Motivational interviewing: Key ingredients associated with taking a step toward employment

Area of Science:

• Psychiatry
• Psychology
• Rehabilitation

Background:

• Unemployed veterans with serious mental illness (SMI) face significant barriers to competitive employment (CE).
• Motivational interviewing (MI) is a therapeutic approach that may facilitate employment-related behavior change.

Purpose of the Study:

• To identify specific components of MI associated with unemployed veterans with SMI taking steps toward CE.
• To examine the predictive value of client talk (change talk, sustain talk) and counselor MI practice.

Main Methods:

• Analysis of 195 audiotaped MI sessions with 39 veterans with SMI.
• Coding of counselor MI behaviors and client talk (change talk, sustain talk).
• Multivariate modeling using generalized estimating equations, controlling for covariates.

Main Results:

• Client intensity of change talk and sustain talk significantly predicted taking steps toward CE.
• Counselor adherence to MI technical principles (cultivating change talk, softening sustain talk) was also significant.
• These factors remained significant after controlling for session number, work importance, work confidence, and unemployment duration.

Conclusions:

• Client change talk and sustain talk are associated with employment-seeking behaviors in veterans with SMI.
• Counseling strategies focused on cultivating change talk and softening sustain talk enhance the likelihood of veterans with SMI pursuing competitive employment.