The route to change: within-session predictors of change plan completion in a motivational interview.
This study is the first to examine within-session therapist and client language/process predictors of a client's decision to complete a written Change Plan in an alcohol-focused motivational interview (MI). Data were from an ongoing hospital-based clinical trial (N = 291). Trained raters coded audiorecorded MI sessions using the Motivational Interviewing Skill Code. Logistic regression analyses found that therapist MI-consistent behaviors (b = .023, p < .001) and client change talk (b = .063, p < .001) were positive predictors, and client counter change talk (b = -.093, p < .001) was a negative predictor of the decision to complete a Change Plan regarding alcohol use. Mean comparisons showed that compared to noncompletion, Change Plan completion did not result in significantly greater changes in client motivational readiness. Completion of a Change Plan is a proximal outcome in MI that is associated with client intention to change (change talk) and may predict follow-up alcohol outcomes. Analyses of such theory-driven proximal client mechanisms provide a more complete model of MI process and may inform MI providers of necessary treatment ingredients.
Magill
Molly
M
Brown University, Center for Alcohol and Addiction Studies, Providence, RI 02912, USA. molly_magill@brown.edu
Apodaca
Timothy R
TR
Barnett
Nancy P
NP
Monti
Peter M
PM
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D003376:Counseling / Q000379:methods*; D003657:Decision Making; D004636:Emergency Service, Hospital; D005260:Female; D006040:Goals; D006801:Humans; D033182:Intention; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011369:Professional-Patient Relations; D012944:Social Support; D013695:Temperance / Q000523:psychology*