MET’s focus on rapid change also makes it suitable for cases where the therapist has only limited contact with an individual. The nonconfrontational and nonjudgmental style adopted by therapists also makes MET an effective approach in the treatment of adolescents who may be experiencing identity issues and/or trying to assert their independence. Standard DBT is quite resource intensive, consisting of an hour of weekly individual therapy, a two-hour weekly skills training (DBT-ST) component, telephone coaching and a weekly consultation group for therapists. Relapse prevention counseling is a cognitive-behavioral therapy (CBT) method, but the counselor can use motivational counseling strategies to engage the client in the process and help the client resolve ambivalence about learning and practicing new coping skills.
MET and Stages of Change: 6 Steps for Recovery
It is considered a brief intervention and has the same efficacy and outcomes as other forms of motivational therapies (DiClemente et al., 2017). Over 300 clinical trials have been published and a number of meta-analyses and reviews (DiClemente et al., 2017). It is a structured and goal-directed form of therapy with the overarching aim of enhancing motivation in the client. The use of focused open-ended questions, known as Socratic questioning, encourages clients to reflect, bringing to their awareness hidden or new perspectives and uncovering unidentified motivations (Clark & Egan, 2015).
Content Overview
In motivational enhancement therapy, an individual examines their ambivalence surrounding change. By evoking a person’s own thoughts, feelings, and language for change, a client and therapist can work to develop a plan that can help the individual succeed. While motivational enhancement therapy can be beneficial and effective for many people, that doesn’t mean that it is right for everyone or every situation. As the National Institute on Drug Abuse notes, evidence suggests that the efficacy of this approach tends to be mixed when it comes to substances other than alcohol and marijuana.
The Treatment of Cannabis Use Disorder
Its aim is to provide the client with the opportunity to develop a focus in their life, other than their addiction. It emphasizes creating a coping plan to reduce the risk of recurrence in high-risk situations, identifying new behaviors that reinforce change, and establishing relapse prevention strategies. This chapter discusses strategies counselors can use to help clients raise doubt and concern about their substance use and move toward contemplating the possibility of change. In this study, we set out to test a group MET pre-treatment in two real-world settings (a hospital clinic and a post-secondary institution), where EA present with a range of concerns and where resources are limited. The goal of this pilot study was to investigate whether a pre-treatment MET group for EA with mild to moderate mental health difficulties improved the treatment effects of a 12-week DBT-ST protocol.
- Motivational enhancement therapy (MET), also referred to as motivational interviewing (MI), is a patient-oriented counseling approach focusing on resolving ambivalence in order to treat substance abuse (Miller, 1996, 2002).
- However, some extrinsically motivated patients may attend treatment regularly but be reluctant to participate in the treatment program.
- Some of this work might be carried over to the second session, which builds on the initial progress made.
- It is particularly indicated for clients who are reluctant, ambivalent or defensive about change.
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In the contemplation stage, the patient decides to change his or her behavior after weighing the positive and negative aspects of change. In the preparation stage, the patient increases his or her commitment to change and plans to take action. In the action stage, the patient develops specific behavioral strategies to change his or her drinking behavior. Finally, in the maintenance stage, the patient strives to avoid relapse by developing a lifestyle that supports the changes in his or her drinking. For successful recovery, patient motivation is important throughout the entire process, although it is an especially important focus during the first three stages. Motivational interviewing (MI) and other motivational counseling approaches like 10 ways to control high blood pressure without medication nch healthcare system are effective ways to enhance motivation throughout the SOC.
Matching Patients to Alcoholism Treatment
Currently, psychological approaches, such as cognitive–behavioral therapy and crack vs coke, are the mainstay (Danovitch & Gorelick, 2012). The available evidence supporting the effectiveness and safety of a pharmacological intervention to mitigate this psychiatric condition and/or the withdrawal symptoms of cannabis is still scarce. However, it is worth remembering that some of the aforementioned drugs may be useful for the treatment of the anxiety and/or mood disorders commonly seen in cannabis users. Motivational enhancement therapy is a strategy of therapy that involves a variation of motivational interviewing to analyze feedback gained from client sessions.
Motivational Enhancement Therapy puts the emphasis on increasing the client’s motivation. This is critical in addiction recovery because although the knowledge that change is necessary may be there, motivation can be difficult to access because the draw of the substance is so strong. It’s critical that a client really identifies for themselves how their lives would be positively affected by the change. Motivational Enhancement Therapy uses motivational interviewing (MI) as its core process.
The largest difference occurred 6 months after the end of treatment, when clients without concomitant psychopathology had 87% days abstinent in TSF versus 73% in CBT. The findings of Project MATCH surprised many and challenged the belief that alcohol detox and rehab programs patient-treatment matching was critical in the treatment of alcoholism. Contrary to the expectations generated by the supporting literature, large and uniform effects for matches between single-patient characteristics did not emerge.
MI/MET uses a specific interpersonal style that mixes open-ended questions and other common counseling techniques to facilitate behavior change. MI is also sometimes combined with other types of interventions (e.g., Cognitive Behavioral Therapy) in order to enhance treatment retention and engagement. Motivational enhancement therapy tries to decrease ambivalence so as to enhance the change in the subject’s self-efficacy which assists the individuals in abstinence from alcohol.
