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Kahler CW, Janssen T, Gruber S, Howe CJ, Laws MB, Walthers J, Magill M, Mastroleo NR, Monti PM. Change talk subtypes as predictors of alcohol use following brief motivational intervention. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:875-885. [PMID: 36442021 PMCID: PMC10225014 DOI: 10.1037/adb0000898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVE To examine the relative importance of client change language subtypes as predictors of alcohol use following motivational interviewing (MI). METHOD Participants were 164 heavy drinkers (57.3% female, Mage = 28.5 years, 13.4% Hispanic/Latinx, 82.9% White) recruited during an emergency department visit who received MI for alcohol and human immunodeficiency virus/sexual risk in a randomized-controlled trial. MI sessions were coded with the motivational interviewing skill code (MISC) and the generalized behavioral intervention analysis system (GBIAS). Variable importance analyses used targeted maximum likelihood estimation to rank order change language subtypes defined by these systems as predictors of alcohol use over 9 months of follow-up. RESULTS Among GBIAS change language subtypes, higher sustain talk (ST) around change planning was ranked the most important predictor of drinks per week (b = -5.57, 95% CI [-8.11, -3.02]) and heavy drinking days (b = -2.07, 95% CI [-3.17, -0.98]); this talk reflected (a) rejection of alcohol abstinence as a desired change goal, (b) rejection of specific change strategies, or (c) discussion of anticipated challenges in changing drinking. Among MISC change language subtypes, higher ST around taking steps-reflecting recent escalations in drinking described by a small minority of participants-was ranked the most important predictor of drinks per week (b = 22.71, 95% CI [20.29, 25.13]) and heavy drinking days (b = -2.45, 95% CI [1.68, 3.21]). CONCLUSIONS Results challenge the assumption that all ST during MI is a negative prognostic indicator and highlight the importance of the context in which change language emerges. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Tim Janssen
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | | | - Chanelle J. Howe
- Center for Epidemiologic Research, Department of Epidemiology, Brown University School of Public Health
| | - M. Barton Laws
- Center for Gerontology and Health Care Research, Department of Health Services, Policy, & Practice, Brown University School of Public Health
| | - Justin Walthers
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Molly Magill
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | | | - Peter M. Monti
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
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Pueyo-Garrigues S, Pardavila-Belio MI, Pueyo-Garrigues M, Canga-Armayor N. Peer-led alcohol intervention for college students: A pilot randomized controlled trial. Nurs Health Sci 2023; 25:311-322. [PMID: 37271216 DOI: 10.1111/nhs.13023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 04/17/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023]
Abstract
This study aims to assess the preliminary efficacy and feasibility of a brief, peer-led alcohol intervention to reduce alcohol consumption in binge-drinking Spanish nursing students. A pilot randomized controlled trial was conducted with 50 first-year nursing students who were randomly assigned either a 50-min peer-led motivational intervention with individual feedback or a control condition. Primary outcomes for testing the preliminary efficacy were alcohol use and alcohol-related consequences. Quantitative and content analyses of open-ended survey questions were performed. Participants in the intervention condition significantly reduced binge-drinking episodes, peak blood alcohol content, and consequences compared to the control group. Principal facilitators were completing the questionnaire during the academic schedule and providing tailored feedback through a graphic report. The main barrier was the unreliability of students' initial commitment. The findings suggest that a brief motivational intervention could be effective for reducing alcohol consumption and alcohol-related consequences in Spanish college students. Peer counselors and participants reported high satisfaction, indicating that the intervention is feasible. However, a full trial should be conducted taking into account the identified barriers and facilitators.
