Motivational Enhancement Therapy
What is Motivational Enhancement Therapy?
Motivational enhancement therapy (MET) is tool therapists use to help clients overcome their disdain for seeking treatment. It can be used to motivate a person to seek rehabilitation for drug or alcohol abuse, and it can be used to motivate them to actually give treatment a shot.
It typically consists of 2-4 sessions in which a therapist talks with their client about their specific substance abuse. MET also incorporates:
- Self-Motivational Statements
- Plan Development
- Coping Skills
During these sessions, therapists will monitor their client’s progress in abstaining from substance use and committing to therapy. The main goals are to ensure that clients seek change on their own rather than being forced into it by their family, friends, and even therapist. MET works by giving clients tools to motivate themselves to change.
How is MET Different?
Because MET works to encourage clients to remain in treatment through internal motivation, it uses different techniques than most other therapies. Motivational enhancement is going to:
- Place less emphasis on labels, such as “addict” or “addiction”
- Clients make their own choices about receiving treatment and about future drug or alcohol use
- Clients discuss their personal concerns rather than focusing on the concerns of others
- Resistance is met by a change in the therapists approach rather than viewing it as something wrong with the client
- Provide clients with various motivational strategies
- Place little to no emphasis on “changing” or “correcting” behaviors and instead ask clients to reflect on those behaviors without labels
- Allow the client to direct change in their treatment plan
Motivational Enhancement Phases
There are typically three different phases to MET, and the pace at which clients move through them is entirely up to the client.
Phase One: Building Motivation for Change
Because every person is different, especially when it comes to addiction, each client comes to treatment at varying levels of readiness to change. This phase is going to evaluate the client’s motivation for change and provide them with different strategies to increase that motivation. This includes:
- Using self-motivational statements that apply to the specific client and their situation.
- Eliciting concerns that the client has about their drug use or drinking, especially as pertaining to tolerance, memory, relationships, health, legal problems and finances.
- Therapist empathy for the client.
- Asking questions about the clients history, substance use, and goals for treatment.
- Providing feedback both by the clinician and the client.
- Affirming the clients beliefs and feelings. The goal is to make sure that the client is validated in all areas of recovery.
- Making sure that therapist behavior does not induce resistance (interrupting, arguing, sidetracking, defensiveness) from the client.
- Reframing beliefs or perceptions in a new way to bring about a new perspective that may positively influence treatment or the desire to change.
- Reflecting on what has been said and how it connects to overall motivation for change.
Phase Two: Strengthen Commitment to Change
Once client motivation is enhanced and there is a desire to change, the second phase of MET can begin. There are a number of different ways to know when clients are ready for phase two. This can include decreased resistance, fewer questions asked, a more peaceful client, increased motivating statements, or if the client begins imagining how their life could be.
During phase two, therapists will discuss the plan moving forward with their client. It is important to include the client in this conversation because it continues to give them the lead. It is also critical that clients are always given free choice. It is their choice to continue with sobriety, and no one else can decide that for them. From this point on, every step of their recovery journey is theirs to take.
Phase two will also include:
- Having clients think about the consequences they may face if they continue to use drugs or drink. Therapists may also ask their client to think about the consequences of not drinking. This allows clients to compare action versus inaction.
- Providing information, advice and options about continued use or change. Clients may ask for facts or for the opinion of their therapist.
- Emphasizing abstinence from any and all drugs of abuse.
- Asking for commitment from the client to see the process all the way through.
Though motivational enhancement is primarily an individual type of therapy, phase two is when therapists may ask the client to include a significant other as this can impact motivation and continued treatment.
Phase Three: Followthrough Strategies
This final phase will last as long as it takes, but it should only begin once the client has the motivation to change and has committed to that change.
- Clients will work with their therapist to review progress at each consecutive meeting. Plans will be discussed and reviewed to see how well the client has implemented those plans.
- Motivation will continue to be renewed within the client as this is the key factor in changing negative behaviors.
- Clients will also make modifications to plans that aren’t working and continuously renew their commitment to change.
Does MET Work?
Motivational enhancement therapies were originally designed to help those with alcohol abuse disorders. Extensive research has shown that MET is effective in helping people who struggle with alcohol addiction become motivated to make that change. Studies also indicate, however, that the effectiveness of MET depends on the drug of choice. It is effective in the treatment of alcohol and marijuana. It may or may not be effective in treating individuals who abuse drugs like heroin and cocaine or who abuse more than one drug.
At the end of the day, motivational enhancement alone does not treat substance abuse or addiction. It can be an effective tool at the beginning of treatment to enhance client motivation, but it is most effective when used in conjunction with other therapies and programs.
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