Finding a provider and talking about how MET can help you reach your goals is the first step. According to the National Institute on Drug Abuse, MET is most effective at getting substance users to begin or participate in treatment and less effective at getting people to actually reduce their substance use. Because it strongly emphasizes individual choice, it helps foster a sense of empowerment and motivation. A therapist trained in MET can often help an individual to view behaviors more objectively, and through MET, an individual may become empowered to begin the process of change.
Motivational Interviewing (MI) is a counseling approach designed to help individuals resolve ambivalence about their alcohol and/or drug use, and support efforts to change it. Present study was carried out to assess and compare the effectiveness of motivational enhancement therapy on self-efficacy before and after intervention in person with alcohol dependence. While MET is commonly used to treat substance use disorder, it can also be applied to support individuals exploring behavior change. This approach is meant to spark rapid motivation to change your behavior instead of being walked through each step of recovery by a therapist. Individuals work collaboratively with their therapist to develop a plan of action and maintain motivation.
This approach assumes that the patient is responsible for changing his or her addictive behavior and recognizes ambivalence as a natural part of the process. In contrast to confrontational approaches, MI is designed to assist patients in working through their ambivalence and in moving toward positive behavioral change. A growing body of evidence indicates that early and brief interventions demonstrate positive treatment outcomes in a wide variety of settings including specialty SUD treatment programs, primary care offices, and emergency departments. Brief interventions emphasize reducing the health-related risk of a person’s substance use and decreasing consumption as an important treatment outcome. First, we could not examine the unique effectiveness of DBT-ST because there was no control condition. The study design did not include a waitlist control as one of sites was newly established and did not have a waitlist at study inception.
Based on the evidence, they are likely to help reduce drinking in the short-term compared either to no intervention or to simply assessing students’ drinking. Questions around whether these reductions translate to better functioning and whether MI outperforms other active interventions for college student drinking need further research. Motivational enhancement therapy (MET) is an effective intervention to help people stay motivated while changing their behavior. One study showed that MET was useful in motivating individuals who struggled with heavy drinking and aggressive behavior toward partners to change their behavior. Healthcare professionals use MET to identify reasons for and against change and build motivation for taking steps in a positive direction.
Before you begin, ask your therapist about what type of training and experience they have in the practice of MET. When a client is ready to change, the language that they use is described as preparatory. The client expresses desire, talks about their ability to change, will indicate their reasons for change, and describe the need for change. The first and one of the most powerful therapeutic techniques is to express empathy to the client. It is critical to establish a trusting relationship in the MET program quickly because it is short term. Get a premium reading experience on our blog and support our mission for $1.99 per month.
Patients’ readiness to change at the start of treatment had a significant impact on their success in quitting and reducing drinking throughout the 3 years after treatment. During sessions 3 and 4, the therapist focuses on reviewing patient progress and renewing motivation and commitment by exploring remaining ambivalent feelings that the patient might have about changing the targeted behavior. Termination of the treatment and future plans are also discussed at the end of session 4, which involves a summary of the treatment progress.
Finally, because we excluded people with more severe disorders, we cannot generalize our findings beyond people with emotional dysregulation and moderate levels of clinical distress. An increasing number of treatment strategies and programs are being used to address the patients’ motivational needs. Some programs have established groups or initial program components to examine and increase motivation. Many substance abuse programs are incorporating MI techniques into their treatment repertoire, either by developing a separate motivational component or by incorporating those techniques into established treatments.
MET shows that the techniques of respect, empathy, and compassion can go a long way toward creating health in our clients. Motivational therapies have been an invaluable addition to the therapist’s toolbox in recent years. This is not surprising because therapists want to elicit change in their clients.
Sustain talk is essentially statements the client makes for not changing (i.e., maintaining the status quo), and change talk is statements the client makes in favor of change. The key to helping the client move in the direction toward changing substance use behaviors is to evoke change talk and soften or lessen the impact of sustain talk on the client’s decision-making process. Brief motivational interventions, including SBIRT, are effective in specialty SUD treatment facilities and opportunistic settings (e.g., primary care offices, emergency departments). It had been hypothesized that clients high in alcohol dependence would do better in TSF whereas those lower in that trait would benefit more from CBT. Aftercare clients low in alcohol dependence had better outcomes when treated with CBT than TSF, (i.e., abstinence on 96% of post-treatment days vs. 89%). However, at higher levels of dependence, the better treatment choice was TSF, (i.e., 94 vs. 84% days abstinent).
The tools used in this phase are reviewing progress, renewing motivation, and redoing commitment. The International Personality Disorder Examination (IPDE; Loranger, 1997) is a semi-structured interview used to determine if participants met full criteria for BPD. It is generally regarded as a conservative diagnostic instrument that generates few false positives. Short-term test-retest reliability has been shown to be good and interrater reliability has been shown to be excellent (Loranger, 1997). All eligible participants were randomly assigned to either DBT-ST only or MET followed by DBT-ST. Seventy-six EA met eligibility criteria and were randomized (See Fig. 1 for CONSORT diagram) by the research coordinator in blocks with a minimum of two eligible participants, using a random number generator.