Motivational structure. Relationships with substance use and processes of change.

The motivational model stresses that substance misuse occurs in the context of the satisfactions and frustrations that people derive from incentives in other areas of their lives. Therefore, it is important to assess substance users' motivational structure, that is, the patterns by which they strive for these incentives. This article presents a technique for assessing motivational structure, through which people's motivation to use substances can better be understood. Results of studies using the assessment suggest the following: (a) Unless university students with alcohol-related problems have adaptive motivational structures, they are less able to control their drinking. (b) Alcohol abusers' motivational structure leads them to experience less life satisfaction than does university students' motivational structure. (c) In treatment, substance abusers with more adaptive motivation show less problem denial and more motivation for change than those with a more maladaptive pattern. (d) Alcohol abusers with healthier motivational structures show better immediate responses to treatment and have better long-term outcomes than those with less healthy patterns. (e) Systematic Motivational Counseling (SMC) improves motivational structure and reduces substance use. These results support the motivational model.