Chasing change talk: the clinician's role in evoking client language about change.

Client "change talk," or language in favor of changing a target behavior, is a hypothesized active ingredient of motivational interviewing that can predict actual behavioral change. This study isolated and manipulated change talk in a context resembling a psychotherapeutic encounter, comparing its prevalence in two conditions: change talk evocation (CT) and functional analysis (FA). Using a single-baseline (ABAB) design, clinicians alternated between CT and FA, consequating change talk only in the CT condition. Clinicians were 9 clinical psychology graduate students, and clients were 47 undergraduates with concerns about drinking. The hypothesis that greater Percentage Change Talk would be observed in CT than in FA was supported, t(46) = 6.561, p < .001, d = 1.19. A rationale for the development of a behavioral rating system to evaluate clinicians' proficiency in recognizing, responding to, and evoking client change talk is presented.

[1]  T. Little,et al.  Using motivational interviewing with smokers: do therapist behaviors relate to engagement and therapeutic alliance? , 2006, Journal of substance abuse treatment.

[2]  W. Miller,et al.  Client commitment language during motivational interviewing predicts drug use outcomes. , 2003, Journal of consulting and clinical psychology.

[3]  D. Chavira,et al.  The Scale of Ethnic Experience: Development and Psychometric Properties , 2006, Journal of personality assessment.

[4]  P. Christopher,et al.  Client language as a mediator of motivational interviewing efficacy: where is the evidence? , 2007, Alcoholism, clinical and experimental research.

[5]  W. Miller,et al.  Toward a theory of motivational interviewing. , 2009, The American psychologist.

[6]  P. L. Peterson,et al.  Adolescent change language within a brief motivational intervention and substance use outcomes. , 2008, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[7]  M. Mayo,et al.  Adherence to Principles of Motivational Interviewing and Client Within-Session Behavior , 2005, Behavioural and Cognitive Psychotherapy.

[8]  Mohamed Faouzi,et al.  Counsellor behaviours and patient language during brief motivational interventions: a sequential analysis of speech. , 2008, Addiction.

[9]  Scott T Walters,et al.  Dismantling motivational interviewing and feedback for college drinkers: a randomized clinical trial. , 2009, Journal of consulting and clinical psychology.

[10]  T. Moyers,et al.  Therapist influence on client language during motivational interviewing sessions. , 2006, Journal of substance abuse treatment.

[11]  A. Kazdin Mediators and mechanisms of change in psychotherapy research. , 2007, Annual review of clinical psychology.

[12]  P. Christopher,et al.  From in-session behaviors to drinking outcomes: a causal chain for motivational interviewing. , 2009, Journal of consulting and clinical psychology.

[13]  Steven G. Hosier,et al.  The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review. , 2006, Alcohol and alcoholism.

[14]  W. Miller,et al.  Motivational interviewing: preparing people for change. , 2002 .

[15]  J. Strang,et al.  Can the practitioner correctly predict outcome in motivational interviewing? , 2004, Journal of substance abuse treatment.

[16]  D. Cicchetti Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology. , 1994 .

[17]  W. Miller,et al.  enhancing Motivation for Change in Problem Drinking: A Controlled Comparison of Two Therapist Styles , 1995 .

[18]  F P Rivara,et al.  The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. , 2001, Addiction.

[19]  S. Walters In Praise of Feedback: An Effective Intervention for College Students Who Are Heavy Drinkers , 2000, Journal of American college health : J of ACH.

[20]  C. Wagner,et al.  Beyond Cognition: Broadening the Emotional Base of Motivational Interviewing. , 2008, Journal of psychotherapy integration.

[21]  W. Miller,et al.  Eight Stages in Learning Motivational Interviewing , 2006 .

[22]  P. Christopher,et al.  A behavior-analytic account of motivational interviewing , 2009, The Behavior analyst.

[23]  W. Miller,et al.  Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles. , 1993, Journal of consulting and clinical psychology.

[24]  T. Tracey,et al.  Factor structure of the Working Alliance Inventory. , 1989 .

[25]  T. Cook,et al.  Quasi-experimentation: Design & analysis issues for field settings , 1979 .

[26]  P. Amrhein How Does Motivational Interviewing Work? What Client Talk Reveals , 2004, Journal of Cognitive Psychotherapy.