Client language during Motivational Interviewing interventions is an important predictor of drinking outcomes, but there are inconsistencies in the literature regarding what aspects of client ...language are most predictive. We characterized the structure of client language by factor analyzing frequency counts of several categories of client speech. The results provide limited support for a model proposed by Miller et al. (2006) and Amrhein et al. (2003) but with some important differences. While Amrhein et al. (2003) found that only increasing strength in client commitment language predicted behavior change, the current study revealed that client language preparatory to commitment predicted drinking outcomes.
Clients who verbalize statements arguing for change (change talk CT) in psychotherapy are more likely to decrease alcohol and other drug use (AOD) compared with clients who voice statements in ...opposition of change (sustain talk ST). Little is known about how CT and ST are expressed in groups in which adolescents may vary in their AOD use severity and readiness to change. First, we examined how session content was associated with CT/ST, and then we looked at whether different subtypes of CT/ST were associated with subsequent AOD outcomes 3 months later. Audio recordings (N = 129 sessions) of a 6-session group motivational interviewing (MI) intervention, Free Talk, were coded. Session content was not associated with CT; however, some session content was associated with higher percentages of ST (e.g., normative feedback). Subtypes of CT (Commitment and Reason) were associated with improved AOD outcomes, whereas Ability subtype remarks were related to increased marijuana use, intentions, and consequences. Findings offer helpful guidance for clinical training and narrow in on the type of CT to try to elicit in Group MI sessions. Regardless of session content, adolescents can benefit from hearing CT during the group.
Hippocampal (relational memory) and prefrontal cortex (PFC; working memory) impairments have been found in patients with schizophrenia (SP), possibly due to a dysfunctional connection between ...structures. Neuroanatomical studies that describe reduced fractional anisotropy (FA) in the uncinate fasciculus support this idea. The dysconnection hypothesis in SP was investigated by examining frontotemporal anatomical connectivity (uncinate fasciculus FA) and PFC‐hippocampal memory and their relationship with each other and everyday functioning. PFC‐hippocampal memory was examined with two working‐relational memory tasks: transverse patterning and a virtual Morris water task. SP exhibited a performance deficit on both tasks and had lower FA in bilateral uncinate fasciculus than healthy volunteers. Lower frontotemporal anatomical connectivity was related to lower working‐relational memory performance, and both predicted worse everyday functioning.
It is often difficult for evidence-based practices (EBPs) to find their way into addiction treatment programs. One goal of the National Institute on Drug Abuse's Clinical Trials Network (CTN) is to ...disseminate these EBPs into community treatment programs. The Southwest
Node of CTN hosted a series of 13 local workshops in EBPs led by experts in the topic areas. Participants (N = 327) were asked to complete an online evaluation of the training with a follow-up rate of 75.8%. Respondents reported that the trainings had been applied in their workplace. Qualitative analysis revealed themes of gratitude and a need for additional training opportunities. Participant enthusiasm for training was indicated by the willingness to travel up to a thousand miles and independently pay for travel expenses. Frontline providers are aware of EBPs and eager for further trainings. Future studies should include formal assessments of training needs and measures of skill acquisition.
Social network support for abstinence has been associated with improved treatment outcomes among samples of individuals with alcohol use disorders. As a result, research studies have focused on the ...inclusion of significant others (SOs) in the treatment process. Nonetheless, little is known about 1) the specific influence SOs may have on clients during treatment sessions or 2) whether SO within-session behaviors have any relationship to client post-treatment drinking.
In the current study, Motivational Enhancement Therapy sessions in which a SO was present were coded using a behavioral coding system designed to measure SO and client within-session language.
Relationships were observed between SO and client within-session language. Furthermore, some specific SO categories of language predicted post-treatment client drinking.
This study is the first systematic evaluation of SO contributions in substance abuse treatment sessions. Future research examining SO language in the treatment of alcohol use disorders might allow clinicians to avoid contributions from SOs that are associated with poorer drinking outcomes.
