动机性访谈(MI)理论和过程研究强调了治疗师技术和关系行为在预测客户会话中陈述是否支持或反对行为改变(即,改变和维持谈话,分别)。这些客户声明,反过来,已被证明可以预测干预结果。当前的研究检查了治疗师行为与客户变化之间的顺序关联,并在大量饮酒的拉丁裔个体样本中维持了谈话。
数据来自针对Latinx个体中酒精使用和后果的文化适应(CAMI)与未适应MI的完整随机临床试验。
该研究收集了具有动机访谈技能代码的观测编码数据(MISC2.5,即治疗师行为和全球评级)和客户语言评估-近端/远端(CLA-PD,即,客户端语言)。Frequentist和Bayesian顺序分析检查了9种不同类别的治疗师行为和3种不同类别的客户语言之间的关系(即,改变谈话,维持谈话,中性)。我们检查了方向的赔率比和条件概率,量级,以及MI技术行为的使用与随后的客户关于变更的陈述之间的关联的重要性。这项研究比较了低/平均之间的这些相同的过渡关联(即,<4)和高(即,≥4)MI精神会议。
结果模式在两个分析框架中复制。关于改变谈话与维持谈话与中立陈述的问题和反思表明,预测预期客户响应的可能性更大(即,改变谈话,维持谈话,中性,分别)与其他可能的客户端响应进行比较。这些转变的条件概率很高,范围从0.55到0.88。在低/平均和高MI精神会议之间,某些技术转换的幅度显着不同。
分析支持此Latinx样本中治疗师使用技术MI行为与客户更改语言之间的假设关联。对MISpirit作为这些转变的主持人的分析显示出部分支持。
Motivational interviewing (MI) theory and process research highlights the role of therapist technical and relational behaviors in predicting client in-session statements for or against behavior change (i.e., change and sustain talk, respectively). These client statements, in turn, have been shown to predict intervention outcomes. The current study examines sequential associations between therapist behaviors and client change and sustain talk in a sample of Latinx individuals who engage in heavy alcohol consumption.
Data are from a completed randomized clinical trial of a culturally adapted (CAMI) versus unadapted MI targeting alcohol use and consequences among Latinx individuals.
The study collected observational coding data with the Motivational Interviewing Skill Code (MISC 2.5, i.e., therapist behaviors and global ratings) and the Client Language Assessment - Proximal/Distal (CLA-PD, i.e., client language). Frequentist and Bayesian sequential analyses examined the relationship among nine different categories of therapist behaviors and three different categories of client language (i.e., change talk, sustain talk, neutral). We examined odds ratios and conditional probabilities for the direction, magnitude, and significance of the association between the use of MI technical behaviors and subsequent client statements about change. The study compared these same transitional associations between low/average (i.e., <4) and high (i.e., ≥4) MI Spirit sessions.
The pattern of results was replicated across both analytic frameworks. Questions and reflections about change talk versus sustain talk versus neutral statements showed greater odds of predicting the intended client response (i.e., change talk, sustain talk, neutral, respectively) compared to other possible client responses. Conditional probabilities for these transitions were high, ranging from 0.55 to.88. The magnitude of certain technical transitions significantly differed between low/average and high MI Spirit sessions.
Analyses supported the hypothesized associations between therapist use of technical MI behaviors and client change language within this Latinx sample. Analyses of MI Spirit as a moderator of these transitions showed partial support.