Motivation_for_Change_in_Substance_Abuse_Treatment_6_hours.pdf

This preview shows page 1 out of 261 pages.

Unformatted text preview: Presents MOTIVATION FOR CHANGE IN SUBSTANCE ABUSE TREATMENT Internet Based Coursework 6 hours of educational credit Approved by such credentialing bodies as: National Association of Alcoholism and Drug Abuse Counselors National Board of Certified Counselors (All approval bodies are listed at ) Formerly CCJP.com Motivation for Change in Substance Abuse Treatment Welcome to the growing family of coursework participants at CEU Matrix - The Institute for Addiction and Criminal Justice Studies. This distance learning course package was developed for CEUMatrix by Robert Shearer, Ph.D. It is based on information found in TIP 35 Enhancing Motivation for Change in Substance Abuse Treatment, Based on TIP 35 (Center for Substance Abuse Treatment). DHHS Publication No. (SMA) 01-3602. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2001. Copies may be obtained free of charge from SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), (800) 729-6686 or (301) 468-2600; TDD (for hearing impaired), (800) 487-4889; or electronically through the following Web site: . This package contains the complete set of SAMHSA course materials, along with the post test and evaluation that are required to obtain the certificate of completion for the course. You may submit your answers online to receive the fastest response and access to your online certificate of completion. To take advantage of this option, simply access the Student Center at ; login as a Returning Customer by entering your email address, password, and click on 'Take Exam'. For your convenience, we have also enclosed an answer sheet that will allow you to submit your answers by mail or by fax. Copyright Notice The documents and information on this Web site excluding the SAMHSA materials are copyrighted materials of CEUMatrix, LLC, and its information providers. Reproduction or storage of materials retrieved from this service is subject to the U.S. Copyright Act of 1976, Title 17 U.S.C. © Copyright 2010 CEUMatrix, LLC. All rights reserved. Do not duplicate or redistribute in any form. Printed in the United States of America. No portion of this publication may be reproduced in any manner without the written permission of the publisher. About the Instructor: Dr. Robert A. Shearer is a retired professor of Criminal Justice, Sam Houston State University. He received his Ph.D. in Counseling and Psychology from Texas A & M University, Commerce. Prior to teaching Criminal Justice, he taught Educational Psychology at Mississippi State University on campus and in the extension program across rural Mississippi during the civil rights era. He has been teaching, training, consulting and conducting research in the fields of Criminal Justice, human behavior, and addictions for over thirty-six years. He is the author of over sixty professional and refereed articles in Criminal Justice and behavior. He is also the author of Interviewing: Theories, Techniques, and Practices, 5th edition published by Prentice Hall. Dr. Shearer has also created over a dozen measurement, research, and assessment instruments in Criminal Justice and addictions. He has been a psychotherapist in private practice and served as a consultant to dozens of local, state, and national agencies. His interests continue to be substance abuse program assessment and evaluation. He has taught courses in interviewing, human behavior, substance abuse counseling, drugs-crime-social policy, assessment and treatment planning, and educational psychology. He has also taught several university level psychology courses in the Texas Department of Criminal Justice Institutional Division, led group therapy in prison, trained group therapists, and served as an expert witness in various courts of law. He has been the president of the International Association of Addictions and Offender Counseling and the editor of the Journal of Addictions and Offender Counseling as well as a member of many Criminal Justice, criminology, and counseling professional organizations prior to retirement. Using the Homepage for CEU Matrix - The Institute for Addiction and Criminal Justice Studies The CEU Matrix – The Institute for Addiction and Criminal Justice Studies homepage ( ) contains many pieces of information and valuable links to a variety of programs, news and research findings, and information about credentialing – both local and national. We update our site on a regular basis to keep you apprised of any changes or developments in the field of addiction counseling and credentialing. Be sure to visit our site regularly, and we do