Short- and Long-Term Effects of Within-Session Client Speech on Drinking Outcomes in the COMBINE Study

There is evidence of a causal chain in motivational interviewing (MI) involving counselor MI-consistent skills, client change language, and outcomes. MI was a key component of the combined behavioral intervention in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (...

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Bibliographic Details
Published in:Journal of studies on alcohol and drugs Vol. 79; no. 2; p. 217
Main Authors: Houck, Jon M, Manuel, Jennifer K, Moyers, Theresa B
Format: Journal Article
Language:English
Published: United States 01.03.2018
Subjects:
Adult
Alcohol Drinking - therapy
Alcoholism - psychology
Alcoholism - therapy
Behavior Therapy
Female
Humans
Male
Middle Aged
Motivational Interviewing - methods
Negotiating
Outcome Assessment, Health Care
ISSN:1938-4114, 1938-4114
Online Access:Get more information
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Summary:There is evidence of a causal chain in motivational interviewing (MI) involving counselor MI-consistent skills, client change language, and outcomes. MI was a key component of the combined behavioral intervention in the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) Study. Participants in COMBINE were treatment-seeking and medication-seeking, and were required to maintain a period of abstinence before enrollment. Counselors were closely monitored and were temporarily removed from the study for remediation and supervision if their performance fell below threshold. The purpose of this study was to evaluate the MI causal chain among initial-session combined behavioral intervention audio recordings in this unique sample of highly motivated clients and highly monitored counselors. Session 1 audio recordings (N = 254, 73.5% men) were evaluated using the Motivational Interviewing Skill Code Version 2.0 with good interrater reliability. Counselor speech was measured using a summary measure of MI-consistent behavior. Client change language was assessed, using change talk and sustain talk. The outcome measure of drinks per week was computed using the COMBINE data set. Higher sustain talk was significantly associated with increased drinking during treatment, whereas higher change talk was significantly associated with decreased drinking at the 1-year follow-up. In addition, there were significant indirect effects linking counselor behavior, client speech, and drinking both during treatment and at 1 year. Results supported the posited causal chain for MI. Despite somewhat lower variability of counselor behavior and use of a coding instrument that did not capture directional counselor behaviors, counselor behavior, client speech, and drinking outcomes were clearly linked in this unique sample.
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ISSN:1938-4114
1938-4114
DOI:10.15288/jsad.2018.79.217