Drug Treatment Programs

Brief Interventions and Motivational Interviewing

Motivational interviewing is a therapeutic approach to helping clients build motivation and reach a decision to change. The approach aims to facilitate expression, clarification, and resolution of ambivalence that may block a client from making a commitment to change. Motivational interviewing is an appropriate intervention for people who are not yet ready to change or who are experiencing ambivalence about their drug use. A number of clinical trials have evaluated motivational interviewing, and meta-analytic reviews have supported the efficacy of motivational interviewing. Unsurprisingly, motivational interviewing is likely to be less effective than more intensive interventions.

Brief interventions are delivered in a short timeframe, ranging anywhere from 10 minutes to four-hour-long sessions. They are generally directed at people with lower levels of dependence. Brief interventions usually consist of the following:

• Providing feedback about the level of drug use and the harms
• Recommending a change in behavior with clear and firm advice to cut down on use
• Presenting options to facilitate the change
• Checking and responding to the client's reaction
• Providing follow-up care

There is an extensive literature in the alcohol field regarding the effectiveness of brief interventions, [Page 248]particularly in primary care settings but less so in the illicit drugs area. A number of studies have found one or two-session interventions with cannabis users to be effective.

Withdrawal Interventions

Drug withdrawal, sometimes referred to as detoxification, refers to the physical process of removing drugs from the body. The features, severity, and duration of drug withdrawal depend on the drugs used; the frequency, quantity and duration of use; the individual's knowledge and understanding of what to expect and how to cope; the individual's physical, psychological, and psychiatric condition; and the environment around the individual, including social supports or stressors.

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