What is the impact of therapists’ response to resistance talk in MI?
Research type
Research Study
Full title
How does a therapist respond to resistance and what impact does this have on the client? An analysis of speech in Motivational Interviewing based treatment sessions for alcohol misuse.
IRAS ID
148566
Contact name
Laura Drage
Contact email
Sponsor organisation
University of Leeds
Research summary
Resistance to change occurs when a person is ambivalent about it (has reasons both for and against change) and they feel pressure to make a change they are not ready for. It emerges from an interaction between two or more people (e.g. a client and therapist). Resistance is reliably observed in client speech as discussing reasons against change or maintaining their status quo (‘counter-change talk’).
Such resistance is commonly observed in heavy drinkers and can add to an individual’s difficulty in overcoming their addiction. This has negative consequences to their physical and psychological health and is costly for the NHS.
Motivational Interviewing (MI) is an acceptable treatment for heavy drinkers who are seeking treatment to change their addictive behaviour. A central feature of MI is to minimise resistance as this reduces the likelihood of change. How the therapist responds to a client’s resistance talk is therefore important. Existing evidence from sequential speech analysis suggests therapist speech affects what the client will say next and vice versa. Client speech also predicts their future behaviour (if they verbalise commitment to change they are more likely to make that change).
The objective of this research is to investigate how the therapist responds to client resistance talk and if this makes a difference to the client’s subsequent response. The sequential speech analysis will focus on three utterances (defined as a complete thought or thought unit):
i) Client language that expresses resistance,
ii) The therapist’s response to this resistance and
iii) The client’s subsequent speech.The data will be obtained from existing in-session therapy recordings from the UKATT trial (UK Alcohol Treatment Trial). Client and therapist speech will be coded using a specialist manual; MISCOPE (Motivational Interviewing Sequential Code for Observing Process Exchanges). All speech codes will be grouped into categories for analysis.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
14/WM/0075
Date of REC Opinion
27 Feb 2014
REC opinion
Favourable Opinion