Borsari Brian, Apodaca Timothy R, Jackson Kristina M, Mastroleo Nadine R, Magill Molly, Barnett Nancy P, Carey Kate B
Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center.
Department of Pediatrics, Children's Mercy.
J Consult Clin Psychol. 2015 Feb;83(1):56-67. doi: 10.1037/a0037635. Epub 2014 Aug 11.
Each year, thousands of college students receive mandated intervention as a sanction for alcohol use or alcohol-related behavior. For these mandated students, brief motivational interventions (BMIs) are currently the most efficacious individual intervention. However, little is known about how the technical (therapist behaviors) and relational (e.g., global ratings of therapist empathy) components of BMIs influence client language as well as subsequent change in alcohol use and consequences.
This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from 2 randomized clinical trials that facilitated significant reductions in alcohol use (Study 1, n = 91) and alcohol-related consequences (Study 2, n = 158) in mandated students.
There were significant relationships among therapist behaviors, global scores, and client language both for and against change, yet there were no links between in-session client language and subsequent changes in alcohol use or problems. In contrast, relational aspects of motivational interviewing (MI; global ratings of therapist MI Spirit and client self-exploration) were most predictive of postsession alcohol use. Mediation models incorporating both technical and relational components revealed that higher levels of client self-exploration mediated the relationship between higher therapist ratings of MI Spirit and reduced drinking at follow-up.
Findings highlight the importance of considering how both technical and relational components of MI may influence alcohol use in mandated college students and also suggest more exact analyses to better understand this complex relationship.
每年，数以千计的大学生因饮酒或与酒精相关的行为而受到强制干预。对于这些被强制要求的学生来说，简短动机干预（BMI）是目前最有效的个体干预措施。然而，对于BMI的技术（治疗师行为）和关系（例如，治疗师同理心的总体评分）成分如何影响来访者的语言以及随后饮酒行为和后果的变化，人们知之甚少。
本研究使用动机性访谈技能编码（MISC 2.0；Miller、Moyers、Ernst和Amrhein，2003）对两项随机临床试验中的BMI疗程进行编码，这两项试验促进了被强制要求的学生饮酒量（研究1，n = 91）和与酒精相关后果（研究2，n = 158）的显著减少。
治疗师行为、总体评分与支持和反对改变的来访者语言之间存在显著关系，但疗程中的来访者语言与随后饮酒行为或问题的变化之间没有联系。相比之下，动机性访谈（MI）的关系方面（治疗师MI精神的总体评分和来访者自我探索）最能预测疗程后的饮酒情况。纳入技术和关系成分的中介模型显示，较高水平的来访者自我探索介导了治疗师较高的MI精神评分与随访时饮酒减少之间的关系。
研究结果突出了考虑MI的技术和关系成分如何可能影响被强制要求的大学生饮酒行为的重要性，也建议进行更精确的分析以更好地理解这种复杂关系。
