Temporal variation in facilitator and client behavior during group motivational interviewing sessions

Area of Science:

• Behavioral Psychology
• Clinical Psychology
• Addiction Research

Background:

• Motivational Interviewing (MI) is effective for behavior change.
• The causal chain of MI involves facilitator speech influencing client speech.
• Previous research explored session and utterance levels, but not cross-session effects in groups.

Purpose of the Study:

• To examine the influence of facilitator speech on client change talk (CT) across segments of group MI sessions.
• To investigate the temporal dynamics between facilitator and client speech within group MI.
• To understand how specific facilitator behaviors (open-ended questions, reflections) impact client CT over time.

Main Methods:

• Analyzed 129 adolescent Group MI sessions using a behavioral coding system.
• Segmented sessions into 5 quintiles to track facilitator and client speech.
• Employed cross-lagged panel analysis with a zero-inflated negative binomial model.

Main Results:

• Facilitator speech showed minimal direct influence on subsequent client CT across most of the session.
• Client CT significantly predicted subsequent client CT and facilitator speech.
• Facilitator open-ended questions had differential effects, suppressing CT early and enhancing it late in sessions.

Conclusions:

• Session-level effects of facilitator speech on client speech are not sustained long-term.
• Client's change talk is a powerful driver of therapeutic process within group MI.
• Clinicians should reinforce spontaneous client CT and strategically use open-ended questions, particularly near session's end.