Apodaca Timothy R, Jackson Kristina M, Borsari Brian, Magill Molly, Longabaugh Richard, Mastroleo Nadine R, Barnett Nancy P
Children's Mercy Kansas City, Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Rd., Kansas City, Missouri, 64108.
Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI, 02912.
J Subst Abuse Treat. 2016 Feb;61:60-5. doi: 10.1016/j.jsat.2015.09.001. Epub 2015 Sep 21.
To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions.
Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral).
Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (p<.001), simple reflection (p<.001), and complex reflection (p<.001)], but significantly less likely to immediately follow others (giving information (p<.001) and closed question (p<.001)]. Sustain talk was significantly more likely to follow therapist use of open questions (p<.001), simple reflections (p<.001), and complex reflections (p<.001), and significantly less likely to occur following therapist use of therapist affirm (p=.012), giving information (p<.001), and closed questions (p<.001).
Certain individual therapist behaviors within motivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk.
确定在动机性访谈环节中能引发来访者改变谈话或维持谈话的个体治疗师行为。
对一次针对大学生的单节酒精干预动机性访谈环节进行录音、转录，并使用治疗过程编码系统动机性访谈技能编码（MISC）进行编码。参与者包括92名大学生和8名提供治疗的治疗师。MISC用于对17种与动机性访谈使用相关的治疗师行为，以及反映朝着行为改变方向（改变谈话）、远离行为改变方向（维持谈话）或与目标行为无关（跟进/中性）的来访者语言进行编码。
来访者的改变谈话在个体治疗师行为[肯定（p = 0.013）、开放式问题（p < 0.001）、简单回应（p < 0.001）和复杂回应（p < 0.001）]之后立即出现的可能性显著更高，但在其他行为（提供信息（p < 0.001）和封闭式问题（p < 0.001））之后立即出现的可能性显著更低。维持谈话在治疗师使用开放式问题（p < 0.001）、简单回应（p < 0.001）和复杂回应（p < 0.001）之后出现的可能性显著更高，而在治疗师使用肯定（p = 0.012）、提供信息（p < 0.001）和封闭式问题（p < 0.001）之后出现的可能性显著更低。
动机性访谈中的某些个体治疗师行为既可以引发来访者的改变谈话和维持谈话，也可以抑制这两种类型的来访者语言。肯定是唯一一种既能增加改变谈话又能减少维持谈话的治疗师行为。
