Assessing Motivation

Motivation to change is an important predictor of treatment outcome, so it is important to assess the motivation level of the person who is drinking. Treatment planning should take motivational state into account so as to maintain and enhance motivation to control excessive drinking. 

The Transtheoretical Model of Change is the most widely applied model of motivation for change. It conceptualises readings for change as involving the following stages: 

• • • A pre-contemplative stage, during which the person is not considering changing 

    • A contemplative stage, during which the person becomes more aware of the benefits of changing, but is ambivalent about changing and does not act 

    • A preparation stage, during which the person formulates plans for change, may take steps to monitor their problem behaviour and initiate behaviour change 

    • An action stage, during which the person will engage in active attempts to moderate or to cease the behaviour 

    • A maintenance stage, which occurs after the behaviour has been moderated or stopped but during which the person could relapse and return to an earlier stage 

    • A relapse stage, when the individual resumes or even increases the intensity or frequency of the previous behaviour 

If there is a low level of motivation to change, motivational intervention may be helpful and intensive intervention is likely to be unhelpful (see Chapter 9 Psychosocial interventions for alcohol use disorder).