Motivational Enhancement Team

 

Overview of the service  

The Motivational Enhancement Team provides a service to clients who are concerned about their use of drugs or alcohol. Each team comprises a registered nurse, who provides a service at a local hospital, and a community worker, who provides a service from community clinics. The team offer a series of brief motivational interventions to clients. These interventions are delivered in a stepped-care model. For instance, some people require only one brief motivational intervention to make a significant and long-lasting change. Others, with more complex needs, might require additional support, and so additional sessions are offered to clients according to their need. The service provides a maximum of four individual sessions and a group programme. Clients who require more support than the four sessions are directed to the appropriate services.

The Motivational Enhancement Team also provides a motivational intervention to clients who are entering inpatient detoxification. This service is provided to patients who are either in general hospitals or are clients of the Community Drug and Alcohol Services in the community.

Aims and Objectives  

The Motivational Enhancement Team has two aims. First, the service aims to engage clients who are at the early stages of their problematic use (e.g., those ambivalent about change) to consider change. Second, it aims to motivate clients who are at the later stages of their problematic use (e.g., those who often drop-out of treatment) to engage more fully with other services.

It achieves these aims by motivating clients to reduce or stop their use of substances in two ways. First, the interventions directly address the clients’ substance misuse (e.g., by asking them to consider the future consequences of their use and providing them with strategies to implement change). Second, the interventions address the impact of the clients’ substance misuse on their lifestyle (e.g., by highlighting the impact that their use has on achieving their future lifestyle goals and by assisting them to attain them).

The MET Service has been undergoing significant development and change over the last three years in response to client need as well as to take on board the latest research findings across Europe. It is only this year that CAIS is happy that we have a finalised product which is capable of being implemented flexibly to meet client need and to affect positive personal outcomes in a cost effective manner as part of a stepped care model.

Similarly original assumptions concerning implementation processes and surroundings have had to be revised e.g. long health waiting list of suitable clients that were to be targeted were no longer in evidence at the point of implantation and working in hospital settings and coping with professional boundary maintenance issues and other operational priorities by health staff has not proved to be helpful in generating referrals.

Unfortunately towards the end of 2004 Gwynedd & Mon SMAT’s decided to decommission the service. The four other SMAT’s in North Wales are monitoring the service closely. They have acknowledged that there is a significant increase year on year in referrals, and strenuous efforts are being made by CAIS to deliver the service effectively in sufficient quantity.

We are confident that we now have an extremely good product together with well trained and committed staff. Nevertheless, this service is one that will need to accelerate even quicker in the coming months if continuing support is to be secured by the SMAT’s into the future.

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