recommend that you bookmark the site for fast and easy return. Motivation for Change in Substance Abuse Treatment Goals and Objectives This 6-hour course utilizes information presented in TIP 35 Enhancing Motivation for Change in Substance Abuse Treatment. It is an introductory course focusing on the stages of change and motivational interviewing. It embraces a fundamentally different way to conceptualize motivation. In this approach, motivation is viewed as a dynamic and changeable state rather than a static trait. This course shows how clinicians can influence this change process by developing a therapeutic relationship, one that respects and builds on the client's autonomy and, at the same time, makes the treatment counselor a participant in the change process. The course also describes different motivational interventions that can be used at all stages of change, from pre-contemplation and preparation to action and maintenance. Goals / Objectives By participating in this internet based course, the trainee will: Be able to describe and utilize the stages of change model Understand how the concepts of motivation and change have evolved in recent years. Utilize intervention techniques that can enhance the clients' motivation. Link motivational intervention techniques with the stages−of−change model. Recognize motivational interviewing as a therapeutic style and how it can be used to interact with substance−using clients to help them resolve issues related to their ambivalence. Enhancing Motivation for Change in Substance Abuse Treatment [Front Matter] [Title Page] Enhancing Motivation for Change in Substance Abuse Treatment Treatment Improvement Protocol (TIP) Series 35 William R. Miller, Ph.D. Consensus Panel Chair U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857 DHHS Publication No. (SMA) 99−3354 Printed 1999 [Disclaimer] This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated. This publication was written under contract number 270−95−0013 with The CDM Group, Inc. (CDM). Sandra Clunies, M.S., I.C.A.D.C., served as the CSAT government project officer. Rose M. Urban, L.C.S.W., J.D., C.C.A.S., served as the CDM TIPs project director. Other CDM TIPs personnel included Raquel Ingraham, M.S., project manager; Jonathan Max Gilbert, M.A., managing editor; Y−Lang Nguyen, production editor; Janet G. Humphrey, M.A., editor/writer; Paddy Cook, freelance editor; Joanna Taylor, editor; Cara M. Smith, editorial assistant; Paul A. Seaman, former editorial assistant; and Kurt Olsson, former editor/writer. The opinions expressed herein are the views of the Consensus Panel members and do not reflect the official position of CSAT, SAMHSA, or the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized client care and treatment decisions. What Is a TIP? Treatment Improvement Protocols (TIPs) are best practice guidelines for the treatment of substance abuse, provided as a service of the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (CSAT). CSAT's Office of Evaluation, Scientific Analysis and Synthesis draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to a growing number of facilities and individuals across the country. The audience for the TIPs is expanding beyond public and private substance abuse treatment facilities as alcoholism and other substance abuse disorders are increasingly recognized as major problems. [Front Matter] 1 Enhancing Motivation for Change in Substance Abuse Treatment The TIPs Editorial Advisory Board, a distinguished group of substance use experts and professionals in such related fields as primary care, mental health, and social services, works with the State Alcohol and Other Drug Abuse Directors to generate topics for the TIPs based on the field's current needs for information and guidance. After selecting a topic, CSAT invites staff from pertinent Federal agencies and national organizations to a Resource Panel that recommends specific areas of focus as well as resources that should be considered in developing the content of the TIP. Then recommendations are communicated to a Consensus Panel composed of non−Federal experts on the topic who have been nominated by their peers. This Panel participates in a series of discussions; the information and recommendations on which it reaches consensus form the foundation of the TIP. The members of each Consensus Panel represent substance abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Panel Chair (or Co−Chairs) ensures that the guidelines mirror the results of the group's collaboration. A large and diverse group of experts closely reviews the draft document. Once the changes recommended by these field reviewers have been incorporated, the TIP is