Motivational Therapy
There are a wide variety of different methodologies and formats of talk therapy available. The one that’s best for you depends on your unique circumstances and needs, such as addiction medicine or addressing addictive behaviors. That said, a willingness to do the work and make the necessary changes in your life to achieve your goals is integral to many types. If this is an area where you suspect you need extra support, motivational therapy, also referred to as motivational enhancement therapy (MET), could be the right fit for you. While a licensed mental health professional is typically the best person to help you decide what type of therapy might be right for your situation, you can learn more about motivational enhancement therapy and motivational interviewing approaches here to see if it’s something you might want to consult with a provider about.
What is motivational enhancement therapy?
Motivational enhancement therapy (MET) is a category of psychotherapy that includes a variety of different practices and strategies for increasing a client’s willingness to change their behaviors. This approach was originally developed by Miller and Rollnick. According to Columbia University Medical Center, it’s a “collaborative approach to identifying and encouraging behavioral change” typically geared toward those experiencing issues related to substance use disorders. It’s usually based on resolving any mixed feelings the individual may have toward substances and helping them find motivation from within for learning to alter their behaviors. It involves giving the power back to the individual and helping them discover their own motivation for change, which is generally more effective than simply telling someone they should do things differently.
Motivational interviewing is one common practice within motivational therapy that enhances motivation. It's a technique where a trained practitioner will guide an individual through a series of open questions designed to help them view their situation in a different way. According to research by the Motivational Interviewing Network of Trainers, it’s intended for those who have:
High ambivalence about changing
Low confidence about their ability to change
Low desire to change, or uncertainty around whether they want to
A low sense of importance or urgency related to making changes
Motivational therapies, like brief intervention, are typically short-term approaches (a few sessions) that may precede a longer, more in-depth type of disorder treatment for substance use or alcohol related problems. Motivational enhancement therapy (MET) can be thought of as a primer or preparatory step that can help facilitate behavior change and increase the chances that the individual will be engaged in further treatment, which can help enhance motivation and overall efficacy.
Who is motivational enhancement therapy for?
Motivational therapy, incorporating stages of change, was devised by Stephen Rollnick and William Miller as a method for treating those experiencing a substance use disorder. In the original trials during the 1990s, such as Project MATCH, it was used to help those with an alcohol use disorder by empathetically supporting them in uncovering their own reasons for wanting to engage in behavior change. Many people still mistakenly believe that substance use issues are a matter of willpower, when they are in fact clinical disorders that often cannot be resolved without professional disorder treatment. Participating in motivational therapy can be a helpful first step in pursuing and adhering to treatment for substance use disorders and beginning the process of change.
That said, psychologists have found other conditions for which motivational therapy, using techniques like reflective listening and enhancing motivation, can be helpful and effective as well. For instance, one study found that people with a gambling addiction who received a combination of motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT) showed “significantly reduced gambling” behaviors six weeks to nine months after treatment. Another study suggests that people with eating disorders can also benefit from MET. It found that their “motivation to change” had increased after receiving this type of treatment, and that a “decrease in depressive symptoms and an increase in self-esteem” were also noted.
Is motivational enhancement therapy an effective mental health treatment?
There’s a substantial body of research to support the efficacy of motivational therapy in certain cases, particularly for alcohol or drug use disorders. These suggest that motivational therapy can:
Increase readiness to change
Promoting readiness to change in clients is one of the key goals of motivational therapy. Employing a client centered counseling style, the therapist aims to help the individual uncover their own reasons for wanting to make adjustments to their habits, along with enhancing self-esteem and fostering self-efficacy to help them believe they can be successful. Helping people change through a realistic change plan and supporting them along the way is generally the basis of motivational enhancement therapy.
Increase self-efficacy
Self-efficacy is defined as “beliefs in one's capabilities to organize and execute the courses of action required to produce given attainments”. A substantial measure of this quality is generally required for someone experiencing a substance use issue to make changes in their life, and it’s exactly what motivational therapy aims to foster. A 2021 study was conducted with 40 participants, all of whom were identified as “alcohol-dependent subjects.” One group underwent typical treatment for alcohol use disorder. The other underwent the typical treatment in addition to ten sessions of motivational therapy, using techniques like change talk to encourage clients. The second group was found to have a “significant increase in self-efficacy” by the end of the treatment as compared to the control, likely due to the motivational enhancement therapy.
