& Marlatt, 1999). In the fi rst session, clinicians establish rapport, explain what
to expect from BASICS and harm reduction, and guide students to an assessment.
Between the fi rst and second sessions, clinicians develop a personalized
feedback profi le, an individualized report given to students at the second session.
Among other items, this profi le provides graphic data allowing students
to compare their drinking with that of other college students, a calculation of
their typical and peak blood alcohol concentrations (BACs), a review of alcohol- related consequences, and an assessment of students’ risk for dependency.

During the second session, clinicians guide students through a review of the
feedback profi le and the various data points. Having previously assumed that
everyone consumes the way they do (the “birds of a feather” phenomenon), students are oft en surprised to discover that their BACs are in a very risky range and that their use of alcohol diff ers from the norm at their own institution. The written report and the discussion oft en motivate students to think about what
they might do diff erently in the future. Th us, BASICS can serve as an eff ective jumping off point for setting usage goals and/or accepting a referral for further treatment. Research has found favorable responses to this approach . Our experience,
mostly with students mandated to the program following a violation of the
campus code of conduct, is that most participants report liking the program,
and many follow through with more treatment at the counseling center.

Tags: counseling, substance abuse