title: Sustain talk predicts poorer outcomes among mandated college student drinkers receiving a brief motivational intervention.
abstract: Within-session client language that represents a movement toward behavior change (change talk) has been linked to better treatment outcomes in the literature on motivational interviewing (MI). There has been somewhat less study of the impact of client language against change (sustain talk) on outcomes following an MI session. This study examined the role of both client change talk and sustain talk, as well as therapist language, occurring during a brief motivational intervention (BMI) session with college students who had violated college alcohol policy (N = 92). Audiotapes of these sessions were coded using a therapy process coding system. A series of hierarchical regressions were used to examine the relationships among therapist MI-consistent and MI-inconsistent language, client change talk and sustain talk, as well as global measures of relational variables, and drinking outcomes. Contrary to prior research, sustain talk, but not change talk, predicted poorer alcohol use outcomes following the BMI at 3- and 12-month follow-up assessments. Higher levels of client self-exploration during the session also predicted improved drinking outcomes. Therapist measures of MI-consistent and MI-inconsistent language, and global measures of therapist acceptance and MI spirit were unrelated to client drinking outcomes. Results suggest that client sustain talk and self-exploration during the session play an important role in determining drinking outcomes among mandated college students receiving a BMI addressing alcohol use.
authors.affiliation: Children's Mercy Kansas City.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Apodaca
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 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: Molly
authors.initials: M
authors.lastname: Magill
authors.affiliation: Department of Psychiatry and Human Behavior, Brown University.
authors.forename: Richard
authors.initials: R
authors.lastname: Longabaugh
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: Nancy P
authors.initials: NP
authors.lastname: Barnett
mesh_terms: D000428:Alcohol Drinking / Q000628:therapy*; D000067292:Alcohol Drinking in College; D001294:Attitude to Health; D003376:Counseling / Q000379:methods; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D037141:Mandatory Programs; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D013811:Psychotherapeutic Processes; D012044:Regression Analysis; D013060:Speech; D013334:Students; D016896:Treatment Outcome; D014495:Universities; D055815:Young Adult