title: Ambivalence: Prerequisite for success in motivational interviewing with adolescents?
abstract: The exploration and resolution of ambivalence play an essential role in motivational interviewing (MI) theory. However, most adolescent MI studies have not examined ambivalence as a contributor to behaviour change. This paper reviewed research findings on the role of ambivalence in the adolescent change process.
  
  
  
  We undertook a narrative review of the published empirical and theoretical literature on ambivalence and mechanisms of change in MI for adolescents and found that current MI evaluations appear not to have access to reliable and valid measures of ambivalence in adolescence or neuroimaging methods to evaluate the mechanisms of treatment response.
  
  
  
  Improved instrumentation is needed to assess adolescents' ambivalence in clinical and research settings. Innovative methodology, including neuroimaging, may help identify factors mediating relationships between adolescents' ambivalence and treatment response.
authors.affiliation: Oregon Health & Science University, Department of Child & Adolescent Psychiatry, Portland, OR, USA. feldstei@ohsu.edu.
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Feldstein Ewing
authors.affiliation: Children's Mercy Kansas City, Kansas City, MO, USA.|University of Missouri-Kansas City School of Medicine, Department of Pediatrics, Kansas City, MO, USA.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Apodaca
authors.affiliation: Lausanne University Hospital, Department of Community Health and Medicine, Alcohol Treatment Center, Lausanne, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Gaume
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D003657:Decision Making; D006801:Humans; D062405:Motivational Interviewing; D059906:Neuroimaging / Q000379:methods; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation
keywords: Adolescents; ambivalence; brain; developmental; innovative approaches; measurement; motivational interviewing; neuroimaging; substance use
references.citation: Psychol Addict Behav. 2014 Dec;28(4):1212-9
references.pmid: 24955660
references.citation: JAMA. 2010 Aug 4;304(5):527-35
references.pmid: 20682932
references.citation: JAMA. 2006 May 3;295(17):2003-17
references.pmid: 16670409
references.citation: BMJ. 2005 Sep 10;331(7516):541
references.pmid: 16150764
references.citation: Addiction. 2010 Dec;105(12):2106-12
references.pmid: 20840175
references.citation: J Adolesc Health. 2015 Mar;56(3):323-9
references.pmid: 25586227
references.citation: Psychol Addict Behav. 2015 Sep;29(3):779-86
references.pmid: 25961144
references.citation: Am Psychol. 1990 May;45(5):612-30
references.pmid: 2350080
references.citation: Behav Cogn Psychother. 2015 Mar;43(2):129-41
references.pmid: 24229732
references.citation: Addict Behav. 2015 Mar 12;46:113-120
references.pmid: 25863581
references.citation: Behav Cogn Psychother. 2009 Mar;37(2):129-40
references.pmid: 19364414
references.citation: J Consult Clin Psychol. 2014 Dec;82(6):973-83
references.pmid: 24841862
references.citation: Psychol Addict Behav. 2013 Jun;27(2):510-25
references.pmid: 22925010
references.citation: Annu Rev Clin Psychol. 2005;1:91-111
references.pmid: 17716083
references.citation: J Adolesc Health. 2015 Aug;57(2):179-85
references.pmid: 26115908
references.citation: J Consult Clin Psychol. 2015 Feb;83(1):56-67
references.pmid: 25111429
references.citation: Psychol Addict Behav. 2005 Mar;19(1):79-87
references.pmid: 15783281
references.citation: Addiction. 2014 Jun;109(6):894-903
references.pmid: 24467265
references.citation: J Subst Abuse Treat. 2007 Mar;32(2):153-65
references.pmid: 17306724
references.citation: N Engl J Med. 2015 Feb 26;372(9):793-5
references.pmid: 25635347
references.citation: Alcohol Clin Exp Res. 2014 Mar;38(3):853-9
references.pmid: 24125097
references.citation: Am J Health Promot. 1997 Sep-Oct;12(1):38-48
references.pmid: 10170434
references.citation: Natl Vital Stat Rep. 2013 Dec 20;62(6):1-96
references.pmid: 24364902