prepared for publication, in print and online. The TIPs can be accessed via the Internet on the National Library of Medicine's home page at the URL: . The move to electronic media also means that the TIPs can be updated more easily so they continue to provide the field with state−of−the−art information. Although each TIP strives to include an evidence base for the practices it recommends, CSAT recognizes that the field of substance abuse treatment is evolving and that research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front line" information quickly but responsibly. For this reason, recommendations proffered in the TIP are attributed to either Panelists' clinical experience or the literature. If there is research to support a particular approach, citations are provided. This TIP, Enhancing Motivation for Change in Substance Abuse Treatment, embraces a fundamentally different way to conceptualize motivation. In this approach, motivation is viewed as a dynamic and changeable state rather than a static trait. This TIP shows how clinicians can influence this change process by developing a therapeutic relationship, one that respects and builds on the client's autonomy and, at the same time, makes the treatment counselor a participant in the change process. The TIP also describes different motivational interventions that can be used at all stages of change, from precontemplation and preparation to action and maintenance. The goal of this TIP is to make readers aware of the research, results, and promise of motivational interventions in the hope that they will be used more widely in clinical practice and treatment programs across the United States. Other TIPs may be ordered by contacting SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), (800) 729−6686 or (301) 468−2600; TDD (for hearing impaired), (800) 487−4889. Editorial Advisory Board Karen Allen, Ph.D., R.N., C.A.R.N. Professor and Chair Department of Nursing Andrews University Berrien Springs, Michigan Richard L. Brown, M.D., M.P.H. Associate Professor Editorial Advisory Board 2 Enhancing Motivation for Change in Substance Abuse Treatment Department of Family Medicine University of Wisconsin School of Medicine Madison, Wisconsin Dorynne Czechowicz, M.D. Associate Director Medical/Professional Affairs Treatment Research Branch Division of Clinical and Services Research National Institute on Drug Abuse Rockville, Maryland Linda S. Foley, M.A. Former Director Project for Addiction Counselor Training National Association of State Alcohol and Drug Abuse Directors Washington, D.C. Wayde A. Glover, M.I.S., N.C.A.C. II Director Commonwealth Addictions Consultants and Trainers Richmond, Virginia Pedro J. Greer, M.D. Assistant Dean for Homeless Education University of Miami School of Medicine Miami, Florida Thomas W. Hester, M.D. Former State Director Substance Abuse Services Division of Mental Health, Mental Retardation and Substance Abuse Georgia Department of Human Resources Atlanta, Georgia James G. (Gil) Hill, Ph.D. Director Office of Substance Abuse American Psychological Association Washington, D.C. Douglas B. Kamerow, M.D., M.P.H. Director Office of the Forum for Quality and Effectiveness in Health Care Agency for Health Care Policy and Research Rockville, Maryland Stephen W. Long Director Office of Policy Analysis National Institute on Alcohol Abuse and Alcoholism Editorial Advisory Board 3 Enhancing Motivation for Change in Substance Abuse Treatment Rockville, Maryland Richard A. Rawson, Ph.D. Executive Director Matrix Center and Matrix Institute on Addiction Deputy Director, UCLA Addiction Medicine Services Los Angeles, California Ellen A. Renz, Ph.D. Former Vice President of Clinical Systems MEDCO Behavioral Care Corporation Kamuela, Hawaii Richard K. Ries, M.D. Director and Associate Professor Outpatient Mental Health Services and Dual Disorder Programs Harborview Medical Center Seattle, Washington Sidney H. Schnoll, M.D., Ph.D. Chairman Division of Substance Abuse Medicine Medical College of Virginia Richmond, Virginia Consensus Panel Chair William R. Miller, Ph.D. Regents Professor of Psychology and Psychiatry Director of Research Center on Alcoholism, Substance Abuse, and Addictions Department of Psychology University of New Mexico Albuquerque, New Mexico Workgroup Leaders Edward Bernstein, M.D., F.A.C.E.P. Associate Professor and Academic Affairs Vice Chairman Boston University School of Medicine Boston, Massachusetts Suzanne M. Colby, Ph.D. Assistant Professor of Psychiatry and Human Behavior Center for Alcohol and Addiction Studies Brown University Providence, Rhode Island Consensus Panel 4 Enhancing Motivation for Change in Substance Abuse Treatment