Counsellor behaviours and patient language during brief motivational interventions: a sequential analysis of speech
Counsellor behaviours and patient language during brief motivational interventions: a sequential analysis of speech
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DOI：
10.1111/j.1360-0443.2008.02337.x
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发表时间：
2008-11-01
期刊：
影响因子：
6
通讯作者：
Daeppen, Jean-Bernard
中科院分区：
文献类型：
--
作者：
Gaume, Jacques;Gmel, Gerhard;Daeppen, Jean-Bernard
目的：通过分析心理咨询师行为和患者语言之间的衔接，在简短的动机干预（BMI）解决风险酒精消费的假设关系的心理咨询师动机访谈（MI）技能和患者的变化谈话（CT）进行实证研究。设计序贯分析的心理语言代码由两个独立的评分员使用动机面试技巧代码（MISC），版本2.0。对一项随机对照试验的数据进行二次分析，该试验评价了BMI在急诊科的有效性。研究对象97例患者在接受BMI时进行录音。测量MISC变量分为三个辅导员的行为（MI一致，MI不一致和“其他”）和三种病人的语言（CT，反CT（CCT）和话语不与酒精主题）。使用序贯分析软件计算观察到的转换频率、条件概率和基于比值比的显著性水平。结果MI一致的行为是唯一的辅导员行为，显着更有可能被病人CT。这些行为更有可能被患者改变探索（CT和CCT），而MI不一致的行为和“其他”顾问行为更有可能被与酒精话题无关的话语所遵循，而CT则不太可能被遵循。MI一致的行为更有可能改变探索后，而“其他”辅导员的行为更有可能只有在话语不与酒精主题。结论研究结果支持MI一致的行为和CT之间的假设关系，突出患者对辅导员行为的影响的重要性，并强调MI技术和精神的有用性，在简短的干预措施，针对变化增强。
Aims To investigate empirically the hypothesized relationship between counsellor motivational interviewing (MI) skills and patient change talk (CT) by analysing the articulation between counsellor behaviours and patient language during brief motivational interventions (BMI) addressing at-risk alcohol consumption. Design Sequential analysis of psycholinguistic codes obtained by two independent raters using the Motivational Interviewing Skill Code (MISC), version 2.0. Setting Secondary analysis of data from a randomized controlled trial evaluating the effectiveness of BMI in an emergency department. Participants A total of 97 patients tape-recorded when receiving BMI. Measurements MISC variables were categorized into three counsellor behaviours (MI-consistent, MI-inconsistent and 'other') and three kinds of patient language (CT, counter-CT (CCT) and utterances not linked with the alcohol topic). Observed transition frequencies, conditional probabilities and significance levels based on odds ratios were computed using sequential analysis software. Findings MI-consistent behaviours were the only counsellor behaviours that were significantly more likely to be followed by patient CT. Those behaviours were significantly more likely to be followed by patient change exploration (CT and CCT) while MI-inconsistent behaviours and 'other' counsellor behaviours were significantly more likely to be followed by utterances not linked with the alcohol topic and significantly less likely to be followed by CT. MI-consistent behaviours were more likely after change exploration, whereas 'other' counsellor behaviours were more likely only after utterances not linked with the alcohol topic. Conclusions Findings lend support to the hypothesized relationship between MI-consistent behaviours and CT, highlight the importance of patient influence on counsellor behaviour and emphasize the usefulness of MI techniques and spirit during brief interventions targeting change enhancement.