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.
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.
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.
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.
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!
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!
Commonly Asked Questions About This Topic
What are the types of motivational therapy?
There are currently two types of MET. Motivational enhancement therapy (MET) is the first one that does precisely what it sounds like - it is designed to help improve a person’s motivation to change.
MET is a client centered counseling style that helps individuals struggling with substance use disorders find ways to challenge the beliefs and behaviors that lead to ambivalence, unwillingness, or even doubt that they make a positive change. Counselors will encourage clients to find more productive ways of thinking about situations, which will facilitate behavior change that is crucial for the recovery process. It will include a comprehensive assessment and meta analysis that can serve as feedback to the client.
Another counseling approach is motivational interviewing (MI). In this, goals are very similar to MET in that they’re both designed to increase a person’s motivation to change beliefs and behaviors toward alcohol abuse and drug use so that they can commit to recovering from substance use disorders.
When a counselor uses MI, which is another person centered approach, they will utilize common strategies you’d see in other counseling sessions, such as asking open-ended questions and reflective listening to build a trusting relationship with their client.
Techniques seen here, like reflective listening, show the client thoughts, feelings, and concerns about substance use and addiction treatment are being heard, which can make them feel more comfortable in a clinical setting, while direct advice a counselor provides will give them practical and effective strategies to facilitate a readiness to change and ultimately, achieve change.
What are the 5 principles of interviewing?
Motivational interviewing has five main principles. These are
Expressing Empathy - show the client that you accept and understand whatever challenges they are going through by actively listening.
Develop Discrepancy - counselors should aim to have clients identify the reasons they should start making a change, for example, perhaps it's destroying their family life or physical health, and also have them realize that their current behavior isn’t conducive to reaching their goals. If you hear phrases such as “I want to… or “I wish I could”, you are hearing the early stages of change talk.
Avoid Arguments - avoid forming conflicts with a client who doesn’t have any intrinsic desire to change. It is up to them to find motivation through your professional advice, guidance, and encouragement, not instructions and your own arguments.
Roll with Resistance - you should strive to avoid correcting resistance, and instead, help them find positivity to make behavior changes necessary to reach the goals they create.
Support Self-Efficacy - while your client will discover what makes them want to overcome substance use disorder as well as develop personal solutions, which is change talk and self efficacy.
What are motivational counseling techniques?
MET uses a lot of the same techniques and strategies, especially ones you’d find in typical counseling style sessions, like reflective listening, showing empathy, discussing decisional balance, and using reinforcement towards ideas that indicate a readiness to change, take action, and begin reducing health risk behaviors.
Sometimes mental health professionals may also incorporate cognitive-behavioral therapy techniques as well. CBT can help clients identify negative thinking and behavior patterns, whereas the behavioral psychotherapy component of it will help them understand how addictive behaviors are being reinforced. Cognitive behavioral therapy will address both of these factors by showing you how they’re intertwined and how you can change them.
What are the stages of motivational enhancement therapy?
In MET and addiction treatment, there are six stages that are designed to encourage change and overcome drug and alcohol abuse.
The contemplation stages are arguably the most important steps in clinical psychology, addiction medicine, and substance use disorder treatment because this is where patients start to recognize that they have a problem and are looking for ways to address it, but are unsure how. Nonetheless, the determination and action stages are where significant progress toward change preparation will be made in MET, and from here, they can start preparing people for the maintenance stage.
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