The Brief Marijuana Dependence Counseling (BMDC) approach combines elements from previously demonstrated treatments for substance use disorders:

• Motivational enhancement therapy (MET) (CSAT 1999b; Miller and Rollnick 2002)

• Cognitive behavioral therapy (CBT) (CSAT 1999a; Kadden et al. 1994; Monti et al. 1989)

• Case management (CSAT 1998).

MET strategies are perceived as potentially useful with the chronic marijuana-using population because of their success in addressing substance use disorders.

The client-centered engagement approach of MET is a good fit for individuals who, in many cases, never have been involved in treatment before and have been frustrated with previous attempts at locating marijuana-specific treatment opportunities. MET provides the overall theoretical framework, and specified MET strategies are used heavily during sessions 1 and 2. Although the remaining seven sessions focus increasingly on skill building rather than motivation, MET concepts and strategies are incorporated throughout all treatment sessions. The counselor is encouraged to pay attention to the client’s readiness for change and its implications for treatment engagement and behavioral and attitudinal changes.

CBT provides a secondary, but complementary, approach in the BMDC model. The CBT sessions focus on building the client’s behavioral, cognitive, and emotional skills necessary to undertake a major life change such as stopping marijuana use.

The case management components are introduced in session 3, which is devoted to identifying life problems that are extraneous to or aggravated by the client’s marijuana problems. The counselor teaches the client how to access support services to address these additional problems.