title: Influence of counselor characteristics and behaviors on the efficacy of a brief motivational intervention for heavy drinking in young men--a randomized controlled trial.
abstract: BACKGROUND
  Brief motivational intervention (BMI) has shown promising results to reduce alcohol use in young adults. Knowledge on mechanisms that predict BMI efficacy could potentially improve treatment effect sizes through data that optimize clinical training and implementation. Particularly, little attention has been given to counselor influence on treatment mechanisms.
  
  
  METHODS
  We investigated the influence of counselors on BMI efficacy in reducing alcohol use among non-treatment-seeking young men (age 20) screened as hazardous drinkers. Participants were randomly allocated to (i) a group receiving a single BMI from 1 of 18 counselors selected to maximize differences in several of their characteristics (gender, professional status, clinical experience, and motivational interviewing [MI] experience) or (ii) a control group receiving assessment only. Drinking at 3-month follow-up was first compared between the BMI and control groups to assess efficacy. Then, the influence of counselors' characteristics (i.e., gender, professional status, clinical experience, MI experience, BMI attitudes, and expectancies) and within-session behaviors (i.e., measured by the Motivational Interviewing Skill Code) on outcome was tested in regression analyses.
  
  
  RESULTS
  There was a significant (p = 0.02) decrease in alcohol use among the BMI group compared to the control group. Counselors that were male, more experienced, that had more favorable BMI attitudes and expectancies, higher MI skills, but surprisingly less MI-consistent behaviors, had significantly better outcomes than the control group while their counterparts did not.
  
  
  CONCLUSIONS
  The current study demonstrated BMI efficacy on alcohol use reduction within a sample of non-treatment-seeking young adult males. Moreover, BMI effect was related to interindividual differences among counselors, and results therefore provide recommendations for BMI training and implementation with similar populations.
authors: Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island; Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland.
authors: Jacques
authors: J
authors: Gaume
authors: Molly
authors: M
authors: Magill
authors: Richard
authors: R
authors: Longabaugh
authors: Nicolas
authors: N
authors: Bertholet
authors: Gerhard
authors: G
authors: Gmel
authors: Jean-Bernard
authors: JB
authors: Daeppen
mesh_terms: D000428:Alcohol Drinking / Q000523:psychology* / Q000628:therapy*; D002983:Clinical Competence; D003376:Counseling; D006801:Humans; D008297:Male; D062405:Motivational Interviewing; D011369:Professional-Patient Relations; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alcohol; Brief Motivational Intervention; Motivational Interviewing Skills; Therapist Effect; Young Adult