The language of change among criminal justice clients: Counselor language, client language, and client substance use outcomes

Abstract

Objective: Counselor and client language have been identified as mechanisms of change in motivational interviewing (MI) counseling sessions. This study evaluated whether language patterns exhibited during MI sessions with substance users in the community would also be found during MI sessions with substance users in the criminal justice system.

Method: Forty audio recordings of MI sessions with substance-using probationers were coded and analyzed sequentially using the Motivational Interviewing Skills Code (MISC) 2.5. Analyses examined the relationship between counselor and client language, and the relationship between client language and client substance use after 2 months.

Results: Counselor MI inconsistent language was associated with decreased change talk (lnOR = - 0.76, p < .05) though not with increased sustain talk. Both sustain talk (b = - 4.591, t = - 18.634 p < .001) and MI inconsistent language MIIN (b = - 4.419, t = - 19.886, p < .001) were positively associated with substance use at 2 months. Sustain talk early in the session (i.e., during deciles 1 and 2) was significantly greater among clients who reported using substances at 2 months, compared to clients who did not use substances.

Conclusion: These findings are broadly consistent with previous literature documenting the association between counselor language, client language, and client outcome.

Trial registration: ClinicalTrials.gov NCT01891656.

Keywords: addiction; motivational interviewing; substance abuse; treatment efficacy.

© 2017 Wiley Periodicals, Inc.

Figures

Figure 1

Frequency of Sustain Talk, by Substance Users vs. Non-Users at 2-months