Motivational Interviewing With Male Couples to Reduce Substance Use and HIV Risk: Manifestations of Partner Discord and Strategies for Facilitating Dyadic Functioning
Motivational Interviewing With Male Couples to Reduce Substance Use and HIV Risk: Manifestations of Partner Discord and Strategies for Facilitating Dyadic Functioning
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DOI：
10.1037/pst0000278
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发表时间：
2020-03-01
期刊：
影响因子：
2.5
通讯作者：
Ingersoll, Karen S.
中科院分区：
文献类型：
--
作者：
Starks, Tyrel J.;Robles, Gabriel;Ingersoll, Karen S.
动机访谈（MI），以减少物质使用的功效是公认的，但是，它的使用与夫妇遇到了喜忧参半的结果。制定这类干预措施对男性夫妇特别重要，因为这一人群中药物使用率相对较高，而且药物使用与性关系功能的各个方面有关。在与夫妇进行MI时注意到的一个挑战是如何应对伴侣彼此不同意或反对改变的情况。在夫妻相互依赖理论的指导下，我们将会话中的冲突概念化为适应过程中的失败。我们使用定性分析，以检查冲突的表现形式在会话中，并确定有效的供应商的响应策略。样本包括14对顺式男性夫妇，其中至少有一名伴侣年龄在18-29岁之间，报告使用药物，并且是HIV阴性。所有夫妇都完成了3次MI疗程，每次持续60-75分钟。冲突的表现形式包括思想/感情的混淆、模糊或间接的沟通以及不准确的假设。有效的供应商的反应包括纠正假设，转移焦点，关系修复，“共同点”的反射，和关系的肯定。观察到的冲突与适应过程的破坏性解决方案的概念化一致（即，忽视和忽视）。有效的供应商对冲突的反应促进了二元功能和催化建设性的住宿。这些结果提供了一个初步的供应商的技能和战略，可能是特别相关的工作与性少数男性夫妇，对他们来说，实现周围的吸毒和性健康目标的住宿往往被视为一个关键的干预机制。
The efficacy of motivational interviewing (MI) to reduce substance use is well established; however, its use with couples has met with mixed results. The development of such interventions is particularly relevant for male couples, as rates of substance use in this population are comparatively high and use is associated with aspects of sexual relationship functioning. One challenge noted in conducting MI with couples is how to respond to situations in which partners disagree with one another or argue against change. Guided by the couples interdependence theory, we conceptualized conflicts within session as failures in the accommodation process. We used qualitative analysis to examine manifestations of conflict in session and to identify effective provider response strategies. The sample included 14 cis-male couples with at least 1 partner was aged 18-29 years, reported substance use, and was HIV negative. All couples completed 3 MI sessions lasting 60-75 min each. Manifestations of conflict included conflation of thoughts/feelings, vague or indirect communication, and inaccurate assumptions. Effective provider responses included correcting assumptions, shifting focus, relationship repair, "common ground" reflections, and relationship affirmations. Observed conflicts aligned with conceptualizations of destructive resolutions to the accommodation process (i.e., exit and neglect). Effective provider responses to conflict facilitated dyadic functioning and catalyzed constructive accommodation. These results provide an initial compendium of provider skills and strategies that may be particularly relevant in work with sexual minority male couples, for whom achieving accommodation around drug use and sexual health goals is often viewed as a key mechanism of intervention.