Motivational Enhancement Therapy

Motivational Enhancement Therapy Defined
Motivational Enhancement Therapy, or MET, is a short-term alcohol addiction treatment that is designed to support clients to recognize and build on personal strengths to help change damaging drinking behaviors. It is an adaptation of Motivational Interviewing. Therapists work with clients to establish goals and encourage self-motivation to change, while educating about health risks of alcohol addiction.

How Motivational Enhancement Therapy Works
MET comprises of a number of counseling sessions with a therapist that motivates an individual to be positive about themselves, their future and their ability to reduce or abstain from consuming alcohol. The first stage of the treatment is to get a patient to give up alcohol, which may involve the input from family and friends for support and to discourage any alcohol consumption. This is not in the form of a traditional ‘intervention’ where family is often used to confront and force a person to make changes. Once the client agrees to give up, the second stage is education – a therapist will talk with the patient about the long and short term affects that alcohol is having on the person.

Motivational Enhancement Therapy Effectiveness
There are a number of reasons that this type of treatment works so well. Firstly, because it is based around self-motivation, only those who are genuinely wanting to get help for their alcohol problems will seek this type of treatment. Secondly, it is inexpensive and accessible. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) considers that this type of therapy is the most cost effective of all treatments and it is readily found in many clinics, rehabilitation centers and other medical centers. It is also successfully used to focus a patient on the health and relationship benefits that come with reducing or quitting drinking.

When to use Motivational Enhancement Therapy
Motivational Enhancement Therapy can be used in all cases of alcohol treatment, from mild to severe. It can also be used in conjunction with other therapies, including drug treatments. MET is often used at the beginning of therapy, even if hospitalization is required, to encourage an addict to give up alcohol. It is best used on individuals who have some level of self-motivation to give up or reduce the amount of alcohol they consume.

Development of Motivational Enhancement Therapy
Motivational Enhancement Therapy is an adaptation of a successful treatment called Motivational Interviewing. Motivational Interviewing was pioneered by W. R. Miller and S. Rollnick in their book Motivational Interviewing: Preparing People for Change (2002). The theory behind the therapy is that personal goals and aspirations should be nurtured in therapy to encourage change from within – self-motivation is imperative for an addiction or dependency to be overcome successfully. Patients are also assisted in dealing with feelings of ambivalence which is a key stage of therapy that is often the most difficult to overcome.

Motivational Enhancement Therapy takes this theory one step further and involves further education about harm caused by alcohol abuse, key ways to change behavior and long term goals. Motivational Enhancement Therapy was developed in 1989 as an assessment followed by a four-session treatment over 12 weeks. The sessions are structured with clear, comprehensive feedback and education that clients take home with them to review.

Five Key Elements of Motivational Enhancement Therapy
Therapists implement 5 key elements when using motivational enhancement therapy. These were developed with extensive research into the motivations and processes of change that individuals encounter when overcoming addiction. These strategies are considered the key elements of change when the motivation to give up an addiction is established.

The 5 key elements of Motivational Enhancement Therapy are as follows:

* Express Empathy – a good relationship between the client and therapist is established where both parties feel they can trust the other and work on change as a team
* Develop Discrepancy – patients will need to discuss their goals and values with the therapist who will help them realize there is a gap between ‘where they are’ and ‘where they actually are’. The patient will be encouraged to realize this gap on their own and evoke self-motivation to resolve their problem drinking.
* Avoid Argument – Therapists will not engage in arguments about the level or severity of the alcohol problem or the treatments that are on offer. Individuals are not forced to accept they have a label of alcoholic. The client is supported to have positive responses to the treatment rather than negative ones.
* Rolling with Resistance – All alcohol treatments will have some level of resistance between the therapist and the client. Assessments can be met with disagreement or a refusal by the person seeking help. MET acknowledges that this is part of the process and works to engage with the client to change focus if required.
* Support Self-efficacySelf-efficacy is defined as the way people view their own competence and achieve their own goals. Therapists will encourage individuals to realize they are capable of many things, including having the strength to give up alcohol.

Pros and Cons of Motivational Enhancement Therapy
Treating a client with Motivational Enhancement Therapy can have tangible successes – self-motivation, achieving goals and reducing drinking levels or abstaining. However, not all people with an alcohol addition have the strengths to commit. Patients with mild to moderate alcohol dependency have the best outcomes with this type of treatment, but severe addicts may not benefit from this short-term therapy. Some individuals could benefit from longer sessions or a longer term treatment.

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