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What is Motivational Enhancement Therapy?

Motivational enhancement therapy is a therapy to increase motivation, facilitating changes for people with substance use disorders. Learn more below.

How Does Motivational Enhancement Therapy Work?

Motivational enhancement therapy, also known as MET, is typically a stand-alone treatment that is done over the course of four to six sessions. This treatment method is based on motivational psychology and uses a combination of assessment, goal setting, and motivational interviewing to help shift the client’s mindset to facilitate change.

Unlike other therapies, motivational enhancement therapy uses clear and direct principles to build client motivation first before attempting to make changes.1

Motivational Enhancement Therapy

The Goal of Motivational Enhancement Therapy

While motivational counseling is often used to treat substance use disorders, unlike other treatments, abstinence is not the prime focus of the treatment. Motivational enhancement therapy aims to move the client into a motivated state for change. Once the individual is in a state where they feel motivated to make positive, productive changes, they can set their own recovery goals and work to create a detailed, individualized plan/course of action. 

Principles of Motivational Enhancement Therapy

Motivational enhancement therapy focuses on five key motivational principles. These motivational therapy techniques include expressing empathy, developing discrepancy, avoiding argumentation, accepting resistance, and supporting self-efficacy. MET also uses motivational interviewing strategies to help individuals gain insight and find motivation.

Express Empathy

This motivational enhancement therapy technique is aimed at helping individuals develop and express empathy for others. The motivational therapist helps do this by first communicating great respect for the client and their freedom of choice. This is enhanced by reflective listening, which is key in motivational interviewing. This communicates acceptance and support for the client.2

Develop Discrepancy

The motivation for change occurs when an individual recognizes a discrepancy between where they are in life and where they want to be. Part of this process is raising awareness of the personal consequences that stem from substance use. Additionally, acknowledging the discrepancy between desire and reality can be pivotal to inspiring change. 

Avoid Argumentation

Argumentation typically is unhelpful in the therapeutic setting as argumentation triggers defensiveness and resistance to change. A motivational therapist is unlikely to argue with you surrounding the problem or assign a label. Instead, MET therapists provide education and help you examine your problem behaviors and their consequences, increasing awareness. The motivation for change comes naturally from within by raising awareness rather than arguing.3

Accept Resistance

Resistance is common in most forms of therapy. Motivational counseling recognizes this, and rather than fighting resistance, the therapist will look for ways to diffuse the struggle. 

MET therapists are trained to “roll with resistance,” using the momentum from resistance to shifting client perceptions. The therapist may invite new ways of thinking but will not force them on the client. Instead, clients can find their solutions and internal motivation to change. 

Support Self-Efficacy

Motivational enhancement therapy emphasizes self-efficacy. Self-efficacy is essentially belief in yourself. Individuals are unlikely to change if they do not believe they will be successful. Self-efficacy is tied to hope, which is needed for change. Motivational therapy seeks to increase self-efficacy and empower individuals to make lasting changes in their life. 

MET and Stages of Change

Motivational therapy is based on the six stages of change from the Transtheoretical Model. The transtheoretical model assumes that behaviors are not changed quickly and on a whim. Rather, that change occurs through a cyclical process continuously.

MET meets the clients in whatever phase they are in and helps them build the self-efficacy and motivation to move through them. The six stages of change are: pre contemplation, contemplation, determination, action, maintenance, and relapse.4

Pre-Contemplation

In this initial phase, the individual is not necessarily prepared to act and has no plan to do so within the next six months. Often a lack of awareness surrounding the consequences of their behavior can be why an individual may be in this phase. Additionally, many individuals who have tried to receive help in the past and failed may be pre-contemplators.

Contemplation

In this phase of change, the individual begins to think about making changes within the next six months. The individual has become aware of the problem behaviors but isn’t ready to make the changes. 

Determination

The third phase is characterized by determination and preparation. At this time, the individual is ready to make the changes and start working through their problems, intending on taking action within the next 30 days. At this phase, individuals strengthen their resolve to change.

Action

Once the motivation and resolve have been found to change, individuals can begin taking action to do so. At this time, individuals are making a conscious effort to implement the changes they want to make in their life. This takes the form of harm reduction or behavioral modification

Maintenance

Once the changes have been sustained for a while, individuals shift into the maintenance phase. This happens around the six-month mark. In this stage, individuals work to maintain their progress and prevent relapse back to earlier phases.