Decrease substance use
Though MET typically happens in the earlier stages of an individual’s recovery process from a substance use disorder, it can still have a significant impact on longer-term results. In one study published in the Journal of Consulting and Clinical Psychology, researchers compared the effects of “counseling as usual” versus MET on substance use frequency after treatment. They found that MET, utilizing its unique counseling style in which the therapist will usually express empathy while encouraging clients to search for their own reasons to change, was associated with “sustained reductions in substance use” for alcohol users over the following twelve-week period, whereas counseling as usual was associated with “significant increases in substance use.”
Seeking the type of behavioral therapy that’s right for you
If you’re experiencing substance use issues, an eating disorder, or certain other disorders, research suggests that behavioral psychotherapy, such as motivational therapy could potentially be helpful for you. That said, it’s typically best to be evaluated by a qualified professional who can make informed recommendations about your specific situation. If you’re not sure where to start, you might consider online therapy. Studies suggest that it can offer similar benefits to traditional, in-person sessions but is generally more reachable and convenient, since it can be done from anywhere you have a working device and a stable internet connection. It’s also typically more cost-effective than in-person sessions.
With a virtual therapy platform like BetterHelp, you can get matched with a licensed therapist after describing your basic needs and preferences in a brief questionnaire. You can then meet with them via phone, video call, and/or online chat to discuss the challenges you may be facing, including helping you decide which type of therapeutic treatment, such as those that enhance motivation, may be most helpful in your particular situation. While BetterHelp doesn't accept insurance, visit costs are comparable to the copays of most insurance plans. See below for client reviews of BetterHelp therapists.
Takeaway
What is the meaning of motivation therapy?
Motivational therapy (MT), also called motivational enhancement therapy (MET), is a counseling approach to treatment for substance use disorders combining humanistic and cognitive-behavioral strategies. Although it is typically used to help individuals overcome addiction, it can be used to help people with anxiety, bipolar, obsessive-compulsive (OCD), and post-traumatic stress disorder (PTSD).
What is the best therapy for motivation?
People respond to treatment in different ways, so the best types of therapy for motivation will likely vary between people. However, motivational therapy combined with cognitive behavioral therapy (CBT) is one of the most common strategies professionals use to help patients improve motivation and increase accomplishment in many areas.
What is a motivational therapist?
A motivational therapist is a mental health professional who specializes in motivational counseling and therapy techniques. They work with individuals to help them identify and work towards their goals, increase their motivation to make positive changes and overcome obstacles that might hinder their progress.
What are the benefits of motivational therapy?
Motivational therapy can offer a range of benefits to individuals seeking to create positive behavior changes and achieve their goals. Here are a few common benefits of motivational therapy:
- Motivational therapy helps individuals explore any ambivalence they might have towards change, identify motivators, and build confidence and commitment to make positive change.
- Through motivational therapy, individuals can develop a sense of self-efficacy or belief in their ability to make successful changes.
- Therapists may use motivational therapy to assist individuals in setting realistic, achievable goals and holding them accountable for taking steps to achieve them.
- Motivational therapy empowers individuals to take control of their behavior and make informed decisions about their lives.
- MT can help individuals build resilience and coping skills to navigate challenges.
- By increasing motivation, self-efficacy, and commitment to change, MT can support individuals in making sustainable, lasting changes in their behavior and lifestyle.
What is the primary goal of motivational counseling?
The overarching goal of motivational counseling is to help reduce people’s resistance to attending counseling and increase their motivation to change unwanted or problematic behaviors. Motivational counseling aims to assist clients in identifying and working towards their goals to make positive change. It is most often used in cases of alcohol or substance abuse but may also help treat other mental health challenges.
What is a key skill in motivational enhancement therapy?
