Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Dec;82(6):973-83.
doi: 10.1037/a0036833. Epub 2014 May 19.

The technical hypothesis of motivational interviewing: a meta-analysis of MI's key causal model

Molly Magill  1 , Jacques Gaume  1 , Timothy R Apodaca  2 , Justin Walthers  1 , Nadine R Mastroleo  1 , Brian Borsari  1 , Richard Longabaugh  3
Affiliations
Meta-Analysis

The technical hypothesis of motivational interviewing: a meta-analysis of MI's key causal model

Molly Magill et al. J Consult Clin Psychol. 2014 Dec.

Abstract

Objective: The technical hypothesis of motivational interviewing (MI) posits that therapist-implemented MI skills are related to client speech regarding behavior change and that client speech predicts client outcome. The current meta-analysis is the first aggregate test of this proposed causal model.

Method: A systematic literature review, using stringent inclusion criteria, identified 16 reports describing 12 primary studies. We used review methods to calculate the inverse-variance-weighted pooled correlation coefficient for the therapist-to-client and the client-to-outcome paths across multiple targeted behaviors (i.e., alcohol or illicit drug use, other addictive behaviors).

Results: Therapist MI-consistent skills were correlated with more client language in favor of behavior change (i.e., change talk; r = .26, p < .0001), but not less client language against behavior change (i.e., sustain talk; r = .10, p = .09). MI-inconsistent skills were associated with less change talk (r = -.17, p = .001) as well as more sustain talk (r = .07, p = .009). Among these studies, client change talk was not associated with follow-up outcome (r = .06, p = .41), but sustain talk was associated with worse outcome (r = -.24, p = .001). In addition, studies examining composite client language (e.g., an average of negative and positive statements) showed an overall positive relationship with client behavior change (r = .12, p = .006; k = 6).

Conclusions: This meta-analysis provides an initial test and partial support for a key causal model of MI efficacy. Recommendations for MI practitioners, clinical supervisors, and process researchers are provided.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest associated with this manuscript.

Figures

Figure 1
Figure 1
Flow of primary study inclusion Notes. K/k is defined as number of groups. aGlynn & Moyers, 2010; Morgenstern et al, 2013. bDeappen et al., 2010; Strang & McCambridge, 2004. cKarno et al., 2010; Moyers et al., 2007; Walker et al., 2011. dc path studies examined the effect of MI-Consistent or Inconsistent Skills on patient outcome (Gaume et al., 2009; McCambridge et al., 2011; Tollison et al., 2008/2010). eThese studies examined the effect of MI training on technical skill acquisition. fApodaca et al., 2013; Miller et al., 1993; Morgenstern et al., 2013. A total of 16 published reports tested the a and/or b paths for 12 clinical trials.
Figure 2
Figure 2
Meta-analytic results on the Technical Hypothesis of MI efficacy Notes. *** p < .001; ** p < .005; * p < .05 †p < .10.
See this image and copyright information in PMC

References

    1. Amrhein PC. How does motivational interviewing work? What client talk reveals. Journal of Cognitive Psychotherapy. 2004;18(4):323–336. doi: 10.1891/jcop.18.4.323.64001. - DOI
    1. Amrhein PC, Miller WR, Yahne C, Palmer M, Fulcher L. Client commitment language during motivational interviewing predicts drug use outcomes. Journal of Consulting and Clinical Psychology. 2003;71(5):862–878. - PubMed
    1. Apodaca T, Longabaugh R. Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence. Addiction. 2009;104(5):705–715. - PMC - PubMed
    1. Apodaca TR, Magill M, Longabaugh R, Jackson KM, Monti PM. Effect of a significant other on client change talk in motivational interviewing. Journal of Consulting and Clinical Psychology. 2013;81(1):35–46. doi: 10.1037/a0030881.. - DOI - PMC - PubMed
    1. Arkowitz H, Miller WR, Westra HA, Rollnick S. Motivational Interviewing in the treatment of psychological problems: Conclusions and future directions. In: Arkowitz H, Westra HA, Miller WR, Rollnick S, editors. Motivational Interviewing in the Treatment of Psychological Problems. Ch 13. Guilford; New York: 2008. pp. 324–41.

Publication types