| Course | PAC 330 Substance Abuse |
|---|---|
| Module | Module 6 |
| Paper type | Individual treatment methods paper |
| Length | About 1,014 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | October 2026 |
Free sample paper for PAC 330 Module 6
Keeping Him in the Chair: Motivational Interviewing, Cognitive-Behavioral Therapy and Incentives for a Client Who Has Left Treatment Twice
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 330: Substance Abuse
Instructor Name
Month Day, Year
Keeping Him in the Chair: Motivational Interviewing, Cognitive-Behavioral Therapy and Incentives for a Client Who Has Left Treatment Twice
Marcus, thirty-eight, runs a warehouse shift in Omaha. He uses cocaine most weekends, often with alcohol, and has missed three Mondays at work this year. He has started treatment twice. He left the first program after two sessions, saying the counselor lectured him about losing everything. He left the second after three weeks, saying the groups were all the same story. His employee assistance program referred him to Prairie Hope, the invented clinic this course has followed. He says he wants to cut back but does not believe treatment works. This paper compares individual treatment methods and builds his plan. Marcus and Prairie Hope are fictional; the research is real.
Motivational Interviewing
The aim of motivational interviewing is to draw out and strengthen the client's own reasons for change, mainly through careful listening, reflections and open questions rather than advice. Burke et al. (2003) pooled controlled trials of motivational interviewing adaptations, most of them brief interventions combining motivational interviewing with feedback. The adaptations were effective for alcohol and drug problems and for diet and exercise, with moderate effects compared with no treatment or placebo, and were about as effective as other active treatments while often requiring fewer sessions. They were less clearly effective for smoking and for HIV risk behaviors.
Motivational Interviewing at Intake
Carroll et al. (2006) tested whether adding motivational interviewing to the intake and early sessions of community treatment programs would improve engagement. At five programs, new clients were randomly assigned to standard intake or to three sessions integrating motivational interviewing. Clients receiving motivational interviewing were more likely to remain in treatment at twenty-eight days. Substance use outcomes did not differ significantly between the groups. The finding is directly relevant to Marcus: his problem has been staying long enough for treatment to help.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy teaches clients to analyze the situations, thoughts and feelings that lead to use and to build skills for coping with craving, refusing offers and solving problems. Carroll et al. (2004) conducted a randomized trial for cocaine-dependent outpatients, comparing cognitive-behavioral therapy with interpersonal therapy, each with either disulfiram or placebo. Participants who received cognitive-behavioral therapy reduced their cocaine use more than those who received interpersonal therapy, and disulfiram also outperformed placebo, though disulfiram's benefit for cocaine has been inconsistent in later research. The trial supported cognitive-behavioral therapy as an effective individual treatment for cocaine use.
Prize-Based Incentives
Contingency management has strong evidence for stimulants, but voucher programs can be expensive. Petry et al. (2005) tested a lower-cost prize-based approach in community outpatient programs serving stimulant users. Participants receiving usual care plus prize-based incentives, in which negative urine tests earned draws from a bowl with a chance of winning prizes of varying value, submitted more stimulant-negative samples and achieved longer periods of continuous abstinence than those receiving usual care alone. The approach was practical in community programs and added benefit to standard treatment.
Comparing the Methods
| Method | What it targets | Evidence | Fit for Marcus |
|---|---|---|---|
| Motivational interviewing | Ambivalence and motivation | Effective for alcohol and drug problems; improves early retention | First, to keep him engaged and avoid the lecturing he rejected |
| Cognitive-behavioral therapy | Triggers, coping and refusal skills | Effective for cocaine use | After engagement, for weekend triggers and drinking |
| Prize-based incentives | Abstinence through reinforcement | Effective for stimulants in community programs | From the start, rewarding negative tests and attendance |
| Interpersonal therapy | Relationship problems | Less effective than cognitive-behavioral therapy for cocaine in Carroll and colleagues' trial | Not first choice |
| Psychoeducation groups alone | Information | Little evidence as stand-alone treatment | The approach he left |
Why the Earlier Attempts Failed
Marcus's two dropouts were not proof that he cannot change. The first counselor's warnings about losing everything resemble the confrontational style that research links to worse outcomes. The second program relied on repetitive groups, an approach with limited evidence for stimulant use. Neither offered motivational interviewing, cognitive-behavioral skills tailored to his triggers or incentives. Viewed through the evidence, both programs offered Marcus the methods least likely to keep him.
What Marcus Wants
When his counselor asked what Marcus wanted from treatment, his answer was narrower than abstinence: to stop missing Mondays, to keep his supervisor's job and to stop the arguments with his partner about money. He was not sure he wanted to stop cocaine completely and said he had no intention of giving up beer. Motivational interviewing does not require the client to share the counselor's goal at the start. It begins with his goals and explores the gap between those goals and his weekends. If his own aims lead him toward abstinence, that decision will be his, which research suggests makes it more durable than a goal imposed by a program he has twice walked out of.
A Sequenced Plan
In the first two weeks, Marcus's counselor will use motivational interviewing, exploring his reasons for wanting to cut back, including his missed Mondays and his worry about his job, and his doubts about treatment. From the first session, he will be enrolled in prize-based incentives for cocaine-negative urine tests twice a week and for attending sessions. By the third week, if he is engaged, cognitive-behavioral work will begin, with a functional analysis of his weekends, which start with drinks after his Friday shift, and skills for handling the friends who offer cocaine. Because alcohol is part of his pattern, both substances will be addressed. Progress will be measured weekly by attendance and urine results, and the plan will be reviewed with Marcus at four and eight weeks.
