Substance abuse is one of the leading social problems in the United States. In particular, alcohol is one of the most abused substances in the country. The American Psychological Association (2004) defines substance abuse as “ a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested” by such symptoms as failure to meet responsibilities to societal constructs, development of physically hazardous tendencies, social deviance leading to legal repercussions, and disruption to destruction of social relationships.
Some symptoms of abuse that conform with the APA (2004) definition are missing class and performing poorly of assessments which indicate failure to meet academic responsibilities which are among the societal constructs to which college students are affiliated with, driving while under the influence of alcohol and getting into physical brawls which examples of the development of hazardous tendencies, being taken into custody by police for diverse transgressions which indicate social deviance leading to legal repercussions, and receiving criticism from friends and family, and arguing excessively which shows the disruption of social relationships.
Other related symptoms include increased instances of dropping out from school or being placed on academic probation, increased tension with family members, and a general decrease in the amount of social and emotional support given to other members of the family (Smith, 2007). It can be affirmed that alcohol abuse is a continuing major concern of contemporary society which substantiates the importance of devising an intervention that can allow people who drink alcohol to do so without endangering themselves and their relationships with other people.
The aim of any intervention should not be to “free” subjects from wanting to use the substance that they abuse, perhaps not even to reduce the amount of the substance that they are abusing, but to help them find ways to use the substance such as to reduce the adverse effects as described in APA (2004). The goal is to find effective means to regulate and plan substance use in such a way that would not produce the adverse affects that abuse is defined to produce.
This paper aims to analyse the effectiveness of Motivational enhancement therapy to be used as intervention methods for helping addicts of alcohol. In this way, the paper particularly addresses the problem of substance abuse. The paper introduces and evaluates an intervention approach aimed at reducing the occurrence of abuse of the particular substance, consequentially reducing its adverse effects as well.
Motivational Enhancement Therapy (MET)
Motivational Enhancement Therapy (MET) is a theoretical model which is designed to help addicts of substance and alcohol abuse to commit themselves to initiate positive behavioural changes (Lambie, 2004). MET is based on strategies which focus client-centred counselling and the systems theory so that clients are motivated to being about positive alterations in their behaviour through brief periods of intervention. MET avoids the use of direct persuasion techniques and counsellors follow a style which is gentle so that the therapeutic relationship is seen as a bond of friendship rather than one in which the client is the receiver and the counsellor, the specialist (Lambie, 2004).
Research and studies indicate the use of MET for substance abuse and alcoholic clients, many of whom display resistance and traits of narcissism. The Met was particularly designed as a standardized form of counselling treatment, occurring in a brief period of four sessions which benefitted patients who reflected low levels of readiness for change and showed better results as compared to the CBT or 12-step model (Ingersoll & Wagner, 1997). Researchers have confirmed MET to be more successful that the preceding approaches due to the enhanced outcomes and retention rate of substance abuse clients (Aubrey, 1998).
MET is a therapy model which enables addicts of alcohol and substance abuse to be motivated to change by the active use of listening and the gentle feedbacks provided by counsellors and therapists. The MET is based primarily on the tenet that addicts and clients have the capacity to change and are responsible enough to desire positive changes in their lives with the help of counsellors who create conditions for the enhancement of motivation and morale of clients (Miller et al., 1995). Counsellors play the vital role to prepare clients for change without actually pressurizing or pushing them, simply by boosting inherent motivation among clients which passively initiates and then gently persuades clients to make efforts for positive behavioural changes in their lives.
Brief Motivational Intervention
Brief motivational intervention is a mindfulness based strategy and intervention plan which focuses largely on acceptance through a non judgemental approach and has been found to yield positive results with addicts of alcohol abuse (Bowen et al., 2007). The intervention is initiated with a screening method which enables the identification of abusers, which is then followed by an intervention design. The method is based on a health questionnaire as the most preferred tool for screening clients (Beich et al., 2003). The self accomplished questionnaire enables the drawing out of honest facts from the client which in turn facilitates the client to self address the alcohol tendencies in an effective manner, over a period of time.
