Once you have established a strong base of motivation for change (Phase 1) and have obtained the client's commitment to change (Phase 2), MET focuses on follow-through. 

This may occur as early as the second session, depending upon the client's pace of progress.  Three processes are involved in follow-through: (1) reviewing progress, (2) renewing motivation, and (3) redoing commitment.  It is also in Phase 3 that the need for further treatment or referral is assessed.

Reviewing Progress

Begin a follow-through session with a review of what has happened since your last session. Discuss with the client what commitment and plans were made, and explore what progress the client has made toward these.  Respond with reflection, questioning, affirmation, and reframing, as before. Determine the extent to which previously established goals and plans have been implemented.

Renewing Motivation

The Phase 1 processes ("Building Motivation for Change") can be used again here to renew motivation for change.  The extent to which this is done will depend upon your judgment as to the client's current commitment to change.  This may be assessed by asking the client what he/she remembers as the most important reasons for making a change in drug use.

Redoing Commitment

The Phase 2 processes ("Consolidating Commitment to Change") can also be continued during follow-through.  This may simply be a reaffirmation of the commitment made earlier. 

If the client has encountered significant problems or doubts about the initial plan, however, this is a time for reevaluation, moving toward a new plan and commitment.  Seek to reinforce the client's sense of autonomy and self-efficacy, an ability to carry out self-chosen goals and plans.

Further Treatment

Through the motivational enhancement processes described above, the client may decide that he or she would like specific additional treatment to help in pursuing goals. 

The important Phase 3 task here is to clarify with the client what goals are to be achieved through such treatment, and then to determine what type of treatment services are mostly likely to be effective in meeting these goals.

[Within the CRAFT format it is acceptable for the therapist to continue to provide such additional treatment for up to a total (including MET) of 12 sessions. 

Referral to a range of community services is also possible, though their cost is not covered by this grant.]