A group motivational treatment for chemical dependency

Patient "motivation" has been implicated as a critical component in addicti on treatment outcomes. To date, treatments utilizing motivational elements have been conducted as individual interventions. We describe the developmen t of a Group Motivational Intervention (GMI), a four-session, manual-driven group approach that employs key hypothesized motivational elements. These include the six motivational elements derived by Miller and Sanchez (1994) from successful alcoholism treatments, described with the acronym, FRAMES ( feedback, responsibility, advice, menu of options, empathy, and self-effica cy). GMI is additionally informed by concepts derived from "self-determinat ion theory" (Deci & Ryan, 1985), concerned with understanding motivation as either internal/autonomous or external/controlled. Evidence indicates that people will value and persist longer in behaviors that they perceive as au tonomously motivated. GMI techniques utilize the interpersonal factors foun d to be autonomy-supportive in self-determination theory. Preliminary resul ts from a randomized clinical trial suggest that key motivational processes are affected by GMI: patients perceive the GMI environment and group leade r as significantly more "autonomy supportive" than treatment "as usual." (C ) 1999 Elsevier Science Inc. All rights reserved.