Motivational Enhancement Therapy is an approach to addiction counseling that motivates drug and alcohol abusers to stop using. MET focuses on increasing intrinsic motivation by raising awareness of a problem, adjusting any self-defeating thoughts regarding the problem, and increasing confidence in one’s ability to change. Instead of identifying a problem and telling a person in therapy what to do about it, the therapist encourages a person in therapy to make self-motivating statements that display a clear understanding of the problem and a resolve to change.
How Does Motivational Enhancement Therapy Work?
Motivational Enhancement Therapy is a counseling approach that helps individuals resolve their ambivalence about engaging in treatment and stopping their drug use. This approach aims to evoke rapid and internally motivated change, rather than guide the patient stepwise through the recovery process. This therapy consists of an initial assessment battery session, followed by two to four individual treatment sessions with a therapist. In the first treatment session, the therapist provides feedback to the initial assessment, stimulating discussion about personal substance use and eliciting self-motivational statements.
Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the patient. In subsequent sessions, the therapist monitors change, reviews cessation strategies being used, and continues to encourage commitment to change or sustained abstinence. Patients sometimes are encouraged to bring a significant other to sessions.
Goals Of Motivational Enhancement Therapy
MET focuses on increasing intrinsic motivation by raising awareness of a problem, adjusting any self-defeating thoughts regarding the problem, and increasing confidence in one’s ability to change. Instead of identifying a problem and telling a person in therapy what to do about it, the therapist encourages a person in therapy to make self-motivating statements that display a clear understanding of the problem and a resolve to change.
MET is based on five motivational principles that are designed to guide the therapist’s work with an individual in therapy:
Express empathy: Therapists create a supportive environment in order to help an individual feel accepted and respected, and they engage in reflective listening rather than direct confrontation. The therapist will listen to what an individual is saying and then reflect it back, with slight but deliberate modifications. The modifications both let the individual know that the therapist has heard and understood and encourage the individual to elaborate.
Develop discrepancy: In MET, the therapist directs attention toward the discrepancy between an individual’s desired state of being and that individual’s actual state of being. This discrepancy may help aid in recognizing the ways that current behaviors hinder one from achieving goals, and it can also provide a strong incentive for behavior change.
Avoid argumentation: A therapist will avoid attacking an individual or an individual’s behavior, as this is thought to result in defensiveness and resistance. Other, gentler methods are used to raise awareness of any problems, and any statements regarding a need for change should come from the individual, not the therapist.
Roll with resistance: Instead of directly confronting any resistance on the part of the individual, the therapist tries to defuse it, often through reflective listening or by simply going along with what an individual is saying. This approach may seem counterintuitive, but it decreases the odds of further defensiveness and may make it more likely that an individual will remain in therapy and benefit from other aspects of the intervention.
Support self-efficacy: One’s motivation to change typically depends not only on the reasons for modifying behavior but also on the belief that one is able to perform the tasks required for change. One aspect of a therapist’s role is to help individuals become aware of their ability to successfully undertake the actions needed for change
Benefits Of Motivational Enhancement Therapy
Research has consistently demonstrated the efficacy of MET in increasing one’s readiness to stop drug use, reducing the severity of substance use, and in lengthening periods of abstinence. Preliminary evidence also indicates that MET may be useful in enhancing the treatment of other conditions, such as anxiety, eating disorders, and problem gambling. This type of therapy may even be of help to persons who are at risk of developing these conditions.
MET can be used regardless of an individual’s commitment level. It has been shown to be particularly effective when an individual has a strong resistance to change or is not strongly motivated to change. An example of this is in the case of substance abuse, as individuals who abuse drugs and alcohol may often find it difficult to stop using due to the reinforcing effects of these habits. MET’s focus on rapid change also makes it suitable for cases where the therapist has only limited contact with an individual.
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