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SAMHSA News - November/December 2005, Volume 13, Number 6

Guidelines Released on Marijuana Counseling

SAMHSA's Center for Substance Abuse Treatment (CSAT) recently published Brief Counseling for Marijuana Dependence: A Manual for Treating Adults.

Based on the research protocol developed by counselors at CSAT's Marijuana Treatment Project, the new treatment manual provides brief marijuana dependence counseling (BMDC) guidelines for counselors, social workers, and psychologists in both public and private settings.

Ten weekly one-on-one sessions offer techniques and strategies to help adult clients end their dependence on marijuana.

The counseling approach presented in this manual comprises three key intervention components: motivational enhancement, cognitive behavioral skills training, and case management. The manual includes guidelines, protocols, assessment forms, and client handouts for each session, as well as supporting information on prevalence of use, clinical research, and program implementation.

Each session presents examples of how a counselor might reinforce the client's resolution to stop using marijuana, provide skills training, and help the client access needed community support.

Case examples of people seeking treatment for marijuana dependence are included along with background information on treatment for marijuana use disorders, current findings about marijuana use, an overview of the Marijuana Treatment Project, and criteria for marijuana dependency counselors.

In addition, the theoretical basis for BMDC treatment is presented in detail. Information includes the therapeutic tasks of the approach, a description of the target population, and suggested sequencing for counseling sessions.

The manual also addresses common treatment issues and potential pitfalls in the BMDC model. Some identified problems are not specific to marijuana treatment and may apply generally to substance use disorders or clinical counseling.

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Getting Started

Strategies for initiating counseling with clients include building rapport, assessment procedures, and motivational enhancement therapy techniques for engaging clients and identifying specific goals and change strategies.

Assessment and scoring tools are provided for completing each client's personal feedback report, which is a critical tool in BMDC implementation. Counselors use the completed report to make clients aware of the effects of marijuana use on critical life areas and to increase motivation.

The manual offers guidelines on how to reinforce each client's efforts to initiate change, review goals, and plan alternative strategies for behavior change, and to encourage support from friends or relatives.

Skill building is a critical factor in ending marijuana use. Cognitive behavioral strategies are outlined for building client motivation and maintaining treatment gains. Six core skill topics are presented that include coping with other life problems, understanding marijuana use patterns, coping with cravings and urges to use, managing thoughts about marijuana use, problemsolving, and marijuana refusal skills.

To obtain a copy of Brief Counseling for Marijuana Dependence: A Manual for Treating Adults, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information at P.O. Box 2345, Rockville, MD 20847-2345. Telephone: 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). Ask for NCADI Publication No. BKD520.

This manual also is available online at For more information, visit the SAMHSA Web site at

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