Integration of Motivational Interviewing and Behavioral Economic Theories to Enhance Brief Alcohol Interventions: Rationale and Preliminary Examination of Client Language

• Published in: Experimental and clinical psychopharmacology 2021-02, Vol.29 (1), p.90-98
• Main Authors: Ladd, Benjamin O., Murphy, James G., Borsari, Brian
• Format: Article
• Language: English
• Subjects: Alcohol Drinking in College - psychology; Alcohol Treatment; Behavior Change; Behavioral Economics; College Students; Economics, Behavioral; Female; Human; Humans; Interviewing; Language; Male; Motivational Interviewing; Motivational Interviewing - methods; Pilot Projects; Students - psychology; Test Construction; Theories; Young Adult
• ISSN: 1064-1297; 1936-2293
• DOI: 10.1037/pha0000363

Motivational interviewing (MI) is a widely disseminated evidence-based therapeutic approach for engaging clients and motivating health behavior change, especially risky substance use. Refinement of MI theory over the past few decades has provided empirical evidence that the technical component of MI (in-session client language) is a promising mechanism of behavior change (MOBC). However, heterogeneous and small to moderate effect sizes suggest the need for refinement of MOBC measurement and consideration of other types of client language. The current article presents a complementary integration of current MI theory and behavioral economic (BE) mechanisms to further understanding of in-session factors associated with subsequent behavior change. In this paper, we define some of the key MOBCs from MI and BE theories, describe our integrated framework, and present preliminary findings from a pilot study of the effectiveness and MOBCs of a novel BE-informed application of MI in risky college student drinkers. Results from preliminary coding development suggest that BE-informed measures of client language better predict response to a brief intervention in risky college students than traditional change talk measures. We posit that BE theory can offer insight into meaningful session content beyond the current MI constructs of change talk and sustain talk, which in turn may serve to enhance development of clinical practice and inform scientific investigations. Public Health Significance This review presents background and rationale for the integration of motivational interviewing and behavioral economic mechanisms of change. Findings from a pilot study suggest adapting and expanding current measures of change talk can improve prediction of health behavior change in college student drinkers from in-session language during a brief alcohol intervention.