A motivational model of alcohol use.

The final, common pathway to alcohol use is motivational. A person decides consciously or uncon-sciously to consume or not to consume any particular drink of alcohol according to whether or not he or she expects that the positive affective consequences of drinking will outweigh those of not drinking. Various factors (e.g., past experiences with drinking, current life situation) help to form expectations of affective change from drinking, these factors always modulated by a persons neuro-chemical reactivity to alcohol. Such major influences include the persons current nonchemical incentives and the prospect of acquiring new positive incentives and removing current negative in-centives. Our motivational counseling technique uses nonchemical goals and incentives to help the alcoholic develop a satisfying life without the necessity of alcohol. The technique first assesses the alcoholics motivational structure and then seeks to modify it through a multicomponent counseling procedure. The counseling technique is one example of the heuristic value of the motiva-tional model. This article presents a motivational formulation of alcohol use. The formulation is intended to incorporate advances made in understanding the inheritable constitutional factors (e.g.,