Alcohol use disorder is a medical condition that involves heavy or frequent drinking of alcohol even when it causes problems, emotional distress, or physical harm. In order to deal with this disorder, the individual can combine the treatment methodology containing medication, behavioral therapy and support groups. Combination of this is regarded as the best way to help someone dealing with Alcohol Use Disorder(AUD). Talking about the therapy that is mostly used to treat individuals with AUD are Motivational Interviewing Therapy (MIT) and Motivational Enhancement Therapy (MET).

Motivational interviewing
Motivational interviewing (MI) is a guiding style of communication, that sits between following (good listening) and directing (giving information and advice). MI is designed to empower people to change by drawing out their own meaning, importance and capacity for change. MI is based on a respectful and curious way of being with people that facilitates the natural process of change and honors client autonomy.

MI has four fundamental processes. These processes describe the “flow” of the conversation although we may move back and forth among processes as needed:

• Engaging: This is the foundation of MI. The goal is to establish a productive working relationship through careful listening to understand and accurately reflect the person’s experience and perspective while affirming strengths and supporting autonomy.
• Focusing: In this process an agenda is negotiated that draws on both the client and practitioner expertise to agree on a shared purpose, which gives the clinician permission to move into a directional conversation about change.
• Evoking: In this process the clinician gently explores and helps the person to build their own “why” of change through eliciting the client’s ideas and motivations. Ambivalence is normalized, explored without judgment and, as a result, may be resolved. This process requires skillful attention to the person’s talk about change.
• Planning: Planning explores the “how” of change where the MI practitioner supports the person to consolidate commitment to change and develop a plan based on the person’s own insights and expertise. This process is optional and may not be required, but if it is the timing and readiness of the client for planning is important.
  
  
  
  Application
  
  Motivational interviewing was initially developed for the treatment of substance use disorder, but MI is continuously being applied across health fields and beyond that. The following fields have used the technique of MI:
  
• Classroom management
• Health based coaching
• Mental disorders (anxiety and depression)
• Gambling problems
• Substance dependence

Motivational enhancement therapy
Motivational Enhancement Therapy (MET) is a counseling approach that helps individuals resolve their ambivalence about engaging in treatment and stopping their drug use.

The primary goal of MET is to help individuals overcome their ambivalence or resistance to behavior change. MET focuses on increasing intrinsic motivation by raising awareness of a problem, adjusting any self-defeating thoughts regarding the problem, and increasing confidence in one’s ability to change.  

While variations are possible, MET is typically brief. It usually consists of about four sessions, preceded by an initial assessment that collects information on behaviors related to the presenting problem. In the first of the four MET sessions, the therapist will generally provide structured feedback based on the assessment. Feedback from the assessment allows individuals to see how their behavior compares to that of the wider population, and it can allow a person to view any concerns in a new light.

Motivational interviewing approaches to therapy focus on five key motivational principles. During treatment, MET therapists may:

Express empathy: This strategy involves helping people develop and express empathy for others. The goal is to help them understand how their own behavior affects other people. By gaining this understanding, people may then feel more motivated to change.

Acknowledge discrepancy: Another key aspect of motivational enhancement therapy is recognizing that there is often a discrepancy between a person’s desired place to be and where they actually are. Being able to acknowledge this disparity between desire and reality can inspire people to take steps to bridge the gap.

Avoid arguments: MET therapists do not argue with an individual about their behavior or substance use. Argumentation often triggers defensiveness and resistance to change, so gently and optimistically helping people become more aware can make the motivation to change come from within them rather than from someone else.

Accept resistance: MET therapy recognizes that resistance is common. Instead of fighting it, therapists look for ways to defuse the struggle. The goal is to minimize resistance and allow the individual to stay in treatment and work toward building intrinsic motivation to change.

Support self-efficacy: In order to make a change, people need to believe that they are capable of achieving their goals. Motivational enhancement therapy helps people improve self-efficacy so that they can recognize their strengths and gain a greater belief in their own capabilities.

Application

• Stigma Reduction

• Alcohol use disorder

• Bipolar disorder

• Compulsive gambling

• Eating disorders

• Generalized anxiety disorder (GAD)

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)
  
  Both MIT and MET are widely used while treating the individuals with Alcohol Use Disorder but there are certain differences and it is explained as below:

	MIT (Motivational interviewing therapy)	MET (Motivational enhancement therapy)
Definition	Motivational Interviewing (MI) is a counseling approach designed to help individuals resolve ambivalence about their alcohol and/or drug use, and support efforts to change it.	Motivational enhancement therapy (MET) is a directive, person-centered approach to therapy that focuses on improving an individual’s motivation to change.
Process	In motivational interviewing (MI), therapists employ several strategies to help patients discover and cure their hesitancy or doubts about seeking help for their drug and alcohol addiction issues.	(MET) uses MI in a clinical style and comes with a personalized assessment, suggestions, and well-sorted plans.
Developed by	MI was originally developed by William R. Miller and Stephen Rollnick in the 1980s in order to aid people with substance use disorders. However, it has also been implemented to help aid in established models with mental disorders such as anxiety and depression.	MET is modified form of MI which was originally developed by William R. Miller and Stephen Rollnick in the 1980s.
	MIT has a broader therapeutic use.	It has a result-oriented approach combining the therapeutic style of MI.
Clients	MI works better on clients who are reluctant and defensive about their addiction but want to change.	MET uses techniques of MI combined with personalized assessment and feedback and works better with less interested patients.
Suggestions	In MI, Therapists are not allowed to give suggestions to patients without their Permission.	MET therapists employ a more direct way of suggesting what’s better for the patient, backed by clinically available data.
	MI uses traditional counseling skills such as listening, summarizing, and paraphrasing to show acceptance.	In MET, clinically relevant assessment data is summarized and put in front of the patient following the MI approach.