A randomized controlled trial to influence client language in substance use disorder treatment

Moyers, Theresa B.; Houck, Jon M.; Glynn, Lisa H.; Hallgren, Kevin A.; Manuel, Jennifer K.

doi:10.1016/j.drugalcdep.2016.11.036

Cited by 26 publications

(26 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rather, the task for MI theory and future research is to consider the population-based factors that might drive the relative roles of change talk versus sustain talk versus the balance of change and sustain talk (i.e., proportion change talk) within MI process. Likely, there are certain client- or outcome-based factors that predict where each indicator takes precedence as a mechanism of behavior change (Moyers, Houck, Glynn, Hallgren, & Manual, 2017). For example, is sustain talk more relevant to younger clients and change talk more relevant to older clients who have accrued more use-related consequences?…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

Magill¹,

Apodaca²,

Borsari³

et al. 2018

Journal of Consulting and Clinical Psychology

251

163

View full text Add to dashboard Cite

Objective In the present meta-analysis, we test the technical and relational hypotheses of Motivational Interviewing (MI) efficacy. We also propose an a priori conditional process model where heterogeneity of technical path effect sizes should be explained by interpersonal/relational (i.e., empathy, MI Spirit) and intrapersonal (i.e., client treatment seeking status) moderators. Method A systematic review identified k = 58 reports, describing 36 primary studies and 40 effect sizes (N = 3025 participants). Statistical methods calculated the inverse variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple target behaviors (i.e., alcohol use, other drug use, other behavior change). Results Therapist MI-consistent skills were correlated with more client change talk (r = .55, p < .001) as well as more sustain talk (r = .40, p < .001). MI-inconsistent skills were correlated with more sustain talk (r = .16, p < .001), but not change talk. When these indicators were combined into proportions, as recommended in the Motivational Interviewing Skill Code, the overall technical hypothesis was supported. Specifically, proportion MI consistency was related to higher proportion change talk (r = .11, p = .004) and higher proportion change talk was related to reductions in risk behavior at follow up (r = −.16, p < .001). When tested as two independent effects, client change talk was not significant, but sustain talk was positively associated with worse outcome (r = .19, p < .001). Finally, the relational hypothesis was not supported, but heterogeneity in technical hypothesis path effect sizes was partially explained by inter- and intra-personal moderators. Conclusions This meta-analysis provides additional support for the technical hypothesis of MI efficacy; future research on the relational hypothesis should occur in the field rather than in the context of clinical trials.

show abstract

Section: Discussionmentioning

confidence: 99%

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

Magill¹,

Apodaca²,

Borsari³

et al. 2018

Journal of Consulting and Clinical Psychology

251

163

View full text Add to dashboard Cite

show abstract

“…CACTI was developed as part of a large MI training study (Moyers, Houck, Glynn, Manuel, & Hallgren, 2017) in order to permit sequential coding of digital audio files without the use of transcripts. It has since been applied successfully in several other studies (Barnett, Moyers, et al, 2014; Fischer & Moyers, 2014; Houck, Moyers, & Tesche, 2013).…”

Section: Methodsmentioning

confidence: 99%

Group motivational interviewing for homeless young adults: Associations of change talk with substance use and sexual risk behavior.

D’Amico¹,

Tucker²,

Ewing³

et al. 2017

Psychology of Addictive Behaviors

View full text Add to dashboard Cite

Homeless young adults exhibit high rates of alcohol and other drug (AOD) use and sexual risk behaviors. This study is a secondary analysis of data collected in a randomized clinical trial of AWARE, a new four session group motivational interviewing intervention. AWARE mainly focused on alcohol use and sexual risk behavior given focus group feedback. We used sequential coding to analyze how the group process affected both AOD use and sexual risk behavior at three month follow up among homeless young adults by examining facilitator behavior and participant change talk (CT) and sustain talk (ST). We analyzed 57 group session digital recordings of 100 youth (69% male, 74% heterosexual, 28% non-Hispanic white, 23% African American, 26% Hispanic, 23% multiracial/other; mean age 21.75). Outcomes included importance and readiness to change AOD use and risky sexual behavior, AOD use and consequences, number of partners and unprotected sex, and condom self-efficacy.. Sequential analysis indicated that facilitator open-ended questions and reflections of CT increased group CT. Group CT was associated with a lower likelihood of being a heavy drinker three months later; group ST was associated with decreased readiness and confidence to change alcohol use. There were no associations with CT or ST for drug use or risky sexual behavior. Facilitator speech and peer responses were related to CT and ST during the group sessions with this high risk population, which were then associated with individual changes for alcohol use. Further research is needed to explore associations with drug use sexual risk behavior.

show abstract

“…MI adherence often varies considerably across different sessions administered by the same provider (Dunn et al, 2016; Imel, Baer, Martino, Ball, & Carroll, 2011), which may be due in part to mutual influence between provider behaviors and patients. For example, while provider adherence can influence clients’ within-session behavior (Moyers, Houck, Glynn, Hallgren, & Manuel, 2017), client characteristics, such as severity of substance use, motivation for change, or interpersonal aggressiveness can influence provider adherence (Boswell et al, 2013; Imel et al, 2011).…”

Section: Factors Influencing MI Adherencementioning

confidence: 99%

Variability in motivational interviewing adherence across sessions, providers, sites, and research contexts

Hallgren

Dembe

Pace

et al. 2018

Journal of Substance Abuse Treatment

Self Cite

View full text Add to dashboard Cite

Providers' adherence in the delivery of behavioral interventions for substance use disorders is not fixed, but instead can vary across sessions, providers, and intervention sites. This variability can substantially impact the quality of intervention that clients receive. However, there has been limited work to systematically evaluate the extent to which substance use intervention adherence varies from session-to-session, provider-to-provider, and site-to-site. The present study quantifies the extent to which adherence to Motivational Interviewing (MI) for alcohol and drug use varies across sessions, providers, and intervention sites and compares the extent of this variability across three common MI research contexts that evaluate MI efficacy, MI effectiveness, and MI training. Independent raters coded intervention adherence to MI from 1275 sessions delivered by 216 providers at 15 intervention sites. Multilevel models indicated that 57%-94% of the variance in MI adherence was attributable to variability between sessions (i.e., within providers), while smaller proportions of variance were attributable to variability between providers (3%-26%) and between intervention sites (0.1%-28%). MI adherence was typically lowest and most variable within contexts evaluating MI training (i.e., where MI was not protocol-guided and delivered by community treatment providers) and, conversely, adherence was typically highest and least variable in contexts evaluating MI efficacy and effectiveness (i.e., where MI was highly protocolized and delivered by trained therapists). These results suggest that MI adherence in efficacy and effectiveness trials may be substantially different from that obtained in community treatment settings, where adherence is likely to be far more heterogeneous.

show abstract

A randomized controlled trial to influence client language in substance use disorder treatment

Cited by 26 publications

References 31 publications

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

Group motivational interviewing for homeless young adults: Associations of change talk with substance use and sexual risk behavior.

Variability in motivational interviewing adherence across sessions, providers, sites, and research contexts

Contact Info

Product

Resources

About