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Randomized Controlled Trial
. 2022 Jan:132:108642.
doi: 10.1016/j.jsat.2021.108642. Epub 2021 Oct 23.

What can clients tell us about whether to use motivational interviewing? An analysis of early-session ambivalent language

David P Forman  1 , Theresa B Moyers  2 , Jon M Houck  3
Affiliations
Randomized Controlled Trial

What can clients tell us about whether to use motivational interviewing? An analysis of early-session ambivalent language

David P Forman et al. J Subst Abuse Treat. 2022 Jan.

Abstract

Background: Although motivational interviewing (MI) is an effective method for promoting change in problematic alcohol and other drug use, it does not benefit all clients. Clinicians have little empirical guidance on who is likely to benefit from MI and who is not. We hypothesized that differences in clients' spontaneously offered language early in the session would predict their responsiveness to MI during the remainder of the session.

Method: The study obtained coding data from 125 counseling sessions from a large randomized controlled trial of clinician training. A cluster analysis created one group of clients whose language reflected ambivalence, and one group whose language reflected readiness to change. We conducted a univariate analysis of variance to compare the mean change in percent change talk across the session between groups.

Results: Clients whose language reflected ambivalence early in the session had a greater change in their percent change talk during the remainder of the session, compared to those whose language reflected greater readiness to change (F (1,90) = 63.02, t = 7.94, p < .001). Surprisingly, the group whose language reflected readiness had a decrease in their percent change talk during the remainder of the session (M = -10.9%, SD = 16.3%). Adjusting the results for regression to the mean effects did not eliminate these differences.

Conclusion: Clients' language early in the session may offer clinicians some guidance on whether MI is likely to be useful or counterproductive in the treatment of substance use disorder.

Keywords: Ambivalence; Change talk; Motivational interviewing; Substance use treatment.

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Figures

Figure 1.
Figure 1.
Between-group difference on Change in Percent Change Talk (C-PCT).
Figure 2.
Figure 2.
Change in clients’ speech from pre-evoking to evoking.
See this image and copyright information in PMC

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