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New Study Explores Ways to Motivate the Unmotivated Problem Drinker


Alcohol dependency is increasing across the globe. The physical consequences of problem drinking are well known. And the relational and psychological damage that alcohol addiction causes are those that affect entire families. But despite having this information, many people with unhealthy drinking behaviors continue to overindulge in alcohol. Changing this type of behavior is a task that must be approached on multiple levels. First, people must acknowledge that they need to make a change. Second, they must have the motivation and be willing to change their destructive behavior. The transtheoretical model of intentional behavior change (TTM) recognizes that this type of change occurs through phases: precontemplation, decision, and action. People must first think about making a change, decide to change, and then actually change their behaviors related to alcohol.

One of the biggest obstacles to the TTM with respect to alcohol is that many individuals with problem drinking behaviors do not see their behaviors as a problem. Fear of stigma and shame related to addictive behaviors often prevent people from passing from the precontemplation mode into the decision mode. To get a better idea of how the key elements of TTM work to create change in alcohol-dependent individuals, Sophie Baumann of the Institute of Epidemiology and Social Medicine at the University Medicine Greifswald in Germany recently led a study that used three specific measures from the TTM to gauge motivation for change in 427 people with alcohol misuse.

Baumann discovered that the three measures were poor indicators of individuals with alcohol misuse issues. Many of the people surveyed found it difficult to accurately answer the questions based on usage. For instance, risky use and low use were subjective, as the amount of alcohol that is seen as accepted varies based on age and gender. Additionally, many of the respondents were hesitant to confess to having consumed more than the accepted amounts for fear of being labeled a problem drinker. The results of this study show that the TTM and other measures used to assess alcohol behavior and motivation might better serve those in need if they were designed to more clearly isolate behavior and removed any threat of stigma. Baumann added, “Such measures could also improve the acceptability of interventions among proactively recruited individuals who are with unhealthy alcohol use primarily unmotivated to change.”

Baumann, S., Gaertner, B., Schnuerer, I., Bischof, G., John, U., Freyer-Adam, J. (2012). How well do TTM measures work among a sample of individuals with unhealthy alcohol use that is characterized by low readiness to change? Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029368

Related articles:
Identifying and Treating Addiction and Substance Abuse Problems
Do I Really Have a Drinking Problem?

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  • hannah August 15th, 2012 at 11:20 PM #1

    “many individuals with problem drinking behaviors do not see their behaviors as a problem.”

    I think this is mainly because they are surrounded by people who are also into drinking.Being surrounded by such people will never let you gain or grow the determination needed to take that decision making step.

  • sasa August 16th, 2012 at 4:18 AM #2

    My thoughts are this-
    if someone is not ready to change, they won’t. Plain and simple

  • CounselorJoe August 16th, 2012 at 12:49 PM #3

    There will always be stigma attached to drinking especially if it is with one who has always had problems controlling the amount of alcohol that they consume.
    But I think that you can readily see that is they are choosing to be dishonest about the amounts that they are drinking for fear that it ill disappoint others, then they are not ready to give up the habit.
    To make that turn in life they have to be willing to be totally honest about how much they are drinking and the ways in which alcohol negatively impacts their lives.
    If they are still coming up with excuses and trying to find ways to hide their behavior, well then, they still have a ways to go on their journey to sobriety.

  • OrangeSun August 16th, 2012 at 7:03 PM #4

    I have a friend who drink every single day,whether with friends or alone.We just graduated and he just doesnt think of it as a problem.He says he can manage that!How can you ‘manage’ something that is proven to be dangerous?!I think there is this cloud in some people’s minds that prevents them from acknowledging the truth about their behavior even though they know it they will never admit it.They say everything is fine and hope it will stay that way.It is nothing but destructive behavior and I just dont know how to convince him,he s a good friend but when it comes to alcohol he doesnt listen to anybody.

  • Trina Smith August 17th, 2012 at 10:43 AM #5

    For those who use drinking as a way of coping with life’s daily problems, not only do they have to be willing to see this as a problem and consider making a change, but they also have to have some real plans in hand for how to cope without the drink. And that tends to be the hardest part for many drinkers as for some of them this is the only way that they know how to cope.

  • Rowan August 19th, 2012 at 9:12 AM #6

    I would also like to know why alcohol dependency as a whole is increasing all over the world. I know that the population is ever growing so that could be part of it but what else is contributing to this rise in drinking and related behaviors? Is it because alcohol is more readily available now then ever before, or is there some great moral failing that we are experiencing that has led to these numbers going on the rise? I suppose that you could also say that the recent economic distress, the relative affordability of alcohol, the decline of the importance of the family. . . wow, now that you start thinking about it there are TONS of reasons why this misuse could be climbing. So this is a real issue that I think that we should start looking at very closely because left unchecked, this could be one of things that gets out of ontrol and we could begin losing entire generations to drinking.

  • Barron August 20th, 2012 at 11:06 AM #7

    Providing addicts with short term attainable steps is a great way to motivate them to stop.
    Don’t make the steps seem so huge that anyone will feel like they can’t reach that.
    But offer them a plan with each step small yet significant, to show them that they can make progress and it does not make the whole process feel so intimidating.

  • charlie August 20th, 2012 at 3:08 PM #8

    Motivation to change will always be key. Providing an individual the right tools at the right time is key to there success in leading a positive life moving forward. Working with TTM and motivational interviewing every day I hear stories of repeated success in helping people change using these modalities.
    Adding a participant centered tool or exercise such as inter-active journaling can help the participant recognize within that change is up to them and that treatment teams and clinical professionals are now here to encourage and assist in that change process not to dictate a rule into their life that must be followed. participants must feel empowered to not only learn why change is positive but that they have it the choice to make that change.

  • Elissa Grunwald August 28th, 2012 at 3:59 PM #9

    While it is true that one of the biggest obstacles to stopping drinking is “that they don’t see it as a problem”; well to motivate the unmotivated, we have this wonderful technology which we still need to master but we all hold in the palm of our hand some magic device that records,takes moving pictures and many times seeing is believing. I often ask clients with addiction if they were to be video taped throughout the day what would we they be watching? Pictures and capturing the behavior by a concerned loved one may open the eyes to the need for help.

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