Motivational Enhancement Therapy For Addiction

Last Updated: October 7, 2021

Authored by Dr. Ahmed Zayed

Reviewed by Michael Espelin APRN

Motivational enhancement therapy (MET) is an effective intervention for individuals with an addiction to nicotine, alcohol, or illicit drugs. MET is a form of limited-contact, non-confrontational, non-judgmental psychotherapy. It produces rapid internal change and improves the client’s engagement and motivation for recovery from addiction.

MET therapy does not produce a transformation in the addict’s drug use. Instead, it makes the drug abuser more engaged and motivated to seek treatment and get sober.

What Is Motivational Enhancement Therapy?

MET is a type of cognitive treatment designed to help people who are ambivalent or unsure about seeking help for drug or alcohol abuse.

What is Motivational enhancement therapy goal? Motivational enhancement therapy has as its goal to help addicts overcome their resistance to change. It encourages engagement with treatment through quick, internally motivated change. It is not a stepwise guided recovery process. Preferably, it consists of an initial battery followed by four sessions of limited-time therapy.

Drug addict refusing rehab treatment while talking to a therapist.

The motivational therapist explores the substance abuser’s motivation and focuses on invoking an internal transformation in unhealthy behaviors. In other words, the treatment provides addiction motivation, which helps addicts make the right choices and avoid relapse in the future.

History

Developed in 1993 as part of Project MATCH, motivational enhancement therapy was the National Institute on Alcohol Abuse and Alcoholism (NIAAA) initiative. MET therapy caters primarily to people with substance abuse problems. It helps create an inner willingness to beat addiction. MET techniques are based on the principles of motivational interviewing and substance abuse counseling. A structured therapeutic approach involves assessing the addict’s behaviors and providing systematic feedback according to guidelines developed by the NIAAA.

MET Goals

MET therapy takes a direct, client-centered approach. It teaches the client cessation strategies for self-destructive behaviors as well as coping mechanisms for difficult situations. In addition, it addresses the addict’s ambivalence and motivation to seek treatment for negative behaviors despite their effect on health, work, family, and social life.

Motivational enhancement therapy has as its goal to help addicts to view their behavior and become empowered to make changes objectively. Clients are taught how to deal with high-risk situations.

MET is a treatment that motivates a substance abuser to transform and improves engagement with treatment. However, it does not produce a change in drug use habits or unhealthy drinking patterns. While MET has been proven effective in treating alcohol addiction and marijuana dependence, the results are mixed for people who abuse hard drugs such as cocaine and heroin.

MET Sessions Explained

This is a relatively brief therapy, which comprises several steps to achieve this goal. The first step is a comprehensive assessment performed during the initial session. It is then followed by two to four 45-55 minute one-on-one sessions with a therapist.

The Initial Session

During the initial meeting, the therapist obtains and evaluates information and sets goals based on the desire to fight substance abuse. During later sessions, the addict is provided with structured feedback, perspective, and positive reinforcement to stay clean. Motivational enhancement addresses the addict’s sense of powerlessness over the problem. The emphasis is on personal choice and control and helping the addict achieve self-set goals and develop a healthy focus in life away from addiction.

MET therapy session with a female substance addict.

The addict first receives feedback on the initial assessment. It compares the client’s behavior to that of the general population. Clients are encouraged to discuss their concerns. The therapist then encourages a discussion about substance use and elicits motivational statements.

Follow-Through Sessions

In subsequent MET therapy sessions, the client’s addiction motivation is strengthened. A plan to switch thoughts and behaviors is developed. The client sets short-term and long-term goals and identifies behaviors that may interfere with these goals.

Rather than utilizing the medication for addiction, the client is encouraged to come up with solutions. The therapist works with the person treated for drug abuse to develop a transformation plan. Initial progress is reviewed at subsequent sessions.

Later motivational enhancement therapy sessions are used to reinforce progress and encourage effort. The assumption is that every individual has the resources to bring about change. MET mobilizes these resources to achieve goals.

Components, Principles, And Techniques Of MET Therapy

Many addicts delay seeking treatment because they may lack confidence or cannot imagine their life without the drug of choice. However, there are drug abusers who lack motivation or even do not see any reason to stop abusing drugs. This is especially a problem when those close to them show signs of enabling behavior. As a result, they continue their behavior until the consequences are so severe that they cannot be ignored. At this point, they are most likely at the precontemplation stage of the transtheoretical model of behavior change.

In other words, addicted people learn to change their thoughts and behaviors, which drive their addiction. MET therapists teach the client how to adjust self-defeating thoughts and gain confidence in the ability to change. Ultimately, this allows a person with substance abuse issues to pursue behavior change and stay sober.

The Five Critical Components Included in a Motivational Enhancement Manual Are:

Empathy

This stage of motivation enhancement establishes trust. MET therapist engages in reflective listening in an environment where the addict feels accepted, supported, and respected. There is no direct confrontation. The addict is made to realize that there is more to them than destructive behaviors. The therapist listens to the addict and reflects on the thoughts expressed with slight modifications. It encourages the addict to elaborate on their thoughts and understand the behavioral changes that are necessary.

Discrepancy

Clients are encouraged to discuss their recovery goals with the therapist, who recognizes and outlines the task ahead. In this way, the discrepancy between the current state and desired state is established. This aids in recognizing which behaviors are hindering the client in achieving their goals. In turn, this provides an incentive for behavior change. MET therapy emphasizes that bridging the gap between the client’s current and desired lifestyles requires time and commitment.

