Counsellor behaviours and patient language during brief motivational interventions: a sequential analysis of speech.
OBJECTIVE
To investigate empirically the hypothesized relationship between counsellor motivational interviewing (MI) skills and patient change talk (CT) by analysing the articulation between counsellor behaviours and patient language during brief motivational interventions (BMI) addressing at-risk alcohol consumption.


METHODS
Sequential analysis of psycholinguistic codes obtained by two independent raters using the Motivational Interviewing Skill Code (MISC), version 2.0.


METHODS
Secondary analysis of data from a randomized controlled trial evaluating the effectiveness of BMI in an emergency department.


METHODS
A total of 97 patients tape-recorded when receiving BMI.


METHODS
MISC variables were categorized into three counsellor behaviours (MI-consistent, MI-inconsistent and 'other') and three kinds of patient language (CT, counter-CT (CCT) and utterances not linked with the alcohol topic). Observed transition frequencies, conditional probabilities and significance levels based on odds ratios were computed using sequential analysis software.


RESULTS
MI-consistent behaviours were the only counsellor behaviours that were significantly more likely to be followed by patient CT. Those behaviours were significantly more likely to be followed by patient change exploration (CT and CCT) while MI-inconsistent behaviours and 'other' counsellor behaviours were significantly more likely to be followed by utterances not linked with the alcohol topic and significantly less likely to be followed by CT. MI-consistent behaviours were more likely after change exploration, whereas 'other' counsellor behaviours were more likely only after utterances not linked with the alcohol topic.


CONCLUSIONS
Findings lend support to the hypothesized relationship between MI-consistent behaviours and CT, highlight the importance of patient influence on counsellor behaviour and emphasize the usefulness of MI techniques and spirit during brief interventions targeting change enhancement.
Gaume
Jacques
J
Alcohol Treatment Centre, Lausanne University Hospital, Mont-Paisible, Lausanne, Switzerland. jacques.gaume@chuv.ch
Gmel
Gerhard
G
Faouzi
Mohamed
M
Daeppen
Jean-Bernard
JB
D000428:Alcohol Drinking / Q000517:prevention & control*; D003142:Communication; D003376:Counseling / Q000379:methods; D004636:Emergency Service, Hospital; D006801:Humans; D007406:Interview, Psychological; D007802:Language; D009042:Motivation; D011369:Professional-Patient Relations; D011578:Psycholinguistics; D011614:Psychotherapy, Brief; D015203:Reproducibility of Results; D012307:Risk Factors; D013557:Switzerland; D014705:Verbal Behavior