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APHA Scientific Session and Event Listing

George M. DuWors, MSW, LCSW, BCD, Private Practice, 1712 Pacific Ave., Suite 204, Everett, WA 98201, 425-339-4119, gduwors1@verizon.net

Motivational Interviewing has rapidly become established as a state-of-the-art modality in the treatment of addictions. It has become inseparable from the �Trans-theoretical Model of Change.� However, virtually all of the research has focused on moving clients from the �Pre-contemplation� and �Contemplation � stages to �Preparation� and �Action.� There has been little discussion and/or research focused on the �Maintenance� stage, as such. This paper will begin to close that gap by exploring the virtually universal thinking at moments of physical relapse. �MI� requires �development of discrepancy� to motivate for change. �Wishful thinking� and �Expletive thinking,� found at moments of (choosing to) relapse, are rich in generic discrepancy. �Wishful thinking� reveals a chemical-free mind controlled by illusion, apparently resulting from failure of memory and unacknowledged craving. �Expletive thinking� reveals a child-like refusal/inability to accept reality. �Wishful thinking� leads to the task of maintaining memory and motivation. �Expletive thinking� implies the task of learning to tolerate frustration, practicing and maintaining �acceptance.� Both imply maintenance work well beyond the initial change work: remembering the realities of addiction and accepting the realities of life, while maintaining the willingness to do both. �Bad Cop� interventions develop the above discrepancies while �Good Cop� helps the person to tolerate the process, to see discrepancy as challenge rather than attack.

Learning Objectives:

• 1. Elicit and understand two types of client thinking at moments of addictive relapse.
• 2. Recognize and elicit four motivational discrepancies inherent in each type of thinking.
• 3. Identify two primary tasks to prevent recurrence of each type of thinking.

Keywords: Alcoholism, Drug Abuse Treatment

Presenting author's disclosure statement:

Not Answered