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Affiliation(s)
| | - Miren Idoia Pardavila-Belio
- School of Nursing, Community, Maternity and Pediatric Nursing, University of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - María Pueyo-Garrigues
- School of Nursing, Community, Maternity and Pediatric Nursing, University of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
| | - Navidad Canga-Armayor
- School of Nursing, Community, Maternity and Pediatric Nursing, University of Navarra, Pamplona, Spain
- IdiSNa, Navarra Institute for Health Research, Pamplona, Spain
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Ingesson Hammarberg S, Sundbye J, Tingvall R, Hammarberg A, Nehlin C. A qualitative interview study of patient experiences of receiving motivational enhancement therapy in a Swedish addiction specialist treatment setting. Addict Sci Clin Pract 2023; 18:44. [PMID: 37475039 PMCID: PMC10357895 DOI: 10.1186/s13722-023-00398-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Motivational enhancement therapy (MET) has shown to be efficacious as treatment of alcohol use disorder (AUD), in reducing alcohol consumption and related consequences. However, qualitative research on how patients perceive this treatment is lacking. The aim of this study was to explore how patients experience MET as a treatment for AUD. METHODS Fifteen patients (8/7 female/male) participated in semi-structured interviews after receiving MET at a specialized addiction outpatient clinic in Sweden. Data were analyzed by thematic analysis. RESULTS Five themes were identified: the therapist conveyed the MI-spirit, the therapist did not guide on how to reach the goal, participants were committed to change before starting treatment, participants were uncertain if treatment was enough to maintain change, and significant others were not wanted in sessions. Participants appreciated the supportive relationship with their therapist, but some experienced therapy as overly positive, with no room to talk about failure. Further, they experienced a low level of guidance in goal-setting. For some, this was empowering, while others requested more direction and advice. Participants perceived their motivational process to have started before treatment. MET was considered to be too brief. None of the participants brought a significant other to a session. CONCLUSIONS Therapist behaviors in line with MI spirit were emphasized as key to the development of a positive therapeutic relationship. More specific advice on goal-setting may be effective for supporting change in some patients. Longer treatment is requested among patients to support the patient's self-efficacy for change. Significant others can support change without necessarily being present in sessions. TRIAL REGISTRATION The current trial was retrospectively registered at isrtcn.com (14539251).
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Affiliation(s)
- Stina Ingesson Hammarberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69, 113 64, Region Stockholm, Sweden.
| | - Jennie Sundbye
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69, 113 64, Region Stockholm, Sweden
| | - Rebecca Tingvall
- Division of Psychiatry, Uppsala University Hospital, Uppsala, Sweden
| | - Anders Hammarberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69, 113 64, Region Stockholm, Sweden
| | - Christina Nehlin
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
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Pas ET, Borden L, Debnam KJ, De Lucia D, Bradshaw CP. Exploring profiles of coaches' fidelity to Double Check's Motivational Interviewing-embedded coaching: Outcomes associated with fidelity. J Sch Psychol 2022; 92:285-298. [DOI: 10.1016/j.jsp.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 01/21/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
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Exploring client messages in a therapist-guided internet intervention for alcohol use disorders - A content analysis. Internet Interv 2021; 26:100483. [PMID: 34824984 PMCID: PMC8605073 DOI: 10.1016/j.invent.2021.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There is a growing interest in offering therapist-guided internet interventions for alcohol use disorders (AUD) in regular addiction services. Elucidating the therapeutic processes during these interventions may help improve clinical delivery. The aim of this paper was to investigate written messages from client to therapist in a therapist-guided internet intervention for AUD. METHODS Data was extracted from the therapist-guided arm (n = 57) of a randomized trial of internet interventions for AUD. Qualitative content analysis was used to identify distinct categories of client behaviors in written messages to therapists. Coding was deductive (applying categories from past literature) as well as inductive (identifying new categories from the data). Subsequently, exploratory correlational and regression analyses were conducted to investigate whether identified client behaviors predicted module completion and drinking outcomes. Also, client questions posed in messages to therapists were categorized separately. RESULTS Eleven distinct behavior categories were identified, of which the two most common were alliance (26.6% of total categorizations) and identifying patterns and problem behaviors (22.8%). Confrontational alliance rupture was the least common category (0.4%). One new behavior category was identified inductively - alcohol-related setback (4.1%). In the exploratory analyses, no categories consistently predicted module completion or drinking outcomes. Client questions were most commonly posed to improve understanding or use of program content or skills. DISCUSSION The behavior categories, although not predictive of module completion or outcomes, may be of use for therapists, treatment developers and health care providers as a tool for understanding therapeutic processes in internet interventions for AUD.
