ABSTRACT
This chapter proposes a protocol for integrating motivational dialogue into routine treatment of alcohol and drug dependence using a stepped care approach. It suggests a further integration whereby all interventions are delivered using stepped care framework starting with assessment and simple advice and working up through increasingly intensive interventions. The chapter illustrates motivational dialogue applied to the delivery of four interventions of different intensities from the stepped care model: Assessment, Simple advice, Motivational enhancement therapy (MET), Social behaviour and network. The chapter demonstrates how treatments with different theoretical underpinning can be delivered in a motivational dialogue style. The intervention is based upon MET as practised in the UK Alcohol Treatment Trial (UKATT) in three sessions: the first session consisted in the giving of feedback from assessments; second session is to establish commitment for change in the light of change plans and for this purpose a change plan worksheet might be used; third session concentrates on building motivation for changed behaviour.