Conclusion
Marcus left treatment twice, and the research suggests the methods he received were part of the reason. Burke, Arkowitz and Menchola show that motivational interviewing helps with alcohol and drug problems, and Carroll and colleagues show that it improves early retention. Carroll and colleagues also show that cognitive-behavioral therapy helps with cocaine, and Petry and colleagues show that prize-based incentives work in community programs. Sequenced around his greatest risk, dropping out, these methods give Marcus a better chance of staying long enough to change.
References
Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials. Journal of Consulting and Clinical Psychology, 71(5), 843-861. https://doi.org/10.1037/0022-006X.71.5.843
Carroll, K. M., Ball, S. A., Nich, C., Martino, S., Frankforter, T. L., Farentinos, C., Kunkel, L. E., Mikulich-Gilbertson, S. K., Morgenstern, J., Obert, J. L., Polcin, D., Snead, N., & Woody, G. E. (2006). Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study. Drug and Alcohol Dependence, 81(3), 301-312. https://doi.org/10.1016/j.drugalcdep.2005.08.002
Carroll, K. M., Fenton, L. R., Ball, S. A., Nich, C., Frankforter, T. L., Shi, J., & Rounsaville, B. J. (2004). Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: A randomized placebo-controlled trial. Archives of General Psychiatry, 61(3), 264-272. https://doi.org/10.1001/archpsyc.61.3.264
Petry, N. M., Peirce, J. M., Stitzer, M. L., Blaine, J., Roll, J. M., Cohen, A., Obert, J., Killeen, T., Saladin, M. E., Cowell, M., Kirby, K. C., Sterling, R., Royer-Malvestuto, C., Hamilton, J., Booth, R. E., Macdonald, M., Liebert, M., Rader, L., Burns, R., ... Li, R. (2005). Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: A National Drug Abuse Treatment Clinical Trials Network study. Archives of General Psychiatry, 62(10), 1148-1156. https://doi.org/10.1001/archpsyc.62.10.1148
Reading the PAC 330 Module 6 assignment instructions
Individual treatment methods are the sixth module of PAC 330, and assignments typically ask you to compare evidence-based individual approaches and choose among them for a client. The Module 6 instructions in your Aspen course govern; Marcus is invented. Describe each method's techniques and theory briefly. Present trial or meta-analytic evidence for each, with the substances and settings studied. Compare methods on the same criteria. Match methods to the client's specific problems, such as poor retention. Sequence or combine them. Plan how progress will be measured, and give each source a full APA 7 reference. Explain why earlier treatment attempts may have failed. Include every substance in the client's pattern, not just the primary one.
How this PAC 330 Module 6 example is built
Marcus left his first program after two sessions and his second after three weeks, saying both felt like being lectured. Burke, Arkowitz and Menchola's Journal of Consulting and Clinical Psychology meta-analysis supports motivational interviewing. Carroll and colleagues' Drug and Alcohol Dependence multisite study shows motivational interviewing at intake improving retention. Carroll and colleagues' Archives of General Psychiatry trial supports cognitive-behavioral therapy for cocaine. Petry and colleagues' trial in the same journal supports prize-based incentives in community programs. A five-row table compares methods. The plan begins with motivational interviewing and incentives, adds cognitive-behavioral skills by week three, addresses his weekend drinking and tracks attendance and urine results weekly.
Reading the PAC 330 Module 6 grading rubric
Treatment methods papers earn credit for accurate evidence, fair comparison and a rationale for matching methods to the client. This example identifies retention as Marcus's main problem and chooses methods with evidence for it, which demonstrates reasoning from the case rather than a catalog of therapies. Each method is supported by a specific trial in a relevant population. The table compares methods on consistent criteria, including fit with this client. The plan sequences methods to fit the client's stage, and it measures attendance as well as use, because staying in treatment is the first goal. The writing explains why the earlier attempts failed in terms of the research. Alcohol is treated as part of the pattern.
Common PAC 330 Module 6 mistakes, and how to avoid them
Students often list treatment methods without choosing among them. Identify the client's main problem and choose methods with evidence for it. Report each method's evidence with the population and setting studied. Compare methods on the same criteria. Combine methods when evidence supports it, since motivational interviewing, cognitive-behavioral therapy and contingency management work together. Sequence methods sensibly. Measure process outcomes, such as attendance, as well as use. Explain past treatment failures with evidence rather than blaming the client. Keep technique descriptions concrete, with an example of what the counselor would say or do in a session. Review the plan with the client at set points.
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PAC 330 Module 6 questions, answered
What does PAC 330 Module 6 usually ask for?
Aspen's PAC 330 covers individual treatment methods here, so comparing evidence-based approaches and choosing among them for a client is typical. Read the Module 6 prompt.
Does motivational interviewing work for drug problems?
Burke, Arkowitz and Menchola's meta-analysis found motivational interviewing adaptations effective for alcohol and drug problems, with moderate effects.
Is cognitive-behavioral therapy effective for cocaine use?
Carroll and colleagues found cognitive-behavioral therapy more effective than interpersonal therapy for cocaine-dependent outpatients.
Where can I find a free PAC 330 Module 6 sample paper?
Read it free here: individual treatment methods compared for a client who has left treatment twice, with a method table and a sequenced plan.
What is prize-based contingency management?
A lower-cost version of incentives in which negative tests earn draws for prizes; Petry and colleagues found it improved outcomes for stimulant users in community programs.