In-session processes of brief motivational interventions in two trials with mandated college students.

Abstract

Objective 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 in mandated students. Method This study used the Motivational Interviewing Skills Code (MISC 2.0; Miller, Moyers, Ernst, & Amrhein, 2003) to code BMI sessions from two 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. Results 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 MI (global ratings of therapist MI Spirit and client self-exploration) were most predictive of post-session 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 improved drinking at follow-up. Conclusions 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.

Does a Brief Motivational Intervention Reduce Frequency of Pregaming in Mandated Students?

“…The BMI lasted approximately 45–60 minutes, and 121 out of 145 BMI sessions (83%) were tape recorded (the other sessions were not recorded due to equipment failure). Fidelity assessments in the parent trial and subsequent examination of in-session processes have demonstrated that these BMIs were delivered with high levels of fidelity (Borsari, Apodaca, Jackson, Magill, Mastroleo, Barnett & Carey, 2015). …”

Drinking Location and Pregaming as Predictors of Alcohol Intoxication Among Mandated College Students

“…Less frequent citations included criminal mischief, disorderly conduct, use of fake identification, resisting arrest, and possession of marijuana. Overall, participants reported consuming an average of 9.60 ( SD = 6.65) drinks in a typical week and reaching peak estimated BACs of .13 ( SD = .09) in the past month, suggesting that they may represent a lower-risk sample than mandated samples described in previous studies (Borsari et al, 2015; Mastroleo, Oakley, Eaton, & Borsari, 2014; Terlecki, Buckner, Larimer, & Copeland, 2015). …”

REMIT: Development of a mHealth theory-based intervention to decrease heavy episodic drinking among college students

“…Current MI theory (Miller and Rose 2009;Arkowitz et al 2015) posits that post-session behavioral change is directly related to in-session client language, specifically referred to as change talk or 'any selfexpressed language that is an argument for change' (Miller and Rollnick 2013, p. 159). Therapists using MI-consistent (MICO) skills (also termed microskills) demonstrated the ability to evoke change language in college students (Apodaca and Longabaugh 2009;Apodaca et al 2014;Borsari et al 2015). This result was confirmed by three recent meta-analyses of MI sessions with other populations Romano and Peters 2016;Magill et al 2017).…”