The final, common pathway to alcohol use is motivational. A person decides consciously or unconsciously 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 person's neurochemical reactivity to alcohol. Such major influences include the person's current nonchemical incentives and the prospect of acquiring new positive incentives and removing current negative incentives.
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 alcoholic's 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 motivational
model.