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Iovino P, Rebora P, Occhino G, Zeffiro V, Caggianelli G, Ausili D, Alvaro R, Riegel B, Vellone E. Effectiveness of motivational interviewing on health-service use and mortality: a secondary outcome analysis of the MOTIVATE-HF trial. ESC Heart Fail 2021; 8:2920-2927. [PMID: 34085763 PMCID: PMC8318502 DOI: 10.1002/ehf2.13373] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/25/2021] [Accepted: 04/01/2021] [Indexed: 01/10/2023] Open
Abstract
Aims Intense health‐care service use and high mortality are common in heart failure (HF) patients. This secondary analysis of the MOTIVATE‐HF trial investigates the effectiveness of motivational interviewing (MI) in reducing health‐care service use (e.g. emergency service use and hospitalizations) and all‐cause mortality. Methods and results This study used a randomized controlled trial. Patients and caregivers were randomized to Arm 1 (MI for patients), Arm 2 (MI for patients and caregivers), or Arm 3 (control group). Data were collected at baseline and at 3, 6, 9, and 12 months. Face‐to‐face MI plus three telephone calls were performed in Arms 1 and 2. The sample consisted of 510 patient (median age 74 years, 58% male patients) and caregiver dyads (median age 55 years, 75% female patients). At 12 months, 16.1%, 17%, and 11.2% of patients used health‐care services at least once in Arms 1, 2, and 3, respectively, without significant difference. At 3 months, 1.9%, 0.6%, and 5.1% of patients died in Arms 1, 2, and 3, respectively. Mortality was lower in Arm 2 vs. Arm 3 at 3 months [hazard ratio (HR) = 0.112, 95% CI: 0.014–0.882, P = 0.04]; no difference was found at subsequent follow‐ups. Mortality was lower in Arm 1 vs. Arm 3 at 3 months but did not reach statistical significance (HR = 0.38, 95% CI: 0.104–1.414, P = 0.15). Conclusion This study suggests that MI reduces mortality in patients with HF if caregivers are included in the intervention. Further studies with a stronger intervention and longer follow‐up are needed to clarify the benefits of MI on health‐care service use and mortality.
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Affiliation(s)
- Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Giuseppe Occhino
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre - B4 School of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Caggianelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Eileen O'Connor Institute of Nursing Research, Australian Catholic University
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Pas ET, Borden L, Herman K, Bradshaw CP. Leveraging Motivational Interviewing to Coach Teachers in the Implementation of Preventive Evidence-Based Practices: A Sequential Analysis of the Motivational Interviewing Process. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:786-798. [PMID: 33866489 DOI: 10.1007/s11121-021-01238-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 11/30/2022]
Abstract
Though emerging research supports the effectiveness of school-based coaching models utilizing motivational interviewing (MI), an examination of the specific drivers behind these effects is notably lacking in the prevention field. This study leveraged sequential analysis to examine how teachers' verbalization of change talk (i.e., language in support of change) and sustain talk (i.e., language in support of maintaining the status quo) was influenced by coaches' use of MI-consistent (i.e., collaborative language supportive of change) and MI-inconsistent (e.g., confrontational, directive) language, respectively. We also examined whether teacher and coach factors were related to coach-teacher language dynamics. Data were collected from 87 teachers in 16 elementary and middle schools randomized in a trial to the Double Check preventive intervention (see Bradshaw et al., 2018). Audio-recorded coaching feedback sessions were coded using an adapted version of the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE). Sequential analyses indicated that MI-consistent and change talk were significantly more likely than chance to occur consecutively. Teachers' sustain talk was also more likely to occur sequentially with coach use of MI-consistent language and teacher change talk; the latter suggests teacher ambivalence. Coaches rarely used MI-inconsistent language, and its occurrence was only associated with more MI-inconsistent language. Regression analyses indicated that teacher age, efficacy, burnout, classroom organization, and some design features (i.e., cohort, coach, coach-teacher racial match) were associated with different coach-teacher language dynamics. This novel school-based study illustrates how coaching MI evoked teacher change talk related to use of evidence-based programs.
