From counselor skill to decreased marijuana use: Does change talk matter?

Barnett, Elizabeth; Moyers, Theresa B.; Sussman, Steve; Smith, Caitlin; Rohrbach, Louise Ann; Park, Sun; Spruijt‐Metz, Donna

doi:10.1016/j.jsat.2013.11.004

Cited by 54 publications

(50 citation statements)

References 34 publications

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“…05, I 2 = 44%). When two high effect, influential studies were removed (Barnett et al, 2014; Vader et al, 2010), the effect size for non-treatment seeking participants remained significant, small, but became homogeneous ( r = −.13; p < .001, k = 17, Q > .05). In summary, while both a and b path conditional process models resulted in noteworthy variance explained, a clinically-informative pattern of magnitude differences, by sub-group, was not observed.…”

Section: Resultsmentioning

confidence: 98%

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

252

163

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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.

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Section: Resultsmentioning

confidence: 98%

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

252

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, 2011) 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, et al, in press; Fischer & Moyers, 2014; Houck, Moyers, & Tesche, 2013). CACTI can be used for sequential coding using any mutually exclusive and exhaustive coding system, such as the MISC 2.5.…”

Section: Methodsmentioning

confidence: 99%

Group motivational interviewing for adolescents: Change talk and alcohol and marijuana outcomes.

D’Amico¹,

Houck²,

Hunter³

et al. 2015

Journal of Consulting and Clinical Psychology

159

130

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Objective Little is known about what may distinguish effective and ineffective group interventions. Group motivational interviewing (MI) is a promising intervention for adolescent alcohol and other drug (AOD) use; however, the mechanisms of change for group MI are unknown. One potential mechanism is change talk, which is client speech arguing for change. The present study describes the group process in adolescent group MI and effects of group-level change talk on individual alcohol and marijuana outcomes. Method We analyzed 129 group session audio recordings from a randomized clinical trial of adolescent group MI. Sequential coding was performed using the Motivational Interviewing Skill Code (MISC) and the CASAA Application for Coding Treatment Interactions (CACTI) software application. Outcomes included past-month intentions, frequency, and consequences of alcohol and marijuana use, motivation to change, and positive expectancies. Results Sequential analysis indicated that facilitator open-ended questions and reflections of change talk (CT) increased group CT. Group CT was then followed by more CT. Multilevel models accounting for rolling group enrollment revealed group CT was associated with decreased alcohol intentions, alcohol use and heavy drinking three months later; group sustain talk was associated with decreased motivation to change, increased intentions to use marijuana, and increased positive alcohol and marijuana expectancies. Conclusions Facilitator speech and peer responses each had effects on change and sustain talk in the group setting, which was then associated with individual changes. Selective reflection of CT in adolescent group MI is suggested as a strategy to manage group dynamics and increase behavioral change.

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“…When clients express CT about the target behavior, it often indicates their readiness to change, whereas clients who express ST are often more ambivalent about change. In fact, client CT has been posited as an active ingredient of successful MI interventions (Baer et al, 2008; Barnett et al, 2014; Moyers, Martin, Houck, Christopher, & Tonigan, 2009). …”

mentioning

confidence: 99%

How group factors affect adolescent change talk and substance use outcomes: Implications for motivational interviewing training.

Osilla¹,

Ortiz²,

Miles³

et al. 2015

Journal of Counseling Psychology

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Clients who verbalize statements arguing for change (change talk, CT) in psychotherapy are more likely to decrease alcohol and other drug use (AOD) compared to clients who voice statements in opposition of change (sustain talk, ST). Little is known about how CT and ST are expressed in groups where adolescents may vary in their AOD use severity and readiness to change. First, we examined how session content was associated with CT/ST, and then we looked at whether different subtypes of CT/ST were associated with subsequent AOD outcomes three months later. Audio recordings (N=129 sessions) of a 6-session group motivational interviewing (MI) intervention, Free Talk, were coded. Session content was not associated with CT; however, some session content was associated with higher percentages of ST (e.g., normative feedback). Subtypes of CT (Commitment and Reason) were associated with improved AOD outcomes, whereas Ability subtype remarks were related to increased marijuana use, intentions, and consequences. Findings offer helpful guidance for clinical training and narrow in on the type of CT to try to elicit in group MI sessions. Regardless of session content, adolescents can benefit from hearing CT during the group.

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From counselor skill to decreased marijuana use: Does change talk matter?

Cited by 54 publications

References 34 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 adolescents: Change talk and alcohol and marijuana outcomes.

How group factors affect adolescent change talk and substance use outcomes: Implications for motivational interviewing training.

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