title: Under what conditions? Therapist and client characteristics moderate the role of change talk in brief motivational intervention.
abstract: OBJECTIVE
  Client change talk has been proposed as a mechanism of change in motivational interviewing (MI) by mediating the link between therapist MI-consistent behaviors (MICO) and client behavioral outcomes. We tested under what circumstances this mechanism was supported in the context of a clinical trial of brief MI for heavy drinking among nontreatment seeking young men.
  
  
  METHODS
  We conducted psycholinguistic coding of 174 sessions using the MI Skill Code 2.1 and derived the frequency of MICO and the strength of change talk (CTS) averaged over the session. CTS was examined as a mediator of the relationship between MICO and a drinking composite score measured at 3-month follow-up, controlling for the composite measure at baseline. Finally, we tested therapist gender and MI experience as well as client readiness to change and alcohol problem severity as moderators of this mediation model.
  
  
  RESULTS
  CTS significantly predicted outcome (higher strength related to less drinking), but MICO did not predict CTS. However, CTS mediated the relationship between MICO and drinking outcomes when therapists had more experience in MI and when clients had more severe alcohol problems (i.e., significant conditional indirect effects).
  
  
  CONCLUSIONS
  The mechanism hypothesized by MI theory was operative in our brief MI with heavy drinking young men, but only under particular conditions. Our results suggest that attention should be paid to therapist selection, training, and/or supervision until they reach a certain level of competence, and that MI might not be appropriate for nontreatment seeking clients drinking at a lower level of risk.
authors.affiliation: Center for Alcohol and Addiction Studies.
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaume
authors.affiliation: Center for Alcohol and Addiction Studies.
authors.forename: Richard
authors.initials: R
authors.lastname: Longabaugh
authors.affiliation: Center for Alcohol and Addiction Studies.
authors.forename: Molly
authors.initials: M
authors.lastname: Magill
authors.affiliation: Alcohol Treatment Centre.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bertholet
authors.affiliation: Alcohol Treatment Centre.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Gmel
authors.affiliation: Alcohol Treatment Centre.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Daeppen
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009042:Motivation; D062405:Motivational Interviewing / Q000379:methods*; D012737:Sex Factors; D019966:Substance-Related Disorders; D055815:Young Adult