However, it must be remembered that intervention can be effective through periodic intervention so that clients can avail of assistance from the initial to the final stage when the abusive tendency has been completely addressed. Brief motivational intervention is a “problem solving process” in which the therapist and the client identify the intervention plan by keeping in view the goals of the therapy (Hofmann and Amundson, 2007). Researchers support and confirm the success of the brief motivational intervention strategy due to the positive impact it has on the reduction in the alcoholic abusive tendencies of addicts (Carey, et al., 2006).
The questionnaire of the motivational intervention therapy fulfils this purpose and helps clients to identify their core beliefs which cause misconceptions leading to use and abuse of alcohol. The brief intervention motivational therapy complements the approach of mindfulness based strategy which focuses on the identification of irrational thoughts in addicts and facilitates self awareness of personal negative and dysfunctional thoughts which are questioned and replaced by positive behavioural approaches (Hofmann and Amundson, 2007).
Motivational intervention strategy encourages clients to formulate and test their hypothesis which enables them to understand their own problems and accordingly devise solutions for solving them (Hofmann and Amundson, 2007).
Motivation is provided by the therapists through encouragement, transparency and clear reasoning while answering questions and reacting to the doubts of the client. The substitution of irrational thoughts and approaches with rational ones is not a simple process which occurs through positive thinking techniques which are not taught to the client, but are modified by the client on the basis of questioning and testing of such behaviour by the clients themselves so that they are able to gain realistic perspectives of the world through introspection and feedback (Hofmann and Amundson, 2007).
Thus, through the various principles of MET applied to brief motivational intervention, therapists encourage clients to gauge the root cause of the problem and motivate them to personally design solutions which can be affirmed after they are appropriately tested. Rather than telling the client what to do, therapists and counsellors function as guides for addicts and clients and facilitate them to draw out their own solutions based on personal values and judgements, through motivation and encouragement.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC.
Aubrey, L. L. (1998). Motivational interviewing with adolescents presenting for outpatient substance abuse treatment. (Doctoral dissertation, The University of New Mexico, Albuquerque) Dissertation Abstracts International, 59, 1357.
Beich, A., Thorsen, T., and Rollnick, S. (2003). “Screening in brief intervention trials targeting excessive drinkers in general practice: systematic review and meta-analysis” British Medical Journal 327 (7414): 536–542.
Bowen S., Witkiewitz K., Dillworth T., and Marlatt A. (2007). The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addictive Behaviors 32 (2007) 2324–2328.
Carey, K., Carey, M., Maistoa, S., and Hensona, J. (2006). “Brief Motivational Interventions for Heavy College Drinkers: A Randomized Controlled Trial.” Journal of Consulting and Clinical Psychology. 74(5): 943-954.
Hofmann S., Asmundson G. (2008). Acceptance and mindfulness-based therapy: New wave or old hat? Clinical Psychology Review 28 (2008) 1–16.
Ingersoll, K., & Wagner, C. (1997). Motivational enhancement groups for the Virginia Substance Abuse Treatment Outcomes Evaluation (SATOE) model: Theoretical background and clinical guidelines. Richmond: The Office of Mental Health and Substance Abuse Services, Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services.
Kremer, M., and Levy, D. (2008). Peer Effects and Alcohol Use among College Students. J Eco Pers. 22 (3), 189-206.
Lambie, Glenn W. (2004). Motivational Enhancement therapy: a tool for professional school counselors working with adolescents. Professional School Counseling 7.4 (April 2004): 268(9).
Miller, W. R., Zweben, A., DiClemente, C. C., & Rychtarik, R. G. (1995). Motivational Enhancement Therapy manual: A clinical research guide for therapists treating individuals with alcohol abuse and dependence (Vol. 2, Project MATCH Monograph Series). Rockville, MD: National institute of Alcohol Abuse and Alcoholism.
Smith, J. (2007). The effects of alcohol abuse on African American families. MAI. 45 (1), 483 – 495.