MET (Motivational Enhancement Treatment) to Improve Treatment Engagement and Outcome in Subjects Seeking Treatment for Substance Abuse
Kathleen Carroll, Ph.D. Lead Investigator Department of Psychiatry VA CT Healthcare Center (151D) 950 Campbell Ave. West Haven, CT 06516 kathleen.carroll@yale.edu

Early dropout, partial attendance, and early relapse are common occurrences in most substance abuse treatment programs. Because the bulk of attrition occurs very early in treatment and retention in treatment has been linked to better outcomes, identifying effective, practical means of enhancing initial treatment engagement and outcome is an important target for the Clinical Trials Network. Motivational Enhancement Treatment is a systematic intervention approach based on the principles of motivational psychology that utilize motivational strategies to mobilize the client's own change resources. The MET counselor evokes a person's intrinsic desire and ability to change drug use behaviors, rather than imposing a directive "do this" approach.

A considerable body of research for more than two decades has shown strong support for the usefulness of motivational interventions in initiating treatment and in reducing use of alcohol, cigarettes, and abused drugs. This protocol will test the therapeutic usefulness of incorporating MET into the standard drug abuse treatment entry process of Community Treatment Programs on improving treatment engagement, retention, and outcome.

Primary Findings: While clients in both treatment conditions reduced substance use during the 4-week treatment periods, clients whose treatment included MET were significantly more likely to sustain this reduced use over the 12-week follow-up, and the counseling-as-usual clients increased their use during that time. In addition, this trial established a standard for MI training and delivery, and demonstrated the essential role played by clinical supervisors in ensuring effective treatment delivery, and a regiment of rigorous training and supervision in MI has been broadly accepted in the field.

Primary Outcomes Paper: Ball S, et al. Site matters: Multisite randomized trial of motivational enhancement therapy in community drug abuse clinics. Journal of Consulting & Clinical Psychology 2007;75(4):556-567. [more. . .]

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