Recent research has begun to develop ways to enhance treatment outcome by affecting client motivation during the assessment phase. The principle aim of this study is to conduct an experimental comparison of confrontational versus motivational assessment techniques at EAPs. All subjects will be recruited as volunteers from EAP clientele and must meet study criteria for a primary substance abuse disorder. Approximately 200 subjects will be included in the study from the four EAP sites. Final outcome measures will focus primarily on the areas of: alcohol/drug abuse and work performance. Additional outcome data will be collected in the following life areas: employment/support status family/social relationships, medical status, legal status, and psychiatric status. A path analytical design is proposed which includes cognitive process variables (i.e., readiness for change, self-efficacy) and behavioral process variables (i.e., change activities, treatment experiences). Data will be collected from the clients at the beginning and end of the assessment process and then 3 months and 1 year post assessment. Data analysis will address the following research questions: 1)Is motivational interviewing more effective than a confrontational approach in decreasing substance abuse and improving work performance and other life areas? 2)Is motivational interviewing more effective than a confrontational approach in promoting client change processes? 3)Is motivational interviewing more effective than a confrontational approach in increasing readiness for change and self-efficacy? 4)What client characteristics predict the ability of counselors to adhere to specific interview styles?
