MOTIVATION ENHANCEMENT THERAPY AND ALCOHOL USE DISORDER

Episode Transcript

(00:00):
Welcome to the Psychological Theories podcast.In this podcast, we take a journey
into the human mind with one psychologicaltheory at a time. So let's begin
Motivational enhancement therapy. This is acommonly used theory for drug addiction, and

(00:20):
today we're going to be talking aboutit in relations to alcohol use disorder.
It's a client centered type of therapydirective approach designed to enhance intrinsic motivation for
change. It was developed as abrief intervention for individuals with substance use disorders,
including alcohol use disorder. Here aresome of the key principles. Expressing
empathy, which is nothing new forany other theories, developing discrepancy, rolling

(00:41):
with resistance, which comes more frommotivational interviewing, and supporting self efficacy.
MET involves a small number of sessionstwo to four and aims to quickly elicit
and strengthen motivation for change, builda plan for change, and increase the
client's confidence and their ability to makechanges. Here's a little brief case study
that I did it with an exampleof a script a forty five year old

(01:03):
man who's been referred to therapy byhis doctor due to concerns about alcohol consumption.
He's resistant to the idea that hehas a problem and believes he can
control it. The therapist, ofcourse, would always begin by using empathy
and building rapport. The therapist wouldbegin, we're welcoming him to the therapy.
Can you tell me a little bitabout what's brought you here the patient.
The client would say, well,my doctor's overreacting. I'd like to

(01:25):
have a few drinks from wine,but it's not a big deal. The
therapist would say, so you feelyour drinking isn't problematic and that your doctor
might be concerned unnecessarily. What areyour thoughts about alcohol use in general?
Now, I don't like to sayfeel. I think that word is not
appropriately used. I would say,so you believe your drinking isn't problematic.

(01:45):
As John talks, the therapist wouldlisten for any mention of problems or concerns
related to drinking, even if aJohn doesn't directly attribute them to alcohol.
The therapists might then use what theycall discrepancy. For instance, the therapist
might say something like, on onehand, you mentioned that drinking helps you
relax off to work, but you'vealso said that you sometimes have trouble getting
up for work in the morning.How are these two things related? In

(02:10):
another session or continuing on, youcan use the scaling method, which is
also comes from solution focused. Atherapist can say, on a scale of
one to ten, with one beingnot at all ready and ten being I'm
ready right now, how ready areyou to make changes to your drinking habits.
Scaling is wonderful technique and you canuse it two ways. One way,
you can say, let's say theclient says three or four. You

(02:32):
can say, that's interesting, whatmade you choose three or four rather than
one or two? Or you cango the other way, what would it
take to get you to a fiveor six? So either way you can
frame it how you want. Thetechnique allows the client to voice their own
opinion and reasons for change. Atherapist would then support the client self efficacy.
You can say things, like you'vementioned successfully making changes in other areas

(02:53):
of your life. What personal strengthsdo you think you could apply if you
decided to change making habits another thing? To develop a change plan, the
therapist can ask, what do youthink might be a good first step towards
changing your relationship with pro alcohol?Now, if you remember Prochaska's six steps.
At this point, you're really lookingfor now preparation, So in other

(03:19):
words, you have pre contemplation.The person's not even thinking about changing contemplation.
They just started preparations, are startingto prepare to think in action.
They're actually taking act. Throughout theprocess, the therapist would roll with any
resistance, avoiding arguments and instead ofinviting the client to consider new perspectives.
The goal of the therapy is notto push the client into change, but
to help him explore his own motivations. So that's motivational enhancement therapy. How

(03:42):
effective is it again, it's difficultto determine. These are one of the
more commonly used ones. I don'tknow exactly what the remission rate numbers are
kind of hard to get, andwhat does it mean to be successful.
Does it mean they're off the substancenow for six months a year? Does
it reduce the amount of alcohol?A lot of variables. Maybe we'll do
another podcast on that.