Arguments

Therapists do not engage in arguments with an addict or attack or judge them. The focus is on positive reinforcement statements rather than negative observations. Attacking an individual with a drug dependence problem often results in resistance to change and defensiveness. The underlying belief is that arguments are counterproductive. MET therapy employs gentler methods to raise awareness of problematic behaviors and the changes necessary to get clean.

Resistance

MET recognizes that some resistance will remain even when the motivation for recovery from addiction is already present. The approach is to roll with any residual resistance instead of directly confronting it. Resistance is diffused by going along with what the addict is saying and listening reflectively without judgment. MET therapists understand that change is difficult. Although the approach appears counterintuitive, it helps make the addict less defensive and more likely to stay in therapy and complete their substance misuse treatment program.

Self-Efficacy

Clients are encouraged to be self-aware, analyze their competence, and understand they can achieve their goals. MET therapist encourages recovering addicts in their capability to make changes and successfully undertake the actions necessary to fight addiction.

Clients learn that they have the power to change and the skills necessary to achieve their addiction recovery goals.

Efficacy Of MET Therapy For People With Addiction Problems

There is evidence suggesting that high-risk individuals, such as young adults diagnosed with HIV, may benefit from motivational enhancement therapy techniques to stimulate positive behavioral changes. In addition, the research states that this form of therapy is particularly effective in people with a strong resistance to change.

This Type of Therapy Has Also Been Shown to Help People With:

Motivational therapy for substance abuse problems is usually completed for a few weeks. Addicts may be asked to bring a confidant to the initial sessions. The presence of a family member or trusted friend helps the substance abusers talk honestly about themselves and their addiction.

No single therapy approach is effective for all individuals with addiction. Every person struggling with problematic drug use faces unique challenges in terms of recovery from addiction. Project MATCH compared the effectiveness of MET to the 12 steps of AA program and cognitive behavior therapy. The project studied the effect of these therapies on drinking patterns, compliance with therapy, and functional status for one year after completion of treatment.

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MET was found to be effective in helping addicts break out of the vicious cycle of substance abuse and become motivated to change with the help of their loved ones.

The MET approach is critical in helping addicts overcome their uncertainty about making changes in destructive behaviors. This motivation to change is vital for one of the most challenging aspects of addiction recovery – adjusting thoughts and behaviors.

Research has shown that motivational enhancement is effective in increasing an addict’s readiness to fight addiction. It also reduces the severity of abuse and increases periods of abstinence.

Combined Treatment With MET And Other Modalities

Motivational enhancement therapy can be a stand-alone treatment; however, it is often combined with other forms of psychotherapy, Neurotherapy, and techniques like EMDR therapy during the treatment process. In fact, MET is frequently a type of pre-treatment to improve an addict’s motivation before starting more specific therapies, such as cognitive-behavioral therapy or dialectical behavior therapy. During other psychotherapies, MET therapy is used to reinforce change.

Based on research, MET is an effective option for those who have low motivation or are at the precontemplation stage of the Transtheoretical model of change. If it sounds like your case, contact an addiction specialist today to learn more about addiction treatment options. Many therapies are available as a part of outpatient or inpatient drug rehab. In rehab, one can get the necessary support and assistance in overcoming addiction.

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Page Sources

  1. Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-2
  2. Paul Crits-Christoph, Robert Gallop, Christina M. Temes, George Woody, Samuel A. Ball, Steve Martino, Kathleen M. Carroll, The Alliance in Motivational Enhancement Therapy and Counseling as Usual for Substance Use Problems, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829757/
  3. Rohsenow, D. J., Monti, P. M., Martin, R. A., Colby, S. M., Myers, M. G., Gulliver, S. B., ... & Abrams, D. B. (2004). Motivational enhancement and coping skills training for cocaine abusers: Effects on substance use outcomes. Addiction, 99(7), 862-874. https://pubmed.ncbi.nlm.nih.gov/15200582/
  4. Carroll, K. M., Farentinos, C., Ball, S. A., Crits-Christoph, P., Libby, B., Morgenstern, J., ... & Woody, G. E. (2002). MET meets the real world: design issues and clinical strategies in the Clinical Trials Network. Journal of substance abuse treatment, 23(2), 73-80. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3651591/
  5. National Institute on Alcohol Abuse and Alcoholism, Project MATCH Monograph Series. https://pubs.niaaa.nih.gov/publications/projectmatch/matchintro.htm
  6. Budney, A. J., Roffman, R., Stephens, R. S., & Walker, D. (2007). Marijuana dependence and its treatment. Addiction science & clinical practice, 4(1), 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797098/
  7. Miller, W. R. (1995). Motivational enhancement therapy with drug abusers. Albuquerque: University of New Mexico Press. https://casaa.unm.edu/download/METManual.pdf
  8. Köpetz, C. E., Lejuez, C. W., Wiers, R. W., & Kruglanski, A. W. (2013). Motivation and self-regulation in addiction: a call for convergence. Perspectives on Psychological Science, 8(1), 3-24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461059/

Published on: April 18th, 2018

Updated on: October 7th, 2021

About Author

Dr. Ahmed Zayed

Dr. Ahmed Zayed is a Bachelor of Medicine and Surgery. He is graduated from the University of Alexandria, Egypt. Dr. Ahmed Zayed has a passion for writing medical and health care articles and focuses on providing engaging and trustworthy information to readers.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.