The technical hypothesis of motivational interviewing: A meta-analysis of MI’s key causal model.

Abstract

Objective The technical hypothesis of motivational interviewing (MI) posits that therapist implemented MI skills will be related to client speech regarding behavior change and that client speech will predict client outcome. The current meta-analysis is the first aggregate test of this proposed causal model. Method A systematic literature review, using stringent inclusion criteria, identified k = 16 reports describing 12 primary studies. Review methods calculated the inverse-variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple targeted behaviors (i.e., alcohol or illicit drug use, other addictive behaviors). Results Therapist MI-consistent skills were correlated with more client language in favor of behavior change (i.e., change talk; r = .26, p < .0001), but not less client language against behavior change (i.e., sustain talk; r = .10, p = .09). MI-inconsistent skills were associated with less change talk (r = −.17, p = .001) as well as more sustain talk (r = .07, p = .009). Among these studies, client change talk was not associated with follow-up outcome (r = .06, p = .41), but sustain talk was associated with worse outcome (r = −.24, p = .001). In addition, studies that examined composite client language (e.g., an average of negative and positive statements) showed an overall positive relationship with client behavior change (r = .12, p = .006; k = 6). Conclusions This meta-analysis provides an initial test and partial support for a key causal model of MI efficacy. Recommendations for MI practitioners, clinical supervisors, and process researchers are provided.

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

“…Other reviews in this area have interpreted such effects as beneficial and potentially meaningful, given the brevity and inexpensiveness of these interventions, as well as the focus on changing behavior during high‐risk periods 14, 15. Moreover, several recent reviews provide support for the theory of change underlying MI interventions 55, 56. Effect sizes common to these reviews suggest that these brief interventions are one useful tool in the public health toolkit for preventing young adult alcohol misuse.…”

Understanding the Human Factor of the Energy Transition: Mechanisms Underlying Energy-Relevant Decisions and Behaviors

“…Third, we propose Motivational Interviewing (MI) to be a social interaction-based approach that may help energy managers to promote energy-saving behaviors in organizations. We draw on empirical evidence in the field of clinical psychology (e.g., Magill et al, 2014) in order to hypothesize how interactional mechanisms could affect energy-relevant behavior. Fourth, we produced demonstration material that highlights how MI-based approaches could be applied in the context of energy-saving interventions.…”

“…It is a communication-based approach that has received large support by numerous meta-analyses as an evidence-based intervention in the helping professions (Hettema et al, 2005;Rubak et al, 2005;Lundahl et al, 2010;Magill et al, 2014). We will briefly present the basic tenets of MI and argue how energy managers in organizations could benefit from MI training.…”

“…We kept the content of each conversation similar but varied the interactional dynamics in each conversation in order to illustrate how subtle micro-behaviors may influence the course of an interaction (i.e., the subsequent response of the conversational partner). The mechanisms of interpersonal dynamics were based on theoretical assumptions (i.e., technical hypotheses) and empirical support from MI research (Magill et al, 2014): The main assumption of the technical hypothesis is that MI inconsistent behaviors are positively associated with sustain talk (e.g., Apodaca and Longabaugh, 2009;Klonek et al, 2014) and negatively associated with change talk (e.g., Gaume et al, 2010), whereas MI consistent behaviors make change talk more likely and sustain talk less likely (e.g., Moyers et al, 2007). With respect to conversations about energy-reductions at work, the technical hypothesis implies that energy managers who are trained in MI verbal skills (Energy Manager B; Audio 2 and 4) will likely increase employees change talk.…”

Group motivational interviewing in schools: Development of a health promotion intervention

“…The facilitators scored highly on MI-consistent skills such as encouraging expression of personal values and evoking motivations and goals. The evocation process of MI aims to elicit statements in support of ha ge, also efe ed to as ha ge talk (Magill et al, 2014). The honesty box activity was structured to encourage students to reflect on their personal motivations for and against drinking alcohol.…”