Deep, reflective listening is perhaps the most essential skill for motivational enhancement therapists. This involves the therapist actively listening to the client, reflecting back what they have heard, and summarizing the client’s thoughts and feelings so their understanding aligns with the client’s perspective. Reflective listening helps the therapist demonstrate empathy, understanding, and validation toward the client to build rapport and trust in their therapeutic relationship. It also allows the client to feel heard and understood, which may increase their motivation to make positive behavioral changes.
What is the primary goal of motivational enhancement therapy?
The primary goal of MET is to help individuals increase their motivation and commitment to making positive behavior changes. MET aims to help clients recognize the discrepancy between their current behavior and desired values and aspirations. By exploring and resolving this discrepancy, individuals can be motivated towards action in behavior change.
What are the first two sessions of motivational enhancement therapy?
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) outlines a MET intervention approach consisting of four sessions in which the first two “focus on structured feedback from the initial assessment, future plans, and motivation for change.”
What are the five stages of change in motivational enhancement therapy?
Motivational enhancement therapy operates according to five stages, during which the counselor and client work together to improve motivation and change unwanted behaviors. They include:
Pre-contemplation
This stage is typically marked by ambivalence or reluctance to consider behavior changes, or, in some cases, the individual isn’t aware that they have a problem. During this stage, friends, family, and colleagues might notice the individual has a problem but cannot communicate with or convince them they need assistance. In some cases, the individual may be forced to seek therapy by the courts or social services and might be more combative. In other cases, there might be a significant health risk associated with the client’s behaviors that prompted their entry into therapy.
During this stage, the therapist focuses on helping the client identify that they do have a problem so they will eventually become more receptive to continuing the process. The therapist will also work with the patient to cultivate more self-awareness to recognize how and when problematic behaviors surface. The last core element of the first step is to help the client boost their self-confidence in their ability to change.
Contemplation
Sometimes, people come to therapy already in the contemplation stage, as they’re already considering that they have an issue. Others reach this step after the pre-contemplation stage. Regardless of their pre-existing levels of awareness, there is still some uncertainty around change. The thoughts and considerations might be present, but the client might not be willing to commit to the process of change.
Therapists might leverage psychoeducation as a tool for motivation during this stage. More in-depth knowledge and communication about their mental health issues can lead to clarity and certainty about whether the individual is ready to change. During this phase, therapists also use motivational interviewing, a process in which the counselor and client discuss their goals, values, and what might drive their motivation to change.
Determination
If the client is committed to moving forward, they enter the determination stage. By now, the client is aware they have an issue they need and want to address to facilitate change. They are ready to take action and change their behaviors. During this stage, clients prepare for the coming changes through more education and working with their therapist to identify their goals and outline their steps to achieve them.
Action
During this stage, the client begins taking the steps necessary to work towards their goals. This might include modifying their schedule, lifestyle, and even the people they associate with. The therapist is deeply involved in this stage, providing care and support to the individual to keep things on track. The counselor and client can work together to address setbacks and learn to cope with them in the future.
During this phase, clients will sometimes discover other areas of their lives that contribute to unwanted behaviors or cause emotional distress. The therapist will work with them to explore these issues more deeply and resolve them. The action stage can take a long time, so helping the client retain their patience and willingness to continue working on the change process is also a large part of this stage.
Maintenance
After the individual has been in the action stage long enough to create new healthy behaviors, eliminate unwanted behaviors, and learn to manage setbacks, they may enter the maintenance phase. However long this takes depends on the individual. During this stage, the client works to maintain any changes they established during the therapeutic process and avoid relapse. Therapy can play a crucial role in supporting individuals during this phase by helping the client recognize signs of a potential relapse, teaching them skills necessary to prevent relapse, and helping people get back on track in the event of a relapse.
How much does motivational enhancement therapy cost?
How much MET costs depends on many factors like location, the level of care you require, availability of services, counselor experience and education, and insurance coverage. It also depends on the type of platform you’re using. For example, subscription therapy platforms like BetterHelp typically run between $60 and $100 per week (billed monthly). In contrast, the average cost of traditional in-person treatment runs an average of $75 to $150 per session.
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