Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine)
Motivational Enhancement Therapy (MET) is a patientcentered counseling approach for initiating behavior change by helping individuals resolve ambivalence about engaging in treatment and stopping drug use. This approach employs strategies to evoke rapid and internally motivated change, rather than guiding people stepwise through the recovery process. This therapy consists of an initial assessment battery session, followed by two to four individual treatment sessions with a therapist. In the first treatment session, the therapist provides feedback to the initial assessment battery, stimulating discussion about personal substance use and eliciting self-motivational statements. Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the patient. In subsequent sessions, the therapist monitors change, reviews cessation strategies being used, and continues to encourage commitment to change or sustained abstinence. Patients sometimes are encouraged to bring a significant other to sessions.
Research on MET suggests that its effects depend on the type of drug used by participants and on the goal of the intervention. This approach has been used successfully with alcoholics to improve both treatment engagement and treatment outcomes (e.g., reductions in problem drinking). MET has also been used successfully with adult marijuana-dependent individuals in combination with cognitive-behavioral therapy, comprising a more comprehensive treatment approach. The results of MET are mixed for participants abusing other drugs (e.g., heroin, cocaine, nicotine, etc.) and for adolescents who tend to use multiple drugs. In general, MET seems to be more effective for engaging drug abusers in treatment than for producing changes in drug use.
Further Reading:
Baker, A., et al. Evaluation of a motivational interview for substance use with psychiatric in-patient services. Addiction 97(10):1329-1337, 2002.
Haug, N.A.; Svikis, D.S.; and Diclemente, C. Motivational enhancement therapy for nicotine dependence in methadone-maintained pregnant women. Psychology of Addictive Behaviors 18(3):289-292, 2004.
Marijuana Treatment Project Research Group. Brief treatments for cannabis dependence: Findings from a randomized multisite trial. Journal of Consulting and Clinical Psychology 72(3):455-466, 2004.
Miller, W.R.; Yahne, C.E.; and Tonigan, J.S. Motivational interviewing in drug abuse services: A randomized trial. Journal of Consulting and Clinical Psychology 71(4):754-763, 2003.
Stotts, A.L.; Diclemente, C.C.; and Dolan-Mullen, P. One-to-one: A motivational intervention for resistant pregnant smokers. Addictive Behaviors 27(2):275-292, 2002.