Gaume Jacques, Gmel Gerhard, Faouzi Mohamed, Daeppen Jean-Bernard
Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland.
J Subst Abuse Treat. 2009 Sep;37(2):151-9. doi: 10.1016/j.jsat.2008.12.001. Epub 2009 Mar 31.
The aim of this study was to estimate the influence of counselor skills during brief motivational interventions (BMIs) on patient alcohol use 12 months later. Ninety-five BMIs delivered by five counselors of similar background and training were recorded and coded using the Motivational Interviewing Skills Code (MISC). Baseline alcohol measures and sociodemographics of patients did not differ across counselors, whereas MISC scores and outcome at 12 months did. Multilevel models showed that counselors with better motivational interviewing (MI) skills achieved better outcomes overall and maintained efficacy across all levels of an important predictor (patient ability to change), whereas counselors with poorer MI skills were effective mostly at high levels of ability to change. Findings indicated that avoidance of MI-inconsistent skills was more important than frequency of using MI-consistent skills and that training and selection of counselors should be based more on the overall MI-consistent gestalt than on particular MI techniques.
本研究的目的是评估简短动机干预（BMI）期间咨询师技能对患者12个月后酒精使用情况的影响。由五位背景和培训相似的咨询师进行的95次BMI被记录下来，并使用动机访谈技能编码（MISC）进行编码。患者的基线酒精测量指标和社会人口统计学特征在不同咨询师之间没有差异，但MISC得分和12个月时的结果存在差异。多层次模型显示，具有更好动机访谈（MI）技能的咨询师总体上取得了更好的结果，并且在一个重要预测因素（患者改变能力）的所有水平上都保持了有效性，而MI技能较差的咨询师大多在高改变能力水平上才有效。研究结果表明，避免使用与MI不一致的技能比使用与MI一致的技能的频率更重要，并且咨询师的培训和选拔应更多地基于整体与MI一致的整体风格，而不是特定的MI技术。