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Affiliation(s)
- Elise T Pas
- Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Lindsay Borden
- School of Medicine, Johns Hopkins University, 733 N Broadway, Baltimore, MD, 21205, USA
| | - Keith Herman
- Missouri Prevention Science Institute, University of Missouri, 611 Conley Ave, Columbia, MO, 65211, USA
| | - Catherine P Bradshaw
- School of Education and Human Development, University of Virginia, 405 Emmet St S, Charlottesville, VA, 22904, USA
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Abstract
Antiretroviral therapy (ART) for HIV requires strict regimen adherence. Motivational interviewing (MI) can improve ART adherence. MI process studies have rarely focussed on ART adherence. Such studies may facilitate MI modifications to improve outcomes. This study employed a single group pre and post-test design with 62 adults with HIV (16 female; mean age 40 years). Therapist use of MI-consistent (MICO) methods, MI spirit, and client change and sustain talk were coded from an MI session. Relationships were assessed with ART schedule adherence. MICO methods positively correlated with change and sustain talk and were negatively associated with proportion of change talk. No variables were associated with ART adherence change. Mediation analysis did not support the MI model of change. This may be due to the fact that ART adherence is determined by both motivational and non-motivational factors. It may also be that bidirectional relationships exist between therapist and client speech.
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Boom SM, Oberink R, van Dijk N, Visser MRM. Assessment of motivational interviewing with the VASE-(Mental) Healthcare: Mixed-methods study to examine feasibility and validity in the general practice setting. PATIENT EDUCATION AND COUNSELING 2020; 103:1319-1325. [PMID: 32115312 DOI: 10.1016/j.pec.2020.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 01/23/2020] [Accepted: 02/12/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The VASE-(M)HC is an instrument to evaluate Motivational Interviewing (MI) skills. We adjusted the previous version for use in the broader (mental) healthcare context, incorporated new MI insights, expanded the scoring system and created a parallel version. Feasibility and validity evidence in the general practice setting was explored. METHODS The teaching staff of the GP specialty-training, GP-, and PN-trainees (N = 156) completed the VASE-(M)HC. In this mixed-methods study, we examined psychometric characteristics, compared parallel versions, and interviewed assessors. RESULTS Our adjustments enable assessment of a wider range of MI skills, and allow differentiation of basic and advanced skills. Inter-rater reliability was excellent and internal consistency of the total scale was good for both versions. The parallel versions are comparable in terms of difficulty. CONCLUSION The VASE-(M)HC is improved by our revisions and adds multiple advantages to the domain of available MI assessment tools. PRACTICE IMPLICATIONS Due to the adjustments, the instrument can be used in the GP setting (instead of sole focus on substance abuse). The parallel version is useful for research (pretest/posttest) and selective assessment (retake of a test). It is promising to further explore its applicability in the broader (mental) healthcare context and as training material.
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Affiliation(s)
- Saskia M Boom
- Department of General Practice/ Family Medicine, University of Amsterdam, Amsterdam UMC, Location AMC, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands.
