What is motivational enhancement therapy?

Howard J. Shaffer, PhD
Addiction Medicine
Motivational enhancement therapy for addiction is a catch-all term for techniques that attempt to increase motivation to change. Examples include motivational interviewing—which encourages people to explore their feelings about their addiction and to examine the discrepancies between their behaviors and their goals—and resistance reduction.

The psychologists who developed motivational enhancement therapy recognized that people have a natural tendency to play devil's advocate. In other words, if one person pushes a particular viewpoint or agenda, those around him or her often naturally raise the opposing viewpoint.

Historically, most therapists treating people with addiction tried to convince their clients that addictive behavior was problematic, unhealthy, and detrimental. This approach sometimes alienated the client, further entrenching the problematic behavior.

Motivational enhancement therapies encourage clients to develop and advance their own agenda and set their own goals. The therapist's role is to listen carefully and to ask provocative but judgment-free questions about the value of using the object of addiction and how such use has affected the client. The answers should help the clients increase their motivation for stopping such use, identify reasons to change, and establish a recovery plan. Clinicians typically use this treatment strategy in conjunction with other therapeutic approaches.

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