BMDC Therapeutic Tasks

BMDC is a short-term treatment to assist clients. The BMDC counselor engages the client in a treatment process that builds on the client’s motivation to change. The approach integrates several models and accompanying strategies and is flexible within the general treatment structure.

The BMDC treatment approach can be tailored to specific clinical situations while retaining its specific set of therapeutic tasks. Those tasks include

• Encouraging therapeutic engagement

• Performing a thorough assessment of the client’s marijuana problem, as well as his or her strengths and resources

• Facilitating motivation for change

• Addressing psychosocial problems beyond marijuana use

• Building skills to establish and sustain change.

Client factors such as marijuana problem severity, general acuity, and psychosocial stresses and supports determine when activities to address these tasks are initiated.

Target Population

BMDC is for people seeking treatment to stop their marijuana use. People with a pattern of longterm marijuana use may have chronic symptoms of physiological and psychological dependence as well as impairments in other life areas, such as family relationships, intrapersonal and interpersonal capabilities, work, and educational achievement. BMDC has been effective with clients who participate voluntarily, but whether it would be effective with individuals who are mandated to treatment is not known. BMDC appears to be effective with clients who are ambivalent about stopping their marijuana use; in fact, the treatment model helps clients explore and resolve such ambivalence (Steinberg et al. 2002). BMDC has been used in outpatient treatment settings with individuals who require a low intensity of service. With clients who require more intensive services or who have significant co-occurring disorders, BMDC may be used adjunctively with other treatments but should not replace needed services.

Structure of BMDC and the Individual Sessions

BMDC comprises nine sessions that are organized into three sections:

• Getting Started: Assessment Session

• Enhancing Motivation (sessions 1 and 2)

• Changing Marijuana Use Through Skill Building (sessions 3 through 9).

Each section begins with an introduction that provides an overview of the basic rationale, goals, counselor skills, and client activities that are used in the sessions in that section. The introduction is followed by an overview and a specific protocol for each session. Each session description begins with a box that provides the following information:

• Session Title

• Total Time

• Delivery Method

• Materials

• Goals for This Session

• Session Outline, including the major subheadings and points to remember.

The box is followed by a detailed protocol that walks the counselor through the session content, provides session-specific background information and rationale, and offers samples of interactions between counselor and client. Italicized text is used to denote a sample script of what a counselor might say to a client to illustrate a principle, an example of a possible dialog between a counselor and a client, or an example of a role play between a counselor and a client. Although each weekly session is unique in content, each includes the following three phases:

Check-in. This includes asking the client about recent events, progress made, and any lapses that may have occurred since the last session. The counselor also reviews any between-session exercises assigned during the previous session.

Presentation of the session material or skill topic. This phase is presented in detail in the session protocol.

Summary. The counselor briefly summarizes the session, asks the client whether he or she understands major points covered, and provides clarification as necessary.