title: In-session processes of brief motivational interventions in two trials with mandated college students.
abstract: OBJECTIVE
  Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, brief motivational interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and relational (e.g., global ratings of therapist empathy) components of BMIs influence client language as well as subsequent change in alcohol use and consequences.
  
  
  METHODS
  This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from 2 randomized clinical trials that facilitated significant reductions in alcohol use (Study 1, n = 91) and alcohol-related consequences (Study 2, n = 158) in mandated students.
  
  
  RESULTS
  There were significant relationships among therapist behaviors, global scores, and client language both for and against change, yet there were no links between in-session client language and subsequent changes in alcohol use or problems. In contrast, relational aspects of motivational interviewing (MI; global ratings of therapist MI Spirit and client self-exploration) were most predictive of postsession alcohol use. Mediation models incorporating both technical and relational components revealed that higher levels of client self-exploration mediated the relationship between higher therapist ratings of MI Spirit and reduced drinking at follow-up.
  
  
  CONCLUSIONS
  Findings highlight the importance of considering how both technical and relational components of MI may influence alcohol use in mandated college students and also suggest more exact analyses to better understand this complex relationship.
authors.affiliation: Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center.
authors.forename: Brian
authors.initials: B
authors.lastname: Borsari
authors.affiliation: Department of Pediatrics, Children's Mercy.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Apodaca
authors.affiliation: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Jackson
authors.affiliation: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University.
authors.forename: Nadine R
authors.initials: NR
authors.lastname: Mastroleo
authors.affiliation: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University.
authors.forename: Molly
authors.initials: M
authors.lastname: Magill
authors.affiliation: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Barnett
authors.affiliation: Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University.
authors.forename: Kate B
authors.initials: KB
authors.lastname: Carey
mesh_terms: D000328:Adult; D000067292:Alcohol Drinking in College / Q000523:psychology*; D019973:Alcohol-Related Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D037141:Mandatory Programs; D062405:Motivational Interviewing / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D013334:Students / Q000523:psychology*; D014495:Universities; D055815:Young Adult
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