MOTIVATIONAL ENHANCEMENT THERAPY

motivational enhancement therapy

motivational enhancement therapy

Motivational Enhancement Therapy (MET) is a systematic intervention approach for evoking change in problem drinkers.

It is based on principles of motivational psychology and is designed to produce rapid, internally motivated change. This treatment employs motivational strategies to mobilize the client's own change resources.

MET consists of four carefully planned and individualized treatment sessions.

The first two focus on structured feedback from the initial assessment, future plans, and motivation for change,

The final two sessions at the midpoint and end of treatment provide opportunities for the therapist to reinforce progress, encourage reassessment, and provide an objective perspective on the process of change. The counselor seeks to develop a discrepancy in the client's perceptions between current behavior and significant personal goal; emphasis is placed on eliciting from clients self-motivational statements of desire for and commitment to change. The working assumption is that intrinsic motivation is a necessary and often sufficient factor in instigating change.

strategies have been introduced for the treatment of addictive problems (see Miller et al., 1995 for an extensive list and evaluation). Some interventions are used extensively despite little evidence of beneficial effects (i.e., educational lectures and confrontational counseling) while other interventions go generally unused despite strong evidence of effectiveness (e.g., behavioral marital therapy; Miller et al., 1995). Skills training (ST) and motivational enhancement are two treatment approaches that have received considerable attention in recent years. These two approaches, broadly categorized, have been extensively described, have well-articulated rationales, and prescribe quite specific intervention strategies. Further, research evaluations provide substantial evidence for positive treatment outcome (Miller et al., 1995). Yet these two approaches also differ considerably with respect to underlying theory and the content of treatment.

Our goal in this article is to explore the clinical integration of these two forms of therapy for addictive problems. We suspect that some combination of ST and motivational strategies are often combined in substance abuse treatment, and, although some authors have drawn from both approaches in describing treatment schemes, we are unaware of a description of such an integrated clinical approach in the current literature. Given that ST and motivational enhancement have different conceptual bases and recommend different types of clinical interventions, integration may not be straightforward. Yet we will argue that, in practice, the two treatments have more in common than is often described, and that integration of the approaches should provide maximal flexibility for therapists to meet client needs. To make the case for integration, we first briefly review the histories, conceptual bases, and potential distinctiveness for ST and motivational interventions. We then critique conceptual separation of these treatments, and suggest both models and techniques for their integration.

Skills training

ST treatment approaches have a history in the treatment of addictive problems dating at least to 1965 (Lazarus, 1965; cited in Monti, P.M., Abrams, D.B., Kadden, R.M. and Cooney, N.L., 2007. . Treating alcohol dependence Guilford Press, New York.Monti, Abrams, Kadden, & Cooney, 2007). A quite comprehensive presentation of this model was published by Monti et ...