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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
Guided self-change (GSC) is a cognitive–behavioral motivational intervention developed in the mid-1980s and evaluated in several studies. This evidence-based approach combines a motivational interviewing therapist style with procedures intended to enhance commitment to change and maintenance of that commitment. Consistent with a large body of research showing that many people resolve substance use problems on their own, and with a similarly large body of research demonstrating the efficacy of brief treatments for alcohol and some other drug problems, the approach is intended to help people help themselves. Thus, clients are provided with frameworks for evaluating their motivation, analyzing the functions of their substance use, and applying problem-solving procedures to generate and put into effect plans for resolving their substance use problems. Although the approach was first developed for persons who had alcohol problems that are not severely dependent, over time the approach has been broadened to include more severe cases as well as cocaine, cannabis, and prescription drug abusers, cigarette smoking, gambling, and lifestyle and diet changes. It has also been used with adolescent and Hispanic (in Spanish) populations, and it has been found to be equally effective in group versus individual therapy format. In terms of substance use disorder treatments, GSC as an empowering and brief treatment stands in strong contrast to traditional 12-Step approaches that require accepting that one has an addictive problem and following a specific recovery program (e.g., surrender to a higher power; lifelong attendance at self-help meetings). The GSC approach was first developed for use with persons who had alcohol problems that were not severe. That is, although their use of alcohol had resulted in life problems or was at levels that put them at risk of problems, they were not physically dependent. Many such individuals see labels (e. g., "alcoholic," "addict") as stigmatizing and not fitting their case because many have more economic and social resources to call upon than persons with more severe problems. In contrast to more chronic cases, many less severely dependent will also typically retain a good deal of self-esteem and thus can be expected to be resistant to approaches that are confrontational. The GSC treatment approach has two dominant themes. First, it is geared to minimize client resistance while strengthening their commitment to change. Second, it is an empowering approach that matches clients who want to take responsibility for planning and making changes in their lives. The approach is probably less well suited for clients who have borderline personality characteristics. Return to Assessing Alcohol Problems Using Motivational Interviewing |
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