Motivational enhancement therapy (MET) is a treatment strategy where individuals are exposed to direct rehabilitation, with the aim of initiating a positive attitude and boosting their inward motivation towards change in certain behaviors.
It works by helping addicted people learn how to change their own thoughts and actions.
MET is an upgrade and combined development of both motivational interviewing and motivational therapy, which focuses on the treatment of negative behaviors, like alcohol addiction and other substance addictions.
Development of Motivational enhancement therapy
MET was developed in 1993 when the US-funded study, Project MATCH, was carried out for options of treatments for individuals with alcohol addiction. It was a clinical trial initiated by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
It was developed by two clinical psychologists, Stephen Rollnick and William R. Miller, to help people overcome their ambivalence and resistance to behavioral changes.
It aims to boost one’s inward motivation by raising their awareness of a problem before going on to eradicate defeatism and self-pity and then springing up one’s confidence in his/her ability to embrace change.
Process of motivational enhancement therapy
MET was designed to help individuals overcome their addictions and get rid of bad behaviors by focusing on and promoting internally motivated change, and this is accomplished through four different therapy sessions.
During the first session, both the patient and the therapist may discuss the patient’s experiences with substance abuse, and the specialist elicits self-motivational statements from the client by giving feedback on the initial assessment.
These styles and techniques of MET are drawn from Motivational Interviewing and are incorporated into a well-structured therapeutic approach involving a comprehensive evaluation of an individual’s behaviors, as well as systematic feedback based on the findings.
The specialist also develops strategies for the patient to cope with the new developments and changes and talks to the patient about it. The patient’s developments are monitored, and cessation strategies used are reviewed by the therapist in subsequent sessions, where patients are encouraged to maintain abstinence and keep improving.
Principles of motivational enhancement therapy
The principles of MET are based on those of motivational psychology; they are effectively used to boost and increase motivation, and to develop a plan for further change in patient’s behavior.
MET is basically founded on five motivational principles designed to guide the therapist through his session with an individual in therapy, and they include:
- Apply empathy: Therapists understand that there is more to each individual than their self-destructive behavior and so they develop trust between themselves and the patients by expressing empathy. They engage in reflective listening and understanding and ask the individuals to elaborate on their feelings and experiences. They show support to patients and make them feel accepted and respected.
- Develop discrepancy: This is the part where the disparity between an individual’s desired behavior and their actual behavior is acknowledged. This approach may help the patient to recognize the ways that current behaviors hinder them from achieving their goals. Although the immediate response to this approach is not guaranteed, the benefits of this approach will come with time and commitment.
- No Arguments: A therapist must avoid judging, attacking, or arguing with an individual, even if that individual is up for a fight. There are harmless, gentle ways that one can point out a problem. Responding positively to negative comments is a very effective way to raise awareness of a problem, and any statements citing a need for change should come from the patient, not the therapist.
- Roll with resistance: MET therapists must not confront resistance to change. Instead of directly confronting any resistance from the patient, the therapist should endeavor to eradicate it. This can be done by listening to the patient without judgment or defensiveness, or by simply going along with whatever the patient is saying. This approach may seem unproductive, but it may lessen the person’s resistance to change and make it more likely that they will remain in therapy as they are given fewer reasons to stop therapy sessions.
- Support self-efficacy: Therapists are to make patients understand that the will and power to change is within their own control. The therapist is there to help individuals become aware of their ability to embrace change and do what they have to do to attain the desired change.
Who can benefit from motivational enhancement therapy?
MET is mostly used to treat alcohol addiction. Still, it may also be used to treat anxiety, eating disorders, gambling addiction, drug use, and addiction, to reduce the severity of substance use, and to lengthen periods of abstinence.
Some studies also suggest that MET can help stimulate positive changes in health-risk behaviors among individuals living with HIV or AIDS.
MET also helps treats co-occurring mental disorders like Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Bipolar disorder, and others.
MET and Other Treatments
MET is usually used as part of a complete addiction rehabilitation program together with others together with other behavioral therapies like Cognitive Behavioral Therapy (CBT) and 12-step programs.
These therapies use special techniques to guide patients towards achieving a desired behavioral change. For example, 12-step programs outline detailed steps to help patients get and stay sober, while CBT focuses mainly on teaching individuals coping strategies for stress.
A motivational enhancement therapy session
While individual needs may vary, MET is typically brief and takes just a few weeks to be completed. It’s usually divided into four sessions, and each one is personalized to the need of the individual. The first two sessions focus on evaluating information from the initial assessment and setting a target for the future.
Later sessions provide the patient with perspective and positive reinforcement for staying sober. For the first one or two weeks, clients are asked to come to sessions with a trustworthy friend or family member as the presence of a confidant may help them express freely and honestly.
When a patient clarifies any concerns, the therapist may focus on addressing those concerns with the available options. The therapist does not prescribe options for treatment, they are instead elicited from the patient, and then the therapist works with the patient to develop a strategy that builds up to the desired change.
The plan is supposed to outline the desired changes, the reasons why change is desired, and steps to be taken to achieve the desired change. Most of this work is done between the first and the second session. The last two sessions are aimed at reinforcing progress and further encourage the patient’s efforts.
Motivational enhancement therapy is a time-limited, four-session rehabilitation technique that aims to invoke inwardly motivated change in an individual with chronic addiction problems and several mental disorders.
Individuals who are addicted to negative and self-destructive behaviors may often have very little motivation towards improving and changing such behaviors, despite knowing and acknowledging the negative impact of such behaviors on their health, family and social life.
This therapy method is designed to help them understand and make efforts to adopt new and sustainable ways of quitting their addiction by boosting their inward motivation towards the desired change.