What Is Motivational Enhancement Therapy?

Motivational enhancement therapy (MET) is a variation of motivational interviewing (MI) used to replace undesirable behaviors with more positive ones. This type of therapy is designed to elicit positive changes and teach self-control by providing the patient with positive affirmations. It is most commonly used to treat alcohol and substance abuse but also works for other behaviors. Motivational enhancement therapy also is used with adolescents and teens who are rebellious, narcissistic or extremely moody. The main goal with MET is empowering the patient to elicit change in himself, giving him the motivation and desire necessary to make the change.

Techniques used in motivational enhancement therapy focus on positive motivations and desires for change rather than on negative reinforcement. This technique has proved particularly useful in treating people who resist change or treatment. In addition to drug and alcohol treatment, motivational enhancement therapy has been successful in assisting in the treatment of people with eating disorders and eliciting change in criminal parole and probation violators, rebellious adolescent behavior and other behaviors to which people resist making positive changes. Motivational therapy is available in all settings, including inpatient centers, outpatient services, schools and other locations.

Motivational enhancement therapy sessions are short, usually involving from two to four sessions, each an hour long. Most sessions are provided privately rather than in group therapy sessions. Trained motivational therapists are not directly involved in making changes, nor do they advocate change; they primarily provide the motivation and support necessary for patient to want to make the changes themselves. Therapists are responsible for providing empathy, supporting self-efficacy, avoiding contradicting the patient and positively empowering the patient. The therapist listens and asks open-ended questions intentionally to provide an opportunity for the patient to talk through the issues.

Each session typically begins with the motivational therapist determining the patient's current level of resistance and motivational levels. The therapist then determines a theme for the decision based on the patient's needs, such as exploring reasons to change or a typical day in the patient’s life. Structured sessions begin with the therapist asking open-ended questions and end with a session summary and feedback. To be effective, the motivational therapist must be respectful and provide confirmation of the patient’s resistance and denial using strategies of reflective listening and selective agreement. Therapists are often available to their patients immediately for crisis situations and explore relapses in the same manner, asking open-ended questions for self-exploration.