| | - Riëtta Oberink
- Department of General Practice/ Family Medicine, University of Amsterdam, Amsterdam UMC, Location AMC, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands
| | - Nynke van Dijk
- Department of General Practice/ Family Medicine, University of Amsterdam, Amsterdam UMC, Location AMC, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands
| | - Mechteld R M Visser
- Department of General Practice/ Family Medicine, University of Amsterdam, Amsterdam UMC, Location AMC, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands
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Walthers J, Janssen T, Mastroleo NR, Hoadley A, Barnett NP, Colby SM, Magill M. A Sequential Analysis of Clinician Skills and Client Change Statements in a Brief Motivational Intervention for Young Adult Heavy Drinking. Behav Ther 2019; 50:732-742. [PMID: 31208683 PMCID: PMC6582982 DOI: 10.1016/j.beth.2018.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 11/17/2022]
Abstract
This study examined sequential relationships between clinician skills and client statements about behavior change in a randomized clinical trial comparing a brief motivational intervention (BMI) to a relaxation training control condition (REL) in a sample of heavy drinking young adults. Clinician and client interactions (N = 167) were assessed according to two established observational rating systems. Sequential analyses examined the transitional associations between clinicians' use of MI-eliciting skills (i.e., questions and reflections), MI-supportive skills (e.g., affirmations, emphasize client autonomy, statements of support), MI-inconsistent skills (e.g., confrontations, unsolicited advice), and subsequent client statements about behavior change (i.e., change talk or sustain talk). In both conditions, clinicians' use of MI-elicitation skills operated in a manner that was largely consistent (100% in BMI; 84% in REL) with the directional relationships proposed by MI theory (i.e., The Technical Hypothesis). More detailed analyses of the BMI condition showed clinician skills were related to statements about behavior change somewhat differently in drinking compared to coping discussions. While elicitations of change talk were associated with increased odds of their intended response (i.e., distal drinking and proximal coping change talk), elicitations of proximal coping sustain talk were associated with higher odds of proximal change talk. MI-supportive skills were also associated with increased odds of proximal change talk, and instances of proximal sustain talk were rare in the sample. This fine-grained analysis presents sequential transitions to client change and sustain talk with greater classification specificity than has been previously reported. Such efforts have the potential to advance our understanding of the function of MI skills in promoting client discussions about drinking (i.e., evoking) and coping (i.e., planning) behavior change.
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Affiliation(s)
| | - Tim Janssen
- Brown University, Center for Alcohol and Addiction Studies
| | | | - Ariel Hoadley
- Brown University, Center for Alcohol and Addiction Studies
| | | | | | - Molly Magill
- Brown University, Center for Alcohol and Addiction Studies.
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Janssen T, Magill M, Mastroleo NR, Laws MB, Howe CJ, Walthers JW, Monti PM, Kahler CW. The role of therapist MI skill and client change talk class membership predicting dual alcohol and sex risk outcomes. J Clin Psychol 2019; 75:1527-1543. [PMID: 31034619 DOI: 10.1002/jclp.22798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 02/22/2019] [Accepted: 03/28/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We investigated the technical model of motivational interviewing (MI) in a dual-outcome intervention (i.e., alcohol, sexual risk; N = 164; 57% female). METHOD We identified latent classes of client change statements, based on the proportion of change talk (CT) over the session. We then examined whether outcomes were related to CT class, and whether the relations between MI skill and outcomes varied by CT class. RESULTS We found three classes of alcohol-CT and two classes of sexual risk-CT. While CT class membership did not predict outcomes directly, greater therapist MI-consistent skill was associated with fewer heavy drinking days in the increasing alcohol-CT class. For sexual risk outcomes, therapist MI-consistent skill was associated with reduced odds of condomless sex for the low sexual risk-CT class. CONCLUSIONS The relation of therapist MI consistency to outcomes appears to be a function of client CT during the session.
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Affiliation(s)
- Tim Janssen
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Molly Magill
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Nadine R Mastroleo
- Community Research and Action, Binghamton University College of Community and Public Affairs, Binghamton, New York
| | - M Barton Laws
- Department of Health Services, Center for Gerontology and Healthcare Research, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island
| | - Chanelle J Howe
- Department of Epidemiology, Centers for Epidemiology and Environmental Health, Brown University School of Public Health, Providence, Rhode Island
| | - Justin W Walthers
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Peter M Monti
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Christopher W Kahler
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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