What's Motivational Enhancement Therapy?
If you or someone you know is experiencing challenges related to alcohol or substance use, you may have heard of motivational enhancement therapy (MET). MET is a type of therapy that’s primarily used for treating substance use disorders, though it has some other potential applications as well. Below, we’ll take a look at this therapeutic method, how it works, and its application for substance use concerns.
Motivational Enhancement Therapy: The Basics
The focus of MET is using specific guidance from a qualified practitioner to help motivate an individual to acknowledge their harmful behavioral patterns and work toward changing them. It’s not uncommon for people with substance use disorder to feel unable to make different choices, even though they know they are negatively impacting their lives and the lives of those around them. With MET, a therapist who is trained in this type of therapy concentrates on enhancing the individual's awareness of and encouraging practical steps toward adjusting the unhealthy behaviors.
The central principle of MET revolves around the idea of giving power back to the individual and helping them look at their behaviors without bias so that they can embark on a journey toward meaningful transformation. MET can be used in conjunction with other therapies, or as a pretreatment to get individuals prepared to engage in other therapies. In other words, if an individual isn't ready to start a new therapy, implementing motivational therapy or MET as a pretreatment can be helpful.
MET For Addiction
Many people still mistakenly believe substance use disorders to simply be willpower or moral issues. However, in actuality, addiction is a disease that’s unlikely to resolve without treatment. It’s defined by the American Psychological Association (APA) as a psychological and/or physical dependence—typically on drugs or alcohol, but it’s also possible to have this type of dependence on an activity such as gambling.
Chemical substance use in particular can alter the wiring of the brain and can therefore affect ways of thinking, making choices, gaining knowledge, recalling information, and managing performance. MET may be used to help the individual develop an awareness of the negative impacts of their substance use and support them in shifting their behaviors. While it may not be applicable in every case, some individuals can experience meaningful benefits from this type of therapy. A 2021 study shows a “significant difference in self-efficacy” in individuals with alcohol use issues who underwent MET.
Motivational Interviewing: A Key Component Of MET
Motivational interviewing is a technique commonly employed as part of MET. It can be especially useful for those who are beginning the therapeutic process but are not yet ready or motivated to change. It may also be helpful for those who are enraged or aggressive at the beginning of treatment. That said, components of this approach may also be used throughout the motivational enhancement therapy process.
The goal of motivational interviewing is to stimulate the individual's motivation to change through a specific type of talk therapy where the therapist is primarily the listener. It focuses on encouraging the client to express what they see as their challenges and explore why they might want to change, with the therapist then mirroring that back to them. The idea is for the individual to gain a new perspective on their situation by hearing themselves and their therapist articulate their challenges out loud, encouraging them to be more open to committing to the process of change.
The MET Protocol
Motivational enhancement therapy typically begins with a preliminary evaluation in which the therapist will usually ask a series of questions to help themselves and their client gain a clear perspective on the situation. These questions might include:
How frequently do you consume alcohol or use substances?
When did your consumption or overuse begin?
What challenges have you faced due to overconsumption or use of substances?
Do you have a family, a partner, or friends who use or consume in excess?
What are your aspirations?
What is most important in your daily existence?
What changes would you make, if you could change anything in your life?
After a preliminary evaluation, MET usually includes four directed treatment meetings. Treatment is individualized to the specific needs of the person being treated. Earlier meetings tend to focus on the individual talking through challenges and the therapist listening without judgment, and the therapist then guiding the client in setting goals. Later meetings tend to focus on strengthening self-esteem and self-care practices.
Increase the individual’s awareness of their difficulties
Encourage the individual to make positive declarations about their motivation toward making changes
Promote self-assurance and confidence that meaningful change can occur
Who Can Benefit From MET?
As mentioned, MET is primarily associated with those experiencing substance use disorders. However, it may also be helpful in the management of some anxiety disorders, eating disorders, and gambling addiction. Another group that has shown promise with this treatment consists of young people who are experiencing substance use issues, truancy issues, and conflict with parents.
It’s important to note that those who are experiencing some type of addiction may also have other mental health disorders, either pre-existing or as a result of the substance use. In cases like these, other forms of therapy may be necessary instead of or in addition to MET .
Seeking Professional Help
Again, substance use issues are clinical disorders, not simply matters of willpower. If you’re experiencing problems with substance use or related mental health conditions, seeking the support of a qualified mental health professional is typically recommended. If you’d prefer in-person treatment, you can search for a provider in your local area. If you’d prefer to meet with a therapist from the comfort of your own home, you might consider online therapy.
With a virtual therapy platform like BetterHelp, for instance, you can get matched with a licensed therapist who has expertise in the area in which you need support. You can then meet with them via phone or video call and even contact them via in-app messaging between sessions. Research suggests that both online and in-person therapy can offer similar benefits in many cases, so you can generally pick the format that feels right for you.
Motivational enhancement therapy is a specific type of talk therapy intended to help an individual get to a place where they want to change their unhealthy behaviors. It’s often used for those experiencing substance use issues. If you’re looking for professional support, you might consider seeking the help of a therapist either online or in person.
Below are some commonly asked questions on this topic.
What is the purpose of motivational enhancement therapy?
The purpose of motivational enhancement therapy (MET) is to foment internally motivated change. It can be used in the recovery process of substance use, drug use, and addiction treatment. It may also serve as an alternative to cognitive behavioral therapy (CBT) for those that need more motivation to make changes in coping strategies.
CBT doesn’t always encourage commitment to motivating oneself, and ruminating on thoughts can sometimes make addictive behaviors worse. Through the motivational counseling approach, drug addiction treatment may be easier than with other therapeutic modalities.
What does a motivational therapy session look like?
In the initial assessment battery session (first session) with your therapist, you’ll tell the therapist about your situation. For example, if you are experiencing challenges with drug use, you’ll discuss this with your therapist. The therapist will likely encourage commitment to your treatment plan, and you might come up with a research-based guide or treatment plan together.
In the subsequent sessions, you’ll work together on motivational interviewing and cessation strategies. Your therapist will likely help you come up with self-motivational statements. In your treatment sessions, you may talk about topics that are difficult to discuss. These motivation sessions are meant to help you through your addiction and are not meant to hurt you.
Meanwhile, another resource that may be of help to you is the Motivational Interviewing book (the third edition), which your therapist may discuss with you throughout your treatment.
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