Motivational Interviewing Skills as Predictors of Change in Emerging Adult Risk Behavior

Emerging adulthood is a unique developmental stage during which significant transitions in living environment, social networks, personal responsibilities, and identity development occur. Stress associated with these transitions relates to increases in health-risk behaviors, such as substance use and high-risk sexual behavior. This research examined health-risk behavior outcomes associated with the Young Adult Family Check-Up (YA-FCU). The YA-FCU comprises three sessions: an initial interview, an ecological assessment, and a feedback session that integrates motivational interviewing (MI) techniques. This study measured treatment fidelity of the YA-FCU and the extent to which therapists adhered to principles of MI during feedback sessions. Therapists included both licensed psychologists and trainees. The study also examined the relationship between therapists' MI fidelity and client change talk (CT), in order to determine if MI fidelity and client CT predicted postintervention health-risk behaviors among emerging adults who participated in the YA-FCU. Measures of health-risk behaviors were collected pre- and post- intervention. Results indicated overall adequate treatment fidelity. MI fidelity was positively related to client CT. Several indicators of MI fidelity predicted decreases in emerging adults' health-risk behaviors. For example, therapist ratio of reflections to questions predicted a decline in emerging adults' alcohol use frequency and marijuana use quantity. These results have important implications for YA-FCU training and implementation and indicate that MI consistent skills might be a mechanism of change in the YA-FCU intervention.