Motivational Therapy

Medically reviewed by April Justice, LICSW
Updated May 2, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

There are a wide variety of different methodologies and formats of talk therapy available. The one that’s best for you depends on your unique circumstances and needs, such as addiction medicine or addressing addictive behaviors. That said, a willingness to do the work and make the necessary changes in your life to achieve your goals is integral to many types. If this is an area where you feel you need extra support, motivational therapy, also referred to as motivational enhancement therapy (MET), could be the right fit for you. While a licensed mental health professional is typically the best person to help you decide what type of therapy might be right for your situation, you can learn more about motivational enhancement therapy and motivational interviewing approaches here to see if it’s something you might want to consult with a provider about.

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What is motivational enhancement therapy?

Motivational enhancement therapy (MET) is a category of psychotherapy that includes a variety of different practices and strategies for increasing a client’s willingness to change their behaviors. This approach was originally developed by Miller and Rollnick. According to Columbia University Medical Center, it’s a “collaborative approach to identifying and encouraging behavioral change” typically geared toward those experiencing issues related to substance use disorders. It’s usually based on resolving any mixed feelings the individual may have toward substances and helping them find motivation from within for learning to alter their behaviors. It involves giving the power back to the individual and helping them discover their own motivation for change, which is generally more effective than simply telling someone they should do things differently.

Motivational interviewing is one common practice within motivational therapy that enhances motivation. It's a technique where a trained practitioner will guide an individual through a series of open questions designed to help them view their situation in a different way. According to research by the Motivational Interviewing Network of Trainers, it’s intended for those who have:

  • High ambivalence about changing

  • Low confidence about their ability to change

  • Low desire to change, or uncertainty around whether they want to

  • A low sense of importance or urgency related to making changes

Motivational therapies, like brief intervention, are typically short-term approaches (a few sessions) that may precede a longer, more in-depth type of disorder treatment for substance use or alcohol related problems. Motivational enhancement therapy (MET) can be thought of as a primer or preparatory step that can help facilitate behavior change and increase the chances that the individual will be engaged in further treatment, which can help enhance motivation and overall efficacy.

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Who is motivational  enhancement therapy for?

Motivational therapy, incorporating stages of change, was devised by Stephen Rollnick and William Miller as a method for treating those experiencing a substance use disorder. In the original trials during the 1990s, such as Project MATCH, it was used to help those with an alcohol use disorder by empathetically supporting them in uncovering their own reasons for wanting to engage in behavior change. Many people still mistakenly believe that substance use issues are a matter of willpower, when they are in fact clinical disorders that often cannot be resolved without professional disorder treatment. Participating in motivational therapy can be a helpful first step in pursuing and adhering to treatment for substance use disorders and beginning the process of change.

That said, psychologists have found other conditions for which motivational therapy, using techniques like reflective listening and enhancing motivation, can be helpful and effective as well. For instance, one study found that people with a gambling addiction who received a combination of motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) showed “significantly reduced gambling” behaviors six weeks to nine months after treatment. Another study suggests that people with eating disorders can also benefit from MET. It found that their “motivation to change” had increased after receiving this type of treatment, and that a “decrease in depressive symptoms and an increase in self-esteem” were also noted. 

Is motivational enhancement therapy effective? 

There’s a substantial body of research to support the efficacy of motivational therapy in certain cases, particularly for alcohol or drug use disorders. These suggest that motivational therapy can:

Increase readiness to change

Promoting readiness to change in clients is one of the key goals of motivational therapy. Employing a client centered counseling style, the therapist aims to help the individual uncover their own reasons for wanting to make adjustments to their habits, along with enhancing self-esteem and fostering self-efficacy to help them believe they can be successful. Helping people change through a realistic change plan and supporting them along the way is generally the basis of motivational enhancement therapy.

One study found that in individuals with binge-eating disorder who underwent a motivational enhancement therapy intervention showed “increased readiness to change” compared to the control group who only received a self-help manual on the topic.

Increase self-efficacy

Self-efficacy is defined as “beliefs in one's capabilities to organize and execute the courses of action required to produce given attainments”. A substantial measure of this quality is generally required for someone experiencing a substance use issue to make changes in their life, and it’s exactly what motivational therapy aims to foster. A 2021 study was conducted with 40 participants, all of whom were identified as “alcohol-dependent subjects”. One group underwent typical treatment for alcohol use disorder. The other underwent the typical treatment in addition to ten sessions of motivational therapy, using techniques like change talk to encourage clients. The second group was found to have a “significant increase in self-efficacy” by the end of the treatment as compared to the control, likely due to the motivational enhancement therapy.

Decrease substance use

Though MET typically happens in the earlier stages of an individual’s recovery process from a substance use disorder, it can still have a significant impact on longer-term results. In one study published in the Journal of Consulting and Clinical Psychology, researchers compared the effects of “counseling as usual” versus MET on substance use frequency after treatment. They found that MET, utilizing its unique counseling style in which the therapist will usually express empathy while encouraging clients to search for their own reasons to change, was associated with “sustained reductions in substance use” for alcohol users over the following twelve-week period, whereas counseling as usual was associated with “significant increases in substance use”. 

Seeking the type of therapy that’s right for you

If you’re experiencing substance use issues, an eating disorder, or certain other disorders, research suggests that behavioural psychotherapy, such as motivational therapy could potentially be helpful for you. That said, it’s typically best to be evaluated by a qualified professional who can make informed recommendations about your specific situation. If you’re not sure where to start, you might consider online therapy. Studies suggest that it can offer similar benefits to traditional, in-person sessions but is generally more reachable and convenient, since it can be done from anywhere you have a working device and a stable internet connection. It’s also typically more cost-effective than in-person sessions. 

With a virtual therapy platform like BetterHelp, you can get matched with a licensed therapist after telling your basic needs and preferences in a brief questionnaire. You can then meet with them via phone, video call, and/or online chat to discuss the challenges you may be facing, including helping you decide which type of therapeutic treatment, such as those that enhance motivation, may be most helpful in your particular situation. While BetterHelp doesn't accept insurance, visit costs are comparable to the copays of most insurance plans. See below for client reviews of BetterHelp therapists.

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Counselor reviews

Ever since I've started my sessions with Deepa, I've noticed a significant increase in my happiness and motivation. She's sympathetic, understanding, and she implements different methods to improve your well-being. I don't ever feel like I'm being judged and there was an inherent understanding present with some situations I was experiencing. I felt like I changed for the better and I wanted to thank you for all the guidance!

Deepa Priyadarshan - (More reviews)MSW,LCSW

Erin is very understanding and straightforward in her counseling. I appreciated her not only being there to listen and offer guidance, but also for providing the tools and motivation to help me understand how to manage my emotions and anxiety. I can feel myself becoming more self-sufficient and turning into more of who I want to be!

Takeaway

Studies show that motivational enhancement therapy can be helpful for some people experiencing substance use disorders, eating disorders, and other conditions. The best way to know what the right type of treatment might be for your situation is to consult with a qualified mental health professional either in person or online.
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