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Motivational Enhancement Therapy and Cognitive Behavioral Therapy for Adolescent Cannabis Users: 5 Sessions

MET/CB5 Treatment

Overview of MET/CBT5 Protocol

The MET/CBT5 treatment, a brief treatment approach for adolescents with cannabis use disorders, consists of two individual motivational enhancement therapy (MET) sessions, followed by three group cognitive behavioral therapy (CBT) sessions. The two initial individual MET sessions are primarily intended to enhance adolescents’ motivation to address their marijuana use and to prepare the clients for the group sessions, with an introduction to functional analysis and the concept of triggers. The purpose of the three group sessions is to assist clients in the development of skills useful for stopping or reducing marijuana use. The CBT sessions focus on the following skills:

• Learning basic skills for refusing offers of marijuana
• Developing a plan for pleasant drug-free activities
• Establishing a social network that will support recovery
• Coping with high-risk situations
• Recovering from a relapse, should one occur.

The table below illustrates the sequence of the five sessions of the MET/CBT5 treatment. Note that the first two (individual) sessions are expected to last for 60 minutes. The final three (group) sessions are scheduled to run for 75 minutes.

Sequence of MET/CBT5 Treatment

While the first two sessions proceed primarily from a motivational enhancement therapy plan, and the remaining three sessions focus primarily on cognitive-behavioral interventions, it is expected that there will be some overlap of each of these approaches in all five sessions. For example, it is expected that therapists will make effective use of MET interventions, to some extent, across all five treatment sessions.

The establishment of rapport between the therapist and the adolescent clients is essential. The therapist facilitates this rapport by expressing a genuine interest in and nonjudgmental reactions to the adolescents’ viewpoints. Therapists are encouraged to use language both familiar and similar to that of the clients. In general, it is recommended that therapists work in accordance with the MET approach across all five treat-ment sessions, including the three CBT-focused group sessions. The MET approach will be described in detail in the next section.

Therapists are encouraged to draw from their MET skills throughout all five sessions for two important reasons. First, many clients will remain ambivalent about abstinence from marijuana beyond the two planned MET sessions. If the therapist continues to utilize motivation-enhancing reflections and comments, clients will have a greater likelihood of developing motivation to quit smoking marijuana. Second, the MET style of intervention is recommended because it helps avoid the potential authoritar-ian power struggle of an adult therapist telling adolescent clients what they “must” do. Utilization of the MET style of intervention maximizes the chance for a collaborative therapist-client dialog.

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