Brown University, Center for Alcohol and Addiction Studies, Providence, RI 02912, USA.
J Subst Abuse Treat. 2010 Apr;38(3):299-305. doi: 10.1016/j.jsat.2009.12.001. Epub 2010 Feb 10.
This study is the first to examine within-session therapist and client language/process predictors of a client's decision to complete a written Change Plan in an alcohol-focused motivational interview (MI). Data were from an ongoing hospital-based clinical trial (N = 291). Trained raters coded audiorecorded MI sessions using the Motivational Interviewing Skill Code. Logistic regression analyses found that therapist MI-consistent behaviors (b = .023, p < .001) and client change talk (b = .063, p < .001) were positive predictors, and client counter change talk (b = -.093, p < .001) was a negative predictor of the decision to complete a Change Plan regarding alcohol use. Mean comparisons showed that compared to noncompletion, Change Plan completion did not result in significantly greater changes in client motivational readiness. Completion of a Change Plan is a proximal outcome in MI that is associated with client intention to change (change talk) and may predict follow-up alcohol outcomes. Analyses of such theory-driven proximal client mechanisms provide a more complete model of MI process and may inform MI providers of necessary treatment ingredients.
这项研究首次考察了在一次酒精为焦点的动机性访谈（MI）中，治疗师和客户的语言/过程预测因素对客户完成书面改变计划的决定。数据来自正在进行的基于医院的临床试验（N=291）。受过训练的评估者使用动机性访谈技能编码对录音的 MI 会话进行编码。逻辑回归分析发现，治疗师的 MI 一致行为（b=.023，p<.001）和客户的改变谈话（b=.063，p<.001）是积极的预测因素，而客户的反改变谈话（b=-.093，p<.001）是决定是否完成关于酒精使用的改变计划的消极预测因素。均值比较表明，与未完成相比，完成改变计划并没有导致客户动机准备的显著变化。完成改变计划是 MI 中的一个近因结果，与客户改变的意图（改变谈话）相关，并可能预测后续的酒精结果。对这些基于理论的近因客户机制的分析提供了一个更完整的 MI 过程模型，并可能为 MI 提供者提供必要的治疗成分。
