Motivational intervention as applied to systems change: the case of dual diagnosis

The concept of motivational interviewing is based on helping individual clients build and sustain a commitment to reach and carry out a decision to change. In this paper, the motivational interviewing model is applied to systems change. Different stages of involvement and readiness to change are identified within systems which closely resemble those found in individuals. When applied to a system, we call this process "Motivational Intervention." In this paper, the motivational intervention model is applied to a psychiatric system of health care delivery where large numbers of psychiatric patients are found to also have substance use-related problems. Several Italian health districts invited the authors to present a series of lectures and workshops in order to facilitate the incorporation of substance user treatment into existing psychiatric services. Using the motivational intervention model to determine where the system was in the process of change, we then identified the tasks necessary to facilitate further change.