Boardman Thuy, Catley Delwyn, Grobe James E, Little Todd D, Ahluwalia Jasjit S
Department of Psychology, University of Kansas, Lawrence, KS, USA.
J Subst Abuse Treat. 2006 Dec;31(4):329-39. doi: 10.1016/j.jsat.2006.05.006. Epub 2006 Aug 1.
This study examined whether therapist behaviors consistent with motivational interviewing (MI) were associated with within-session working alliance and client engagement. Forty-six audiotaped counseling sessions were drawn from a group-randomized comparison-controlled smoking cessation trial for public housing residents. Separate raters coded therapist behaviors and client behaviors. Therapist behaviors were coded using the Motivational Interviewing Skill Code. Results indicated that an MI-consistent style (average of the global ratings of collaboration, egalitarianism, and empathy) was positively associated with alliance and engagement, whereas confrontation was negatively related to alliance. Small to moderate effect sizes were found for affirming, asking open-ended questions, confronting, reflecting, and summarizing. Significant covariates include treatment condition, session sequence, and session date. Findings empirically support Miller and Rollnick's [Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press] emphasis on the importance of MI spirit for enhancing alliance and engagement and their findings that any tears/ruptures in the alliance through the use of confrontation could significantly relate to poor outcomes.
本研究探讨了与动机性访谈（MI）一致的治疗师行为是否与治疗过程中的工作联盟及来访者参与度相关。46段录音咨询会话取自一项针对公共住房居民的小组随机对照戒烟试验。不同的评估者对治疗师行为和来访者行为进行编码。治疗师行为采用动机性访谈技能编码进行编码。结果表明，与MI一致的风格（合作、平等主义和共情的总体评分平均值）与联盟及参与度呈正相关，而对抗与联盟呈负相关。在肯定、提出开放式问题、对抗、反映和总结方面发现了小到中等程度的效应量。显著的协变量包括治疗条件、会话顺序和会话日期。研究结果从实证上支持了米勒和罗尼克[米勒，W.R.，&罗尼克，S.（2002年）。动机性访谈：帮助人们改变（第2版）。纽约：吉尔福德出版社]所强调的MI精神对增强联盟及参与度的重要性，以及他们的研究发现，即通过使用对抗而导致联盟中的任何裂痕/破裂都可能与不良结果显著相关。
