The case for high-dose motivational enhancement therapy

Motivational Enhancement Therapy (MET) is a brief therapy for treating substance use-related problems that draws upon the stages of the change model of Prochaska et al. (1992) and the clinical techniques of Motivational Interviewing (MI) Miller et al. (1992). Studies have shown that MET is effective in improving motivation for change and decreasing substance use. However, comparison of MET with more intensive treatment is limited and no studies have compared the standard low dose of MET with higher doses of MET. This article makes the case for a higher dose model. The rationale for the more intensive dose draws upon several sources: 1) Descriptive studies documenting that length of treatment is a predictor of outcome, 2) Well-controlled, randomized psychotherapy trials for other disorders, such as depression, that show a dose-response relationship, and 3) Conceptual considerations about the nature and process of psychotherapy.