Relapse

Relapse is a part of the cycle of change. Changing behavior is often difficult and is not linear.  It is common at the beginning for individuals to relapse or revert to old behaviors. However, relapse can be used as an opportunity to learn and facilitate deeper change.

What Conditions Can Motivational Enhancement Therapy Help With?

While motivational therapy was designed mainly as a treatment for substance use disorders, it does have other applications. In addition to being a treatment for substance use disorder, MET is also helpful in treating bipolar disorder, anxiety, eating disorders, compulsive gambling, obsessive-compulsive disorder, and post-traumatic stress disorder.

MET and motivational enhancement interviewing are excellent complementary treatments because they resolve ambivalence surrounding treatment and increase motivation for change. 

Substance Use Disorder

For individuals suffering from substance use disorders, motivational enhancement therapy can be beneficial in finding the motivation to quit. It is specifically effective at helping individuals struggling with alcohol use disorder.5

Bipolar Disorder

Motivational therapy can also be beneficial in the treatment of bipolar disorder, especially when it comes to compliance to treatment and medication. MET can be a complementary therapy option for individuals with bipolar.6

Anxiety

MET therapy and motivational interviewing can also be useful in aiding anxiety treatment. Motivational techniques can complement cognitive behavioral therapy as they increase motivation for change and commitment to the intervention.7

Eating Disorders

Motivational therapy can be helpful in the treatment of eating disorders. In a recent study, treatment with motivational interventions effectively reduced binge eating. MET interventions are also superior in increasing motivation to change disordered eating behaviors.8

Compulsive Gambling

Compulsive gambling can also be treated with motivational therapy. Often individuals who struggle with compulsive gambling may lack awareness about their problem. In a recent study, individuals who are treated with motivational therapy have a reduction in money risk and gambling severity over time.9

Obsessive-Compulsive Disorder (OCD)

Motivational therapy is a good way to resolve ambivalence surrounding treatment and increase motivation for change for individuals with OCD. Because it increases self-efficacy, it empowers individuals with OCD to choose different behaviors.

Post-Traumatic Stress Disorder (PTSD)

While MET does not treat PTSD directly, it does increase an individual’s willingness to try therapies to help. A study on veterans with PTSD found that those who participated in MET attended more PTSD program appointments and stayed in treatment programs for longer.10

How Effective is Motivational Enhancement Therapy?

Motivational enhancement therapy can be an effective treatment option because it can quickly help individuals find the intrinsic motivation needed to promote change. Motivational enhancement therapy can also be used in combination with other therapies to enhance them or on its own. Benefits of MET will be detailed below.

Works Quickly

Motivational enhancement therapy is a relatively quick therapy approach and takes place over the course of four to six sessions. This is great for individuals who are ready for immediate change, and determined to do the work in a condensed time frame.

Reduces Resistance

MET recognizes resistance as part of the process of change. In MET, however, the individual is not forced to change or given unhelpful labels that lead to greater resistance.

Emphasizes Choice

MET emphasizes that the therapy is a collaborative partnership rather than the therapist acting as an authority figure. Individuals are encouraged to build their awareness and make their own choices.

Motivational Enhancement Therapy

How Does Motivational Enhancement Therapy Different from Other Methods?

Motivational enhancement therapy is different from other conventional treatment options such as 12-Step Facilitation (TSF) or cognitive behavioral therapy (CBT). 

12-Step Facilitation (TSF)

12-Step facilitation programs facilitate change through the admission of powerlessness. TSF programs guide individuals to turn to a higher power to overcome their addictions. Motivational enhancement therapy differs from this approach because it emphasizes personal power and self-efficacy.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is based on social learning theory and takes a different approach to treatment. CBT focuses on helping the client understand how their thoughts, feelings, and behaviors are all related.

It also helps individuals build new cognitive and behavioral coping skills to replace old ones that are no longer working. Because CBT assumes that the client is already motivated to change, it focuses more on the external. In contrast, MET builds the motivation for change from within.11

Get Effective Motivational Enhancement Therapy at Alta Centers

It can be immensely difficult to facilitate change without the proper motivation. Alta Centers can help. Start your journey with us today; we will equip you with the necessary tools and techniques to bring about positive change and maintain health and wellness.