Motivational Enhancement Therapy (MET) is, as the name suggests, an approach to invoke change through motivation. It is intended to provide fast, internally driven recovery, and it may be used on its own or along with other types of therapy. There are six elements to the process, which can be summed up by the acronym FRAMES – FEEDBACK of personal risk, emphasis on personal RESPONSIBILITY, clear ADVICE, a MENU of alternative change options, therapist EMPATHY, and facilitation of client SELF-EFFICACY or optimism.
Studies have found that both MET participants and those who followed a more traditional therapy program saw less substance use during the four-week therapy session. However, for the 12 weeks of follow-up, the baseline participants returned to their previous levels, while MET participants sustained the reductions. Data also suggest that MET can substantially lower alcohol consumption. Among one group, the average number of weekly drinks for people who participated in three months of MET was reduced from 95 before treatment to 19 afterward. In comparison, clients who received standard treatment, the number of weekly drinks consumed dropped from 85 to 61.
In a study of three treatment interventions investigated by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), MET substantially reduced heavy drinking across a one-year posttreatment period. MET also produced equally effective reductions using only four sessions (over the course of 12 weeks) compared with the 12 sessions employed by the other comparison treatments.
For a MET therapist, the goal is to help patients understand how much of a problem their drug use poses for them and how it is affecting them. Then, in what is called the determination stage, the substance user considers their ability to effect change and the benefits of doing so. The therapist’s role here is not one of an authority figure, but a sounding board and confidant, and the focus is on listening, not lecturing. When done correctly, it is the patient and not the therapist who sets the change in motion.
As opposed to more confrontational models, MET discourages forcing someone to confront their denial, as well as any behavior on the part of the therapist that may be seen as argumentative. MET also avoids the use of any labels, such as addict or alcoholic. Instead of saying, “You’re an addict and you need to stop,” the therapist might begin with, “Tell me about your drug use. Is there anything that makes you think you might need to change?”
There is also no skill training involved in MET, unlike other cognitive-behavioral treatment strategies. The therapist instead builds confidence in the patient that eventually allows them to make their own decisions on how to change and move forward. Another important part of MET is the Personal Feedback Report. This is where the therapist can provide data for their client on things like how their drug use compares to the norm, and how they’ve been doing in general over the course of treatment.
If you or a loved one are suffering from a substance abuse problem, call Asana Recovery at (949) 438-4504 to learn about our medical detox and residential and outpatient therapy programs.
