The Impact of Therapists' Responses to Resistance to Change: A Sequential Analysis of Therapist Client Interactions in Motivational Interviewing

AIMS

The study aims to examine how therapists trained in motivational interviewing (MI) respond to resistance and whether this has an impact on subsequent client speech.

METHODS

Fifty recorded Motivational Enhancement Therapy sessions were examined using a sequential behavioural coding method for speech. Client counter-change talk formed the baseline for coding and categorizing subsequent therapist speech and the following client speech. Transitional analysis identified the probable occurrence of specific therapist and client utterances at each stage.

RESULTS

Following client expressed resistance or counter-change talk, MI consistent therapist utterances were most commonly observed. A moderate to strong predictive relationship was found between MI-consistent therapist speech and subsequent client change talk. A moderate predictive relationship was found between therapist MI-consistent behaviours and client ambivalence. A moderate to strong predictive relationship was found between MI-inconsistent therapist speech and subsequent client counter-change talk and a weak negative predictive relationship was found between MI-inconsistent therapist speech and client expressed ambivalence.

CONCLUSIONS

In the face of initial expressed resistance to change, MI-consistent therapist speech appears to increase subsequent client utterances regarding intentions to change drinking behaviour.

Illicit substance use among university students from seven European countries: a comparison of personal and perceived peer use and attitudes towards illicit substance use

OBJECTIVE

To compare European students' personal use and approval of illicit substance use with their perceptions of peer behaviours and attitudes, and investigate whether perceptions of peer norms are associated with personal use of illicit substances and attitudes.

METHOD

This study used baseline data from the Social Norms Intervention for the prevention of Polydrug usE (SNIPE) project involving 4482 students from seven European countries in 2012. Students completed an online survey which included questions on personal and perceived peer illicit substance use and personal and perceived peer attitude towards illicit substances.

RESULTS

8.3% of students reported having used illicit substances at least once in their life. 49.7% of students perceived that the majority of their peers have used illicit substances more frequently than themselves. The perception was significantly associated with higher odds for personal illicit substance use (OR: 1.97, 95% CI: 1.53-2.54). The perception that the majority of peers approve illicit substance use was significantly associated with higher odds for personal approval of illicit substance use (OR: 3.47, 95% CI: 2.73-4.41).

CONCLUSION

Students commonly perceived that their peers used illicit subtances more often than themselves. We found an association between the perceived peer norms/attitudes and reported individual behaviour/attitudes.

Children's perceptions of attending a residential weight-loss camp in the UK

BACKGROUND AND AIM

Residential camps have been used to deliver weight-loss interventions to paediatric populations, but very little is known about how children perceive and evaluate attending such camps. Therefore, this study examined children's perceptions of attending a residential paediatric weight-loss camp.

METHODS

Fifteen attendees (mean age = 13.56) of the 2002 Carnegie International Camp-UK (CIC-UK) were engaged in semi-structured interviews, which were transcribed verbatim and subjected to an inductive analysis procedure.

RESULTS

Results reflected pre-camp issues including worries (boot camp fears, being bullied) and goals and aspirations (weight loss goals, reducing bullying, increasing self-esteem and making friends). Negative elements pertaining to the camp experience were homesickness and dietary concerns. Positive elements of the camp experience were enjoyment, peer support, staff support and choice of activities.

CONCLUSION

Enjoyment, support from peers and staff and choice over activities appear to be important aspects in the delivery of residential obesity treatments for children.

Children's weight-loss camps: psychological benefit or jeopardy?

OBJECTIVES

To investigate the change in body image, self-esteem, and worries in obese adolescents attending a residential, weight-loss camp.

DESIGN

A longitudinal intervention study, with a nonintervention comparison group of lean adolescents.

PARTICIPANTS

A total of 57 obese adolescents (age: 13,11; BMI: 32.6 kg/m(2)) and 38 normal weight comparison adolescents.

MEASURES

Self-esteem, salience of weight-related issues, body shape preference, weight and height at the start, and end of the weight-loss camp (mean stay: 4 weeks).

RESULTS

The obese adolescents lost 5.6 kg, reduced their BMI by 2.1 kg/m(2), and BMI s.d. score by 0.28 while comparison children gained weight. Body shape dissatisfaction significantly decreased and self-esteem increased on measures of global self-worth, athletic competence, and physical appearance, in the camp attendees. This improvement took place without any exacerbation of existing worries about appearance or weight.

CONCLUSIONS

While obese adolescents had lower self-worth and greater body dissatisfaction relative to the comparison children at the start of the camp, the intervention improved their psychological state. Greater weight loss was associated with greater psychological improvement, indicating the value of the intervention and the relevance of psychological change in effective treatment.