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

University of New Mexico, Albuquerque, NM 87131, USA.
Journal of substance abuse treatment (Impact Factor: 2.9). 04/2010; 39(1):65-70. DOI: 10.1016/j.jsat.2010.03.012
Source: PubMed


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.

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    • "Audio recordings of intervention sessions were used for coding. Independent coders previously rated sessions using an objective sequential behavior coding system (MISC 2.5: Houck, Moyers, Miller, Glynn, & Hallgren, 2010 "
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    ABSTRACT: There is considerable evidence for Motivational interviewing (MI) in changing problematic behaviors. Research on the causal chain for MI suggests influence of facilitator speech on client speech. This association has been examined using macro (session-level) and micro (utterance-level) measures; however, effects across sessions have largely been unexplored, particularly with groups. We evaluated a sample of 129 adolescent group MI sessions, using a behavioral coding system and timing information to generate information on facilitator and client speech (CT: change talk) within 5 successive segments (quintiles) of each group session. We hypothesized that facilitator speech (open-ended questions and reflections of CT) would be related to subsequent CT. Repeated measures analysis indicated significant quadratic and cubic trends for facilitator and client speech across quintiles. Across quintiles, cross-lagged panel analysis using a zero-inflated negative binomial model showed minimal evidence of facilitator speech on client CT, but did indicate several effects of client CT on facilitator speech, and of client CT on subsequent client CT. Results suggest that session-level effects of facilitator speech on client speech do not arise from long-duration effects of facilitator speech; instead, we detected effects of facilitator speech on client speech only at the beginning and end of sessions, when open questions respectively suppressed and enhanced client expressions of CT. Findings suggest that clinicians must remain vigilant to client CT throughout the group session, reinforcing it when it arises spontaneously and selectively employing open-ended questions to elicit it when it does not, particularly towards the end of the session.
    Psychology of Addictive Behaviors 01/2016; DOI:10.1037/adb0000107 · 2.09 Impact Factor
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    • ", self - defenses ) . In MI , counter - change language is captured in terms of sustain talk ( Miller and Rose , 2009 ; Glynn and Moyers , 2010 ) . An example of counter - change language that change recipients could use to defend their self - integrity would be " I see this differently ! "
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    ABSTRACT: Human behavior contributes to a waste of environmental resources and our society is looking for ways to reduce this problem. However, humans may perceive feedback about their environmental behavior as threatening. According to self-determination theory (SDT), threats decrease intrinsic motivation for behavior change. According to self-affirmation theory (SAT), threats can harm individuals' self-integrity. Therefore, individuals should show self-defensive biases, e.g., in terms of presenting counter-arguments when presented with environmental behavior change. The current study examines how change recipients respond to threats from change agents in interactions about environmental behavior change. Moreover, we investigate how Motivational Interviewing (MI) — an intervention aimed at increasing intrinsic motivation — can reduce threats at both the social and cognitive level. We videotaped 68 dyadic interactions with change agents who either did or did not use MI (control group). We coded agents verbal threats and recipients' verbal expressions of motivation. Recipients also rated agents' level of confrontation and empathy (i.e., cognitive reactions). As hypothesized, threats were significantly lower when change agents used MI. Perceived confrontations converged with observable social behavior of change agents in both groups. Moreover, behavioral threats showed a negative association with change recipients' expressed motivation (i.e., reasons to change). Contrary to our expectations, we found no relation between change agents' verbal threats and change recipients' verbally expressed self-defenses (i.e., sustain talk). Our results imply that MI reduces the adverse impact of threats in conversations about environmental behavior change on both the social and cognitive level. We discuss theoretical implications of our study in the context of SAT and SDT and suggest practical implications for environmental change agents in organizations.
    Frontiers in Psychology 07/2015; 6:1-16. DOI:10.3389/fpsyg.2015.01015 · 2.80 Impact Factor
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    • "Developing a supportive environment/relationship and evoking change talk, or any selfexpressed language that is an argument for change is critical in the facilitation of motivational interviewing. The evidence for motivational interviewing provides compelling verification for the notion that the therapist can influence clients' expression of change talk and that there is a relationship between change talk and behavior (Forgatch & Patterson, 1985; Glynn & Moyers, 2010; Miller, Yahne, Moyers, Martinez, & Pirritano, 2004; Moyers & Martin, 2006). Nock and Kazdin (2005) pioneered the application of motivational interviewing in the context of parenting with their Parent Enhancement Intervention, a model that assesses caregiver perception of readiness and that attempts to improve parental engagement and adherence (i.e., attendance). "
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    ABSTRACT: This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary First Step was developed to engage families more effectively and influence and improve parenting practices for children having challenging behavior. Process (fidelity, dosage, and social validity) and outcome data were collected for all participants in the Tertiary First Step condition (N = 33). Parent- and teacher-reported outcomes were collected for the comparison condition (N = 22). Process data suggest the intervention was implemented with fidelity, and that teachers, parents, and coaches perceived the intervention as socially valid. This study presents the first empirical examination of the Tertiary Frist Step variation. The outcomes provide compelling evidence that the Tertiary First Step intervention is promising for improving student outcomes on social-behavioral indices, decreasing problem behavior, and improving academic engaged time.
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