Outcomes of systematic motivational counseling for substance use following traumatic brain injury.

The effects of Systematic Motivational Counseling (SMC) on adults following traumatic brain injury (TBI) were assessed. The sample comprised 40 participants in the SMC Group who received 12 individual SMC sessions and 54 participants in the Comparison Group who received no motivational or substance-abuse treatment. Both groups received rehabilitation for their brain injuries. The SMC additionally focused on participants' personal goals and concerns in various areas of their lives, and helped them to formulate and execute concrete and realistic plans for resolving their concerns. To assess changes across time in the SMC Group, motivational structure, positive and negative affect, and substance use were measured at baseline, immediately after the intervention (mean of 10.2 months from baseline), and at a follow-up (mean of 9.1 months later). Because the comparison group had no SMC intervention, only two assessments were taken: at baseline and at a follow-up (mean of 12.8 months later). Across time, the SMC Group showed significant improvements in motivational structure and a significant reduction in negative affect and the use of substances of abuse. There were no corresponding changes in the Comparison Group. The results indicate that SMC improves motivational indices and may help to moderate substance use; hence they suggest a potential role for SMC in the rehabilitation of patients with TBI.