Do what you say and say what you are going to do : A preliminary meta-analysis of client change and sustain talk subtypes in motivational interviewing

Abstract

This preliminary meta-analysis suggests that aggregate measures of change and sustain talk are comprised of statement subtypes that are not equally meaningful in predicting outcome following MI for addictive behavior change.

Mechanisms of Motivational Interviewing for Antiretroviral Medication Adherence in People with HIV

“…A second study has shown that open questions and complex reflections are associated with changes from sustain talk and change talk (and vice versa) compared to simple reflections and paraphrasing [54]. Similarly, aggregate measures of change and sustain talk may contain subtypes of language that are differentially related to outcome following MI [55,56].…”

Is fidelity to motivational interviewing associated with alcohol outcomes in treatment-seeking 60+ year-old citizens?

“…If MI works as hypothesized, by conveying a relational and technical component (Miller and Rose, 2009), there should be clear associations between the fidelity of these elements and client outcomes. Although MI therapist behaviors are commonly linked to outcomes in studies of MI (Borsari et al, 2015;Gaume et al, 2014;Gaume, Heather, Tober, and McCambridge, 2018;Grodensky et al, 2017), meta-analyses of this hypothesized association have not detected direct associations between MI elements and outcome (Magill et al, 2018;Pace et al, 2017). Indications were found, T however, for indirect pathways of associations between MI-elements and outcome; that is, through measures of client change talk or client sustain talk leading to change outcomes.…”

“…The combination between a more directional therapy with MI has raised some concerns for internal therapist conflicts on which behavior prevails in different situations (Aviram, Westra, Constantino, and Antony, 2016;Boyer, MacKay, McLeod, and van der Oord, 2018;Moyers and Houck, 2011). Findings of fidelity to MI by previous versions of the MITI in these combined settings are mixed (Magill et al, 2018;Aviram et al, 2016;Boyer et al, 2018). The risk of even larger variation in fidelity to MI in combined settings is evident and, thus, measuring fidelity in these treatment approaches is important.…”

“…The technical element of MI has been supported (Copeland, pathway whereby MI consistent behavior on the part of the therapist increases change talk, predicting better client outcomes. However, MI consistent behaviors on the part of the therapist typically increase both change and sustain talk (Magill, Apodaca, et al, 2018;Pace et al, 2017). It is the relative proportion of the two to one another (Magill, Apodaca, et al, 2018;Magill et al, 2018) as well as the sustained level of change talk in the session (Borsari et al, 2018;Houck and Moyers, 2015) that appears to predict better outcome, rather than simple frequency counts or strength ratings of client behavior.…”

“…However, MI consistent behaviors on the part of the therapist typically increase both change and sustain talk (Magill, Apodaca, et al, 2018;Pace et al, 2017). It is the relative proportion of the two to one another (Magill, Apodaca, et al, 2018;Magill et al, 2018) as well as the sustained level of change talk in the session (Borsari et al, 2018;Houck and Moyers, 2015) that appears to predict better outcome, rather than simple frequency counts or strength ratings of client behavior. Perhaps the technical score in the MITI 4 does not capture how well the therapist assists and evokes this important transition in client language across the session -from high levels of sustain talk and low levels of change talk in the beginning of the sessions to low levels of sustain talk and high levels of change talk in the end of sessions (Miller and Rollnick, 2012).…”