What Is Motivational Enhancement Therapy?
Most addiction treatment programs last between 30 and 90 days, and many facilities utilize motivational interviewing during treatment. Motivational interviewing for substance abuse uses four different types of treatment sessions. Each of the four stages of motivational interviewing treatment, often referred to as a treatment phase, addresses specific aspects of the motivational counseling process.
What Can Motivational Enhancement Therapy Help With?
Motivational enhancement techniques are beneficial for addiction, behavioral disorders, and co-occurring (dual diagnosis) conditions. Dual diagnoses are prevalent among those seeking help at an addiction or mental health treatment program. Co-occurring disorders occur when someone has both an addiction and a mental health condition. Motivational enhancement interviewing can help address a range of behavioral addictions and mental health treatment needs, such as: 2
- Eating disorder treatment
- Obsessive-compulsive disorders (OCD)
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD)
- Bipolar disorder
Techniques of Motivational Enhancement Therapy
As noted above, motivational interviewing therapy is a very limited therapy model. Although treatment may last up to six sessions in some instances, most motivational therapy programs only last for four sessions. 3
There are five key motivational interviewing concepts included as part of motivational interviewing strategies. During the four motivational counseling sessions, a provider trained in motivational enhancement therapy for substance abuse may focus on any or several of the below principles.
Developing and Expressing EmpathyThe environment of motivational enhancement therapy sessions is supportive and open. The goal is to ensure that the individual feels respected. The provider actively listens rather than engages in direct questioning.
Acknowledging the Disparity Between Thoughts and RealityDuring a session, the therapist can highlight the differences between thoughts and reality. Understanding these differences can provide clarity on how current behaviors may impact the ability to achieve goals and develop the motivation to change.
Avoiding ArgumentsMET sessions avoid attacking the individual or their behaviors. Rather, the provider attempts to diffuse arguments through reflective listening, allowing the individual to communicate what is on their mind.
Accepting Resistance as Part of the ProcessInstead of confronting resistance, the therapist also uses reflective listening to help the individual reduce defensiveness to therapy and change.
Supporting a Recovering Addict’s Self-EfficacyMotivational enhancement therapy follows the idea that one’s motivation to change depends on their reason for seeking change and their belief that they can take the steps necessary to change. The therapist’s role in MET is to help the individual develop an awareness of their ability to achieve their change goals.
What Happens in a Motivational Enhancement Therapy Session?
What Are the Stages of MET Sessions?
The first therapy session focuses on the assessment. Completing the assessment should help the individual view their behaviors in a different light. The first session also focuses on addressing and exploring concerns about particular issues, concerns, or experiences. A MET therapist may suggest ways to evaluate how the problem behavior may interfere with achieving long and short-term goals.
Treatment options as a part of motivational enhancement therapy are based on information collected from the individual rather than “prescribed” recommendations from a provider. The therapist will work with the individual to create an action plan that outlines their desired changes, why they want to change, and what steps they will take to achieve their change goals.
MET vs. Traditional Therapy
MET differs from other forms of therapy, such as cognitive behavioral therapy, in that it supports personal choice and control. It is designed to be non-judgmental and non-confrontational. As such, traditional diagnostic labels are not used. The provider assumes the individual has the capacity and resources to make a change, so rather than teaching skills and tools, they focus on helping the individual utilize the tools they already have to take positive steps forward.
Motivational Enhancement Therapy and Stages of Change
Motivational enhancement therapy incorporates motivational interviewing and the stages of change model used in treatment for substance abuse and other behavioral addictions. Applying the stages of change is an ideal way to visualize the treatment steps and find the motivation to seek treatment. The stages of change model created by DiClemente and Prochaska in the 1970s has six steps. 4
Motivational interviewing counselors meet the client where they are in their recovery journey. The purpose of motivational interviewing is to assist those seeking recovery as they move through each stage of change; these stages will be detailed below.5
PrecontemplationAt the precontemplation stage, an individual with a substance abuse disorder often does not intend to take action towards seeking recovery anytime within the near future (defined as within the next six months). They are unaware their behaviors are problematic or have negative consequences.
ContemplationWhen someone reaches the contemplation stage, they are ready to make a change soon, again within the next six months. At this stage, they recognize their behaviors may cause problems and are more willing to consider the positive and negative possibilities associated with making change.
Determination (Preparation)At the preparation stage, an addict is ready to make a change, usually within the next 30 days. They will begin to take small steps towards making change and start to understand that developing new and healthy behaviors can lead to a healthier lifestyle.
ActionIn the action stage, individuals have recently made changes to their behaviors and plan to continue progressing forward with change.
MaintenanceSomeone in the maintenance stage has maintained healthy behavioral changes for more than six months and plans to continue strengthening these changes moving forward. In this stage, they work to prevent relapse to a previous stage.
RelapseAlthough not a stage of change experienced in all cases, relapse can occur at any point. Relapse happens when someone cannot maintain change and reverts back to harmful or negative behaviors from a previous stage.
How Effective is Motivational Enhancement Therapy?
Data from the National Institute on Drug Abuse suggest that motivational counseling has several benefits. Motivational enhancement techniques can help someone in recovery from addiction overcome their unwillingness or lack of concern about entering treatment and starting their recovery journey, among various other benefits. These can include: 6
It Works QuicklyOne of the benefits of motivational interviewing is that it works relatively quickly. Rather than a treatment program that requires several steps and weeks to achieve recovery, motivational interviewing in addiction (and motivational interviewing for adolescent mental health and addiction treatment) generally only requires four to six sessions.
It Reduces Resistance and AmbivalenceA primary goal of motivational interviewing is to address addiction by using productive tools rather than counterproductive measures such as labeling, confrontation, and coercion. Motivational interviewing psychology indicates that these techniques are more likely to increase resistance to change rather than help someone develop motivation for recovery.
It Emphasizes Choice
Another benefit of motivational interviewing is its focus on personal choice. Rather than providing direction, therapy to increase motivation emphasizes partnership and collaboration between therapist and patient.
Find Motivational Enhancement Therapy At Soledad House
Motivational enhancement therapy is often incorporated into a comprehensive addiction treatment program that uses other therapy models as well. Depending on one’s treatment needs and goals, therapy models used may consist of behavioral therapies, group, and individual sessions.
If you or a loved one live with drug or alcohol addiction and are ready to take the first steps towards recovery, we can help. At Soledad House, we offer a safe space for women to grow and heal. To learn more about our programs and the benefits of motivational enhancement therapy for addiction, contact us at Soledad House today.
- 2 http://lib.adai.washington.edu/dbtw-wpd/exec/dbtwpub.dll?BU=http%3A//lib.adai.washington.edu/ebpsearch.htm&TN=EBP&QY=Find+AccessNo=16&RF=Full+Display&DF=Full+Display&NP=3&RL=1&DL=0&XC=/dbtw-wpd/exec/dbtwpub.dll&AC=QBE_QUERY&CS=0
- 4 https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangetheories6.html