A randomized controlled trial to influence client language in substance use disorder treatment

Area of Science:

• Psychology
• Clinical Psychology
• Addiction Science

Background:

• Client language, specifically change talk and sustain talk, is linked to substance treatment success.
• It remains unclear if therapists can intentionally modify client language during motivational interviewing (MI).

Purpose of the Study:

• To determine if substance use disorder (SUD) providers can be trained to influence client language during therapy sessions.
• To investigate the impact of specialized MI training on client change and sustain talk.

Main Methods:

• A randomized controlled trial involving 190 SUD treatment providers.
• Providers were assigned to standard MI training (MI-AU) or training focused on influencing client language (MI-LEAF).
• Client sessions were evaluated by masked raters at 3, 6, and 12 months post-training to measure client change and sustain talk.

Main Results:

• Clients of providers receiving specialized MI-LEAF training exhibited significantly lower sustain talk (b=-0.175, p=0.046).
• No significant difference was found in change talk.
• Mediation analysis indicated that training led to providers minimizing sustain talk, which in turn reduced client sustain talk (κ²=0.0833).

Conclusions:

• Specialized motivational interviewing training enables providers to decrease client opposition language (sustain talk) regarding substance use changes.
• This demonstrates that client language is partially controllable by providers, validating the potential for clinical trials focused on language-based interventions.