Carlo C. DiClemente, Ph.D. Department of Psychology University of Maryland, Baltimore County Baltimore, Maryland Robert J. Meyers, M.A. Center on Alcoholism, Substance Abuse, and Addictions University of New Mexico Albuquerque, New Mexico Maxine L. Stitzer, Ph.D. Professor of Psychiatry and Behavioral Biology Johns Hopkins University School of Medicine Baltimore, Maryland Allen Zweben, D.S.W. Director and Associate Professor of Social Work Center for Addiction and Behavioral Health Research University of Wisconsin at Milwaukee Milwaukee, Wisconsin Panelists Ray Daw Executive Director Northwest New Mexico Fighting Back, Inc. Gallup, New Mexico Jeffrey M. Georgi, M.Div., C.S.A.C., C.G.P. Program Coordinator Duke Alcoholism &Addictions Program Clinical Associate Department of Psychiatry and Behavioral Science Duke University Medical Center Durham, North Carolina Cheryl Grills, Ph.D. Department of Psychology Loyola Marymount University Los Angeles, California Rosalyn Harris−Offutt, B.S., C.R.N.A., L.P.C., A.D.S. UNA Psychological Associates Greensboro, North Carolina Don M. Hashimoto, Psy.D. Clinical Director Ohana Counseling Services, Inc. Hilo, Hawaii Dwight McCall, Ph.D. Panelists 5 Enhancing Motivation for Change in Substance Abuse Treatment Evaluation Manager Substance Abuse Services Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services Richmond, Virginia Jeanne Obert, M.F.C.C., M.S.M. Director of Clinical Services Matrix Center Los Angeles, California Carole Janis Otero, M.A., L.P.C.C. Director Albuquerque Metropolitan Central Intake Albuquerque, New Mexico Roger A. Roffman, D.S.W. Innovative Programs Research Group School of Social Work Seattle, Washington Linda C. Sobell, Ph.D. Professor NOVA Southeastern University Fort Lauderdale, Florida Foreword The Treatment Improvement Protocol (TIP) series fulfills SAMHSA/CSAT's mission to improve treatment of substance abuse by providing best practices guidance to clinicians, program administrators, and payors. TIPs are the result of careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non−Federal clinical researchers, clinicians, program administrators, and client advocates debates and discusses its particular areas of expertise until it reaches a consensus on best practices. This panel's work is then reviewed and critiqued by field reviewers. The talent, dedication, and hard work that TIPs panelists and reviewers bring to this highly participatory process have bridged the gap between the promise of research and the needs of practicing clinicians and administrators. We are grateful to all who have joined with us to contribute to advances in the substance abuse treatment field. Nelba Chavez, Ph.D. Administrator Substance Abuse and Mental Health Services Administration H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM Director Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration Foreword 6 Enhancing Motivation for Change in Substance Abuse Treatment Executive Summary and Recommendations This TIP is based on a fundamental rethinking of the concept of motivation. Motivation is not seen as static but as dynamic. It is redefined here as purposeful, intentional, and positive−−directed toward the best interests of the self. Specifically, motivation is considered to be related to the probability that a person will enter into, continue, and adhere to a specific change strategy. This TIP shows how substance abuse treatment staff can influence change by developing a therapeutic relationship that respects and builds on the client's autonomy and, at the same time, makes the treatment clinician a partner in the change process. The TIP also describes different motivational interventions that can be used at all stages of the change process, from precontemplation and preparation to action and maintenance, and informs readers of the research, results, tools, and assessment instruments related to enhancing motivation. The primary purpose of this TIP is to link research to practice by providing clear applications of motivational approaches in clinical practice and treatment programs. This TIP also seeks to shift the conception of client motivation for change toward a view that empowers the treatment provider to elicit motivation. These approaches may be especially beneficial to particular populations (e.g., court−mandated offenders) with a low motivation for change. Despite the preponderance of evidence supporting the efficacy of motivation−focused interventions, their use in the United States has occurred primarily in research settings. One obstacle to their implementation may be ideological: low ...
View Full Document

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture