Motivational interviewing (MI) is a directive, client-centered therapeutic method employed in the treatment of substance abuse, with strong evidence of effectiveness. To date, the sole mechanism of action in MI with any consistent empirical support is """"""""change talk"""""""" (CT), which is generally defined as in-session verbal commitments by clients to change their problem behavior. """"""""Sustain talk"""""""" (ST) incorporates verbal commitments to maintain the status quo. MI maintains that during addiction treatment clients essentially talk themselves into change. Multiple studies have supported this theory, revealing that the frequency and strength of these change talk utterances from MI treatment sessions predict substance use outcomes. Although a causal chain has now been established linking therapist speech, client change talk, and substance use outcomes, the neural substrate of change talk remains largely uncharted. This K01 proposal is designed to explore that neural substrate. Building upon the results of studies of causal mechanisms in motivational interviewing, this application represents an effort to identify biologically-based processes that underlie client change talk during treatment sessions, with the long-term goal of understanding how it might be more efficiently and powerfully elicited to improve substance abuse outcomes. Furthermore, this study is designed to provide important training to prepare me for a career as an independent clinical scientist. My immediate career goals are to: (1) acquire expert-level knowledge about endophenotypes in alcohol use disorders, (2) deepen my knowledge about advanced analysis methodologies including network- level functional neuroimaging analysis and longitudinal data analysis, and (3) develop my scientific and grant writing skills. My overarching goal is to become an independent clinical scientist and a leader in the application of neuroimaging methodologies to study mechanisms of behavior change in substance abuse treatment. Under the guidance of a mentoring team led by Dr. Barbara McCrady and including Dr. Vince Calhoun, Dr. Theresa Moyers, and Dr. Claudia Tesche, I will explore the neural