Background and Goals: Cannabis is the most widely illicit substance around the
world. Treatment success is predicted by different factors, among which, motivation for
changing the behavior is one of these factors. Therefore, identifying the client’s readiness to
change is important. Working with clients that are in precontemplation stage of change
constitutes a big challenge for therapists.
Methods: In this paper, we present the case study of Joao, a young adult with cannabis use
disorder, comorbid with social anxiety. The therapeutic intervention followed the principles
of motivational interviewing, highly recommended with clients less ready to change. It also
combined techniques from cognitive-behavioral therapy and narrative therapy, to help
separate the client from the problem, thus helping him to construct a more fulfilling life.
Throughout the article, the subjective viewpoints of the client will be highlighted, in the form
of micronarratives written by the client, suggested as therapeutic tasks.
Discussion/Results: Several challenges were faced while addressing resistance and
ambivalence, early on and throughout treatment. Joao dropout in the 23rd session, after
achieving some therapeutic gains. Changes in his self-talk, documented in the
micronarratives, served as indicators that his relationship with cannabis started to change.
The therapeutic tasks suggested were important in helping him to increase motivation for
change and to write new paths for his life.
Conclusion: It is crucial to adjust the therapeutic interventions to the client’s readiness to
change, and continuously reflecting about the therapeutic process, addressing moments of
disengagement, early on, to increase the probability of behavior change.