This week’s post is on Motivational Enhancement Therapy (MET): a common therapy utilized in substance abuse centers.
MET is both directive and client-centered, which is one of it’s great advantages. It is directive because the counselor chooses what to respond to, but it also has elements of Rogerian therapy, which also make it client-centered. According to MET, each client has within themselves the capacity for change. The counselor’s role is to help them get in touch with their motivation. MET values client autonomy in that the client is seen as expert and makes the choices, this is what makes MET client centered.
MET is good for issues that have a behavioral component such as alcoholism or uncontrollable gambling, or when a client presents with significant ambivalence (conflicting feelings and thoughts). MET is also good for court ordered clients, which are common in agencies or when working with EAPs. However, MET therapy is not effective for clients who want the therapist to be the authority.
Philosophy
MET is based upon the following research findings:
- Change occurs naturally
- Even very brief interventions can trigger change
- Interpersonal interactions can affect change
- The majority of client change happens within the first few sessions
- A good counselor/client match is essential
- An empathic counseling style facilitates change
- What people say about change is important
According to MET philosophy, humiliation, shame, and negative emotions in general are not the causes of change. Rather, these emotions can inhibit change. Instead, it is validation and understanding that help promote change. As such, the goal of MET is to get people to see the problems associated with their behavior by working with them in a non-threatening and supportive way. The more people are coerced and forced, the more they will rebel. Therefore, MET is about “rolling with resistance;” redirecting people’s natural energy instead of fighting about it.
In sum, MET values collaboration over confrontation, evocation over education, and client autonomy over counselor authority.
Four Main Principles
- Empathy: the client must get the sense that you understand them.
- Develop Discrepancy: highlight the conflicting thoughts, ie. “You like to smoke pot, you think it’s great; but on the other hand you are tired of looking over your shoulder so you don’t get arrested.”
- Rolling with Resistance, ie. if a client is very defensive, don’t argue with them, just say something like “Hey, I don’t know anything about that, why don’t you tell me what is going on.” According to MET, if a client is resistant, then the problem is that there is a mismatch between the counselor’s intervention and the client. So, it is up to the counselor to change the intervention rather than to force the client to do something different.
- Self-efficacy: counselors emphasize the ability of client so help themselves.
In order to utilize MET effectively, counselors must discipline themselves not to impose their own opinions or expert knowledge on the client.
Yours in the Joy of Knowledge,
Barbara LoFrisco
*Source: Aaron Norton, LMHC, presentation at University of South Florida on 4/16/13