We measured brain activity using magnetoencephalography in five participants during ongoing tasks that included prospective memory, retrospective memory, and oddball trials. Sources were identified ...in the hippocampal formation and posterior parietal and frontal lobes. Posterior parietal cortex activation had an earlier onset in the prospective memory condition than retrospective memory or oddball conditions, a higher level of theta activity in the retrospective condition, and higher levels of upper alpha in the prospective and oddball conditions. Activation of the hippocampal formation had a longer duration in the retrospective memory and prospective memory conditions than the oddball condition, but prominent alpha and theta band activity was present in all three conditions. We interpret the early (87 ms) onset of activity in parietal cortex as evidence for an initial noticing of appropriate conditions for a PM response. Hippocampal activity may reflect a subsequent memory search for the intended action.
Although motivational interviewing (MI) is an effective method for promoting change in problematic alcohol and other drug use, it does not benefit all clients. Clinicians have little empirical ...guidance on who is likely to benefit from MI and who is not. We hypothesized that differences in clients' spontaneously offered language early in the session would predict their responsiveness to MI during the remainder of the session.
The study obtained coding data from 125 counseling sessions from a large randomized controlled trial of clinician training. A cluster analysis created one group of clients whose language reflected ambivalence, and one group whose language reflected readiness to change. We conducted a univariate analysis of variance to compare the mean change in percent change talk across the session between groups.
Clients whose language reflected ambivalence early in the session had a greater change in their percent change talk during the remainder of the session, compared to those whose language reflected greater readiness to change (F (1,90) = 63.02, t = 7.94, p < .001). Surprisingly, the group whose language reflected readiness had a decrease in their percent change talk during the remainder of the session (M = −10.9%, SD = 16.3%). Adjusting the results for regression to the mean effects did not eliminate these differences.
Clients' language early in the session may offer clinicians some guidance on whether MI is likely to be useful or counterproductive in the treatment of substance use disorder.
•Assessing clients’ language at the start of the session may tell clinicians whether to use motivational interviewing (MI)•Clients whose language is ambivalent early in the session may respond well to MI•For clients whose are ready to change, MI may be counterproductive•Measuring ambivalence as a balance of change and sustain talk may be a promising method for investigations of MI process and theory
The alcohol treatment literature has established in-session client speech as a mechanism of change that therapist behavior can influence and that can predict drinking outcomes. This study aimed to ...explore temporal patterns of in-session speech in Alcohol Behavioral Couple Therapy (ABCT), including the unique interplay between client and partner speech and the role of speech trajectories in predicting client drinking outcomes. Participants were 165 heterosexual couples receiving ABCT in one of four clinical trials. We coded client speech on an utterance-by-utterance basis using the System for Coding Couples' Interactions in Therapy–Alcohol. We focused on individual-level speech codes of change talk and sustain talk and couple-level variables of positive and negative interactions. We segmented the initial and midtreatment sessions into quartiles to conduct path analyses and latent growth curve models. Path analyses suggested that clients and partners may not have been aligned in terms of treatment goals at the start of the therapy. This misalignment within couples was pronounced during the initial session and decreased by the midtreatment session, reflecting progression toward treatment goals. Of the latent growth curve models, only client sustain talk during the midtreatment session predicted greater client drinking at the end of treatment. Results provide insight into the inner workings of ABCT and suggest recommendations for ABCT therapists. This study also supports a growing consensus that sustain talk may be a stronger mechanism of change than change talk in various alcohol treatment interventions.
•In Session 1, client CT11CT = change talk predicted partner ST,22ST = sustain talk which then elicited client CT.•By mid-treatment, partner CT predicted higher client CT and lower client ST.•Couples' language became more aligned over the course of treatment.•Higher client ST during mid-treatment predicted higher follow-up drinking.
When observers are presented with targets in the context of temporal structure, performance is modulated by that structure. Interval timing mechanisms and coupled oscillators are two popular classes ...of model that attempt to explain how temporal structure modulates attention and motor performance to bring about the behavioral costs and benefits of temporal structure. In this experiment, participants made speeded choice reactions to targets following a series of visual warning stimuli. The warning stimuli afforded prediction of target onset time. Brain activity related to temporally focused attention and motor preparation was measured using magnetoencephalography. Parietal, cerebellar, and somatomotor activity was found to be associated with response latency and the performance benefit of the cued relative to uncued targets. Parietal activity was consistent with an interval timing mechanism, while somatomotor activity was more consistent with a coupled oscillator mechanism. Cerebellar activity had features consistent with both mechanisms. To our knowledge, this is the first evidence that both processes occur simultaneously.
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