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How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within
Theresa B Moyers1, William R Miller1, Stacey M L Hendrickson1
1Center on Alcoholism, Substance Abuse, and Addictions.
Journal of Consulting and Clinical Psychology
|September 22, 2005
Summary
Therapist interpersonal skills in motivational interviewing (MI) enhance client involvement. Surprisingly, even behaviors inconsistent with MI amplified this effect, suggesting complex mechanisms in behavior change therapy.
Area of Science:
- Psychology
- Behavioral Science
- Clinical Psychology
Background:
- Motivational interviewing (MI) is recognized for reducing problem behaviors.
- The causal mechanisms underlying MI's effectiveness, particularly the role of therapist skills, require further investigation.
- Therapist interpersonal skills are hypothesized to influence client engagement and commitment language in MI.
Purpose of the Study:
- To investigate the association between therapist interpersonal skills and client involvement during MI sessions.
- To explore whether therapist behaviors inconsistent with MI impact the relationship between therapist skills and client involvement.
- To examine the role of client involvement as a mediator in the MI process for substance abuse treatment.
Main Methods:
- Analysis of 103 unique MI sessions for substance abuse.
- Utilized the Motivational Interviewing Skills Code (MISC; Version 1.0) rating system.
- Measured therapist interpersonal skills, client involvement (cooperation, disclosure, affect expression), and MI-adherent/non-adherent behaviors.
Main Results:
- Therapist interpersonal skills were positively associated with client involvement.
- Client involvement was positively associated with subsequent client commitment language.
- Unexpectedly, behaviors inconsistent with MI amplified the positive impact of therapist interpersonal skills on client involvement.
Conclusions:
- Therapist interpersonal skills are crucial for fostering client involvement in MI.
- The study highlights the complex interplay between therapist behaviors and client engagement.
- Further research is needed to understand the mechanisms by which MI-inconsistent behaviors may enhance therapeutic impact, alongside addressing study limitations such as sampling bias.