title: Which Individual Therapist Behaviors Elicit Client Change Talk and Sustain Talk in Motivational Interviewing?
abstract: OBJECTIVE
  To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions.
  
  
  METHODS
  Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral).
  
  
  RESULTS
  Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (p<.001), simple reflection (p<.001), and complex reflection (p<.001)], but significantly less likely to immediately follow others (giving information (p<.001) and closed question (p<.001)]. Sustain talk was significantly more likely to follow therapist use of open questions (p<.001), simple reflections (p<.001), and complex reflections (p<.001), and significantly less likely to occur following therapist use of therapist affirm (p=.012), giving information (p<.001), and closed questions (p<.001).
  
  
  CONCLUSIONS
  Certain individual therapist behaviors within motivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk.
authors.affiliation: Children's Mercy Kansas City, Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Rd., Kansas City, Missouri, 64108. Electronic address: trapodaca@cmh.edu.
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, Box G-S121-4, Providence, RI, 02912.
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, Box G-S121-4, Providence, RI, 02912; Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, 830 Chalkstone Avenue, Providence, RI, 02908.
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, Box G-S121-4, Providence, RI, 02912.
authors.forename: Molly
authors.initials: M
authors.lastname: Magill
authors.affiliation: Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI, 02912.
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, Box G-S121-4, Providence, RI, 02912.
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, Box G-S121-4, Providence, RI, 02912.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Barnett
mesh_terms: D000428:Alcohol Drinking / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007802:Language; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D011369:Professional-Patient Relations; D014495:Universities
keywords: Alcohol use; Brief intervention; Change language; Motivational interviewing; Therapy process