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Motivational Enhancement Therapy (MET)

Motivational Enhancement Therapy (MET) is an approach to counselling founded by William Miller and Stephen Rollnik at the US funded ProjectMATCH. MET is designed to treat addicts who lack the motivation to engage in traditional forms of psychotherapy such as cognitive behavioural therapy. MET was developed initially for use in alcohol detox programmes, although MET is now used to treat most types of substance misuse, include heroin and cocaine addiction.

Theoretic foundation of MET

MET is based on the ‘trans-theoretical model’ of behaviour. This model outlines the stages people must pass through in order to enact and maintain change.

The stages of the ‘trans-theoretical model’ include:

  • Pre-contemplation – no motivation to change
  • Contemplation – the person begins to consider changing
  • Determination – a positive decision is made to enact change
  • Action – a positive step to change is made
  • Maintenance – i.e. attending NA/AA meetings following therapy
  • Relapse – i.e. failure to attend NA/AA meetings

MET aims to move patients through this cycle of change, at least to the point where patients are ready and willing to attend traditional therapy sessions.

Further, MET is based on five core concepts that therapists must adhere to. These concepts include:

  • Express empathy towards the patients
  • Develop a discrepancy i.e. the distance the client must travel to achieve stated goal
  • Avoid argument
  • Rolling with resistance

How MET is employed

MET is a combination of ‘motivational interviewing’ and ‘motivational therapy’. MET should really be regarded as a form of preparation therapy. Once patients complete MET they progress onto other forms of addiction-therapy. At Cassiobury Court MET is used either during pre-treatment intervention or during in first few days following detox once rehab has begun.

Like its name suggests, MET is designed to enhance patients’ motivate to receive treatment. MET is typically reserved for the minority of patients who fail to establish the motivation to get better. Patients attending a MET programme typically suffer at the hands of addiction for many years. MET is often a ‘last chance’ programme for many of these patients. Equally, MET is affective for treating teenage addicts. This is because teenage addicts often lack the required motivation to change. Once MET is complete, patients are typically more motivated to engage with traditional programmes of addiction treatment.

MET’s four sessions

MET consists of four defined sessions. The first session is an assessment seeking to establish the patient’s inner-motivations for change. The therapist uses motivational interviewing (MI) technique to establish a plan for change. The therapist limits his or her input to questioning. This allows the patients to reveal their motivations for change without outside influence. MET thus helps patients achieve goals they set for themselves. Patients articulate and define tangible goals from otherwise fractured and ambiguous thoughts and feelings. This process helps patients gain self-control over the process early on. Subsequent sessions aim to help patients achieve their goals they set during the initial session.

The effectiveness of MET

Studies have proven MET to be an effective form of pre-treatment therapy. However MET is more effective at treating certain forms of substance misuse over others. MET is particularly affective at preparing cannabis or alcohol addiction for further therapy. Here MET clearly increased patients’ motivation to reduce their drug consumption and to receive other forms of treatment. However MET has been less successful at treating patients suffering from heroin, cocaine and nicotine addiction.

About Cassiobury Court

At Cassiobury Court we offer a four-week residential rehab programme. Click here to contact our admissions team if you wish to learn more about our programmes.

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