A sequential analysis of motivational interviewing technical skills and client responses

Content Provider	Scilit
Author	Laws, M. Barton Magill, Molly Mastroleo, Nadine R. Gamarel, Kristi E. Howe, Chanelle J. Walthers, Justin Monti, Peter M. Souza, Timothy Wilson, Ira B. Rose, Gary S. Kahler, Christopher W.
Copyright Year	2018
Description	Journal: Journal of substance abuse treatment Background The technical hypothesis of Motivational Interviewing (MI) proposes that: (a) client talk favoring behavior change, or Change Talk (CT) is associated with better behavior change outcomes, whereas client talk against change, or Sustain Talk (ST) is associated with less favorable outcomes, and (b) specific therapist verbal behaviors influence whether client CT or ST occurs. MI consistent (MICO) therapist behaviors are hypothesized to be positively associated with more client CT and MI inconsistent (MIIN) behaviors with more ST. Previous studies typically examine session-level frequency counts or immediate lag sequential associations between these variables. However, research has found that the strongest determinant of CT or ST is the client's previous CT or ST statement. Therefore, the objective of this paper was to examine the association between therapist MI skills and subsequent client talk, while accounting for prior client talk. Methods We analyzed data from a manualized MI intervention targeting both alcohol misuse and sexual risk behavior in 132 adults seen in two hospital emergency departments. Transcripts of encounters were coded using the Motivational Interviewing Skills Code (MISC 2.5) and an additional measure, the Generalized Behavioral Intervention Analysis System (GBIAS). Using these measures, we analyzed the association between client talk following specific classifications of MICO skills, with the client's prior statement as a potential confounder or effect modifier. Results With closed questions as the reference category, therapist simple reflections and paraphrasing reflections were associated with significantly greater odds of maintaining client talk as CT or ST. Open questions and complex reflections were associated with significantly greater odds of CT following ST, were not associated significantly with more ST following ST, and were associated with more ST following CT (i.e., through an association with less Follow Neutral). Conclusions Simple and paraphrasing reflections appear to maintain client CT but are not associated with transitioning client ST to CT. By contrast, complex reflections and open questions appeared to be more strongly associated with clients moving from ST to CT than other techniques. These results suggest that counselors may differentially employ certain MICO technical skills to elicit continued CT and move participants toward ST within the MI dialogue.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250061/pdf http://www.journalofsubstanceabusetreatment.com/article/S0740547217304178/pdf
Ending Page	34
Page Count	8
Starting Page	27
ISSN	07405472
e-ISSN	18736483
DOI	10.1016/j.jsat.2018.06.006
Journal	Journal of substance abuse treatment
Volume Number	92
Language	English
Publisher	Elsevier BV
Publisher Date	2018-06-18
Access Restriction	Open
Subject Keyword	Journal: Journal of substance abuse treatment Clinical Psychology Substance Abuse Change Talk Motivational Interviewing Sequential Analysis Mi Technical Skills Sustain Talk
Content Type	Text
Resource Type	Article
Subject	Clinical Psychology Psychiatry and Mental Health