Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles.
To investigate the impact of counselor style, a 2-session motivational checkup was offered to 42 problem drinkers (18 women and 24 men) who were randomly assigned to 3 groups: (a) immediate checkup with directive-confrontational counseling, (b) immediate checkup with client-centered counseling, or (c) delayed checkup (waiting-list control). Overall, the intervention resulted in a 57% reduction in drinking within 6 weeks, which was maintained at 1 year. Clients receiving immediate checkup showed significant reduction in drinking relative to controls. The 2 counseling styles were discriminable on therapist behaviors coded from audiotapes. The directive-confrontational style yielded significantly more resistance from clients, which in turn predicted poorer outcomes at 1 year. Therapist styles did not differ in overall impact on drinking, but a single therapist behavior was predictive (r = .65) of 1-year outcome such that the more the therapist confronted, the more the client drank.
Miller
W R
WR
Department of Psychology, University of New Mexico, Albuquerque 87131-1161.
Benefield
R G
RG
Tonigan
J S
JS
D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D004311:Double-Blind Method; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology; D009629:Person-Centered Psychotherapy / Q000379:methods; D011613:Psychotherapy / Q000379:methods*