references.citation: J Consult Clin Psychol. 2014 Dec;82(6):1212-8
references.pmid: 24841861
references.citation: Br J Addict. 1992 May;87(5):743-54
references.pmid: 1591525
references.citation: Psychol Addict Behav. 2006 Sep;20(3):254-64
references.pmid: 16938063
references.citation: Am J Drug Alcohol Abuse. 2014 May;40(3):213-24
references.pmid: 24766088
references.citation: Am J Drug Alcohol Abuse. 2007;33(5):737-46
references.pmid: 17891666
references.citation: J Subst Abuse Treat. 2004 Oct;27(3):197-213
references.pmid: 15501373
references.citation: Can J Psychiatry. 2011 Nov;56(11):641-2
references.pmid: 22114917
references.citation: J Subst Abuse Treat. 2012 Sep;43(2):190-203
references.pmid: 22301086
references.citation: Psychiatry Res. 2013 Sep 30;213(3):202-9
references.pmid: 23838052
references.citation: Addict Behav. 2011 Jul;36(7):749-54
references.pmid: 21440994
references.citation: Alcohol Clin Exp Res. 2014 Apr;38(4):1068-77
references.pmid: 24428196
references.citation: Addict Behav. 2013 Feb;38(2):1541-9
references.pmid: 22483100
references.citation: Drug Alcohol Depend. 2011 Nov 1;118(2-3):475-8
references.pmid: 21531089
references.citation: J Cogn Neurosci. 2004 Dec;16(10):1717-29
references.pmid: 15701224
references.citation: J Consult Clin Psychol. 2015 Feb;83(1):68-80
references.pmid: 25365779
references.citation: Alcohol Alcohol. 2015 May;50(3):352-7
references.pmid: 25681463
references.citation: J Subst Abuse Treat. 2005 Jan;28(1):19-26
references.pmid: 15723728
references.citation: Soc Cogn Affect Neurosci. 2015 Jul;10(7):987-93
references.pmid: 25398434
references.citation: Psychol Addict Behav. 2014 Mar;28(1):307-12
references.pmid: 24467198
references.citation: J Subst Abuse Treat. 2006 Apr;30(3):245-51
references.pmid: 16616169
references.citation: Psychol Addict Behav. 2008 Dec;22(4):587-91
references.pmid: 19071986
references.citation: Psychotherapy (Chic). 2014 Sep;51(3):358-63
references.pmid: 25068193
references.citation: Psychol Addict Behav. 2008 Dec;22(4):570-5
references.pmid: 19071983
references.citation: Drug Alcohol Depend. 2011 Jun 1;115(3):229-36
references.pmid: 21227601
references.citation: J Addict Med. 2014 Sep-Oct;8(5):359-67
references.pmid: 25100311
references.citation: Arch Pediatr Adolesc Med. 2011 Mar;165(3):269-74
references.pmid: 21383276
references.citation: Addict Behav. 2014 Dec;39(12):1904-10
references.pmid: 25150658
references.citation: Psychol Addict Behav. 2013 Jun;27(2):329-35
references.pmid: 23815447
references.citation: Subst Abus. 2014;35(4):344-51
references.pmid: 24901750
references.citation: Front Psychiatry. 2014 Aug 26;5:108
references.pmid: 25206342
references.citation: Addiction. 2009 May;104(5):705-15
references.pmid: 19413785
references.citation: J Consult Clin Psychol. 2014 Jun;82(3):521-35
references.pmid: 24547922
references.citation: Am Psychol. 2009 Sep;64(6):527-37
references.pmid: 19739882
references.citation: J Consult Clin Psychol. 2011 Aug;79(4):433-40
references.pmid: 21728400
references.citation: J Adolesc Health. 2012 Aug;51(2):101-5
references.pmid: 22824439
references.citation: Psychol Addict Behav. 2007 Dec;21(4):582-6
references.pmid: 18072842
references.citation: Alcohol Clin Exp Res. 2007 Oct;31(10 Suppl):40s-47s
references.pmid: 17880345
references.citation: Soc Cogn Affect Neurosci. 2014 Jul;9(7):924-31
references.pmid: 23685774
references.citation: J Stud Alcohol. 1997 Jan;58(1):7-29
references.pmid: 8979210
references.citation: Alcohol Clin Exp Res. 2015 Mar;39(3):496-503
references.pmid: 25703135
references.citation: J Subst Abuse Treat. 2014 Apr;46(4):498-505
references.pmid: 24462244
references.citation: Addiction. 2015 Mar;110(3):401-13
references.pmid: 25066309
references.citation: Psychol Addict Behav. 2013 Sep;27(3):878-84
references.pmid: 23025709
references.citation: Psychol Addict Behav. 2011 Sep;25(3):474-84
references.pmid: 21688877
references.citation: J Subst Abuse Treat. 2015 Apr;51:1-18
references.pmid: 25300577
references.citation: Psychol Addict Behav. 2013 Mar;27(1):42-51
references.pmid: 22985054