This TIP on the guidelines for treatment of substance use disorders is based on a fundamental rethinking of the concept of motivation. It suggests that the cognitive-behavioral approach to treatment requires a different perspective on the problem and on the prerequisites for change, while placing greater responsibility on the counselor whose job now includes engendering motivation. Chapter 1 presents an overview of the concepts of motivation and change and describes the model, developed by Prochaska and DiClemente, upon which this TIP is based. Chapter 2 presents interventions that can enhance clients' motivation. Chapter 3 discusses motivational interviewing, developed by Miller and Rollnick, which can be used to help clients resolve issues related to their ambivalence. Chapters 4 through 7 address the stages of change and provide guidelines for clinicians to tailor treatment to clients' stages of readiness for change. Tools and instruments used to measure change are summarized in Chapter 8. Chapter 9 provides examples of integrating motivational approaches into existing treatment programs. Chapter 10 offers directions for future research. Appendixes include "Bibliography,""Screening and Assessment Instruments,""Ordering Information for Assessment Instruments,""Resource Panel," and "Field Reviewers." (Contains 28 figures and approximately 450 resources.) (JDM)