OBJECTIVE Motivational Interviewing (MI) is described as a method for improving clinical outcomes by reducing client ambivalence. If this is true, MI's focus on improving clients' motivational language should be most useful for clients with ambivalence about change and less valuable for those who are ready to implement new behaviors or are opposed to change. To address this hypothesis and potentially add precision to MI delivery in clinical settings, we tested whether the relationship between clients' in-session motivational language and posttreatment alcohol use depended on their baseline motivation to change. METHOD Client speech from 149 sessions from Project MATCH were analyzed. A cluster analysis of the percent change talk during the first decile of the session identified three motivational groups: opposed, ambivalent, and ready. The change in percent change talk (C-PCT) across the session was calculated for each group. Zero-inflated negative binomial analysis was used to test whether the effect of C-PCT on end-of-treatment drinking varied between motivational groups. RESULTS The count part of the model revealed a significant interaction between C-PCT and membership in the ambivalent group (b = -17.710, 95% CI [-25.775, -9.645], p < .001), only for those who received MI. Favorable C-PCT was associated with less drinking (b = -15.735, p = .004). Only baseline drinking was a significant predictor of abstinence at follow-up (b = .032, 95% CI [0.012, 0.051], p = .001). CONCLUSION A putative MI mechanism-improved client motivational language-appears most important for clients who express ambivalence in the opening minutes of the session, with minimal value for those who do not. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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动机语言的改善是否可以预测动机访谈中的饮酒情况？矛盾心理很重要。


客观动机访谈（MI）被描述为一种通过减少客户矛盾心理来改善临床结果的方法。如果这是真的，MI 专注于改善客户的激励语言，这对于那些对变革持矛盾态度的客户来说应该是最有用的，而对于那些准备好实施新行为或反对变革的客户来说则不太有价值。为了解决这一假设并可能提高临床环境中 MI 实施的精确度，我们测试了客户在治疗期间的动机语言与治疗后饮酒之间的关系是否取决于他们改变的基线动机。方法 对来自 Project MATCH 的 149 场会议的客户演讲进行了分析。对会议的第一个十分位期间的百分比变化谈话进行聚类分析，确定了三个动机组：反对、矛盾和准备。计算每组在整个会话中的百分比变化谈话（C-PCT）的变化。使用零膨胀负二项式分析来测试 C-PCT 对治疗结束饮酒的影响在动机组之间是否存在差异。结果 模型的计数部分揭示了 C-PCT 与矛盾组成员之间存在显着交互作用 (b = -17.710, 95% CI [-25.775, -9.645], p < .001)，仅适用于接受治疗的患者米。有利的 C-PCT 与饮酒量减少相关（b = -15.735，p = .004）。只有基线饮酒是随访时戒酒的显着预测因子 (b = .032, 95% CI [0.012, 0.051], p = .001)。结论 假定的 MI 机制——改进的客户激励语言——对于那些在会议开始时表达矛盾心理的客户来说似乎最重要，而对于那些没有表达矛盾的客户来说价值最小。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。