Integration of Motivational Interviewing and Behavioral Economics Theories to Enhance Measurement of Client Language as a Mechanism of Behavior Change

项目摘要 动机面试(MI)理论认为，客户语言的某些衡量标准起着关键作用 行为改变。具体地说，更多的变革言论，或支持走向健康的声明 行为，以及减少维持性谈话或支持维持不健康行为的声明，应该是 减少高风险的酒精使用。虽然研究结果支持MI的这一技术假说的各个方面，但有一个 当前客户语言研究的局限性。值得注意的是，大量的会话语言 未经审查，当前的MI模式缺乏指导会议内容的理论，特别是在 客户还没有准备好讨论饮酒的变化。行为经济学(BE)理论假设 物质的强化价值是物质使用的效益/成本比相对于 其他可用活动的收益/成本；因此，BE提供了一个结构，通过该结构可以了解 酒精和其他强化行为。BE还认为延迟的奖励折扣是一个关键因素 与行为的价值评估相关的。拟议的研究旨在整合尖端的MI过程 运用BE理论进行研究，目标是开发创新的、理论驱动的概念化 与大学生饮酒有关的客户语言和对短暂干预的反应。由Be和 MI专家表示，拟议的研究小组将开发和测试使用并行 涉及每种客户语言发声的多个独立选择的决策过程：一个用于 激励状态，行为目标的另一种状态(例如，谈论一种替代的无物质行为 因为花更多的时间研究与确定的减少饮酒的目标行为相比)，以及第三相关 时间导向(例如，讨论未来目标与当前情况)。在最初的开发期间 阶段，来自三个已完成的随机对照试验的MI会议记录将使用新的编码 客户语言变量，并与传统的改变谈话和维持性谈话的定义进行比较以检验 收敛效度、发散效度和递增效度。接下来，使用另外两个已完成的录音 随机对照试验，新的编码系统将检查客户的语言作为反应的预测因素 与传统的心肌梗死干预相比，这是一种创新的BE临床应用。最后，使用来自所有五个国家的数据 在最初的试验中，我们将检验客户语言的条件模型作为治疗反应的预测因素。这个 目前的研究有很大的潜力来加强努力，减少有风险的年轻人饮酒，并告知临床 训练和实践。

Project Summary Motivational interviewing (MI) theory posits certain measures of client language serve as key mechanisms of behavior change. Specifically, increased change talk, or statements supporting movement toward healthy behavior, and decreased sustain talk, or statement supporting maintenance of unhealthy behavior, should lead to reductions in risky alcohol use. While findings support aspects of this technical hypothesis of MI, there are a number of limitations to the current study of client language. Of note, large amounts of in-session language go unexamined and the current MI model lacks a theory guiding session content, particularly in contexts where clients are not ready to discuss changes in drinking. Behavioral economics (BE) theory assumes the reinforcing value of a substance is a function of the benefit/cost ratio of substance use in relation to the benefit/cost of other available activities; thus BE provides a structure by which to understand the value of alcohol and other reinforcing behaviors. BE also identifies delayed reward discounting as a critical factor associated with value appraisal of behavior. The proposed research aims to integrate cutting-edge MI process research with BE theory with the goal of developing an innovative, theoretically-driven conceptualization of client language associated with college alcohol use and response to brief intervention. Comprised of BE and MI experts, the proposed research team will develop and test an enhanced coding system that uses a parallel decision-making process involving multiple independent choices for each client language utterance: one for motivational state, another for behavioral target (e.g., talking about an alternative substance-free behavior such as spending more time studying vs. the identified target behavior of alcohol use reduction), and a third related to temporal orientation (e.g., discussing future goals vs. present circumstances). During the initial development stage, MI session recordings from three completed randomized controlled trials will be coded using the novel client language variables and compared to conventional definitions of change talk and sustain talk to examine convergent, divergent, and incremental validity. Next, using recordings from another two completed randomized controlled trials, the novel coding system will examine client language as a predictor of response to an innovative BE clinical application compared to a traditional MI intervention. Finally, using data from all five original trials, we will examine conditional models of client language as predictors of treatment response. The current study has significant potential to enhance efforts to reduce risky young adult drinking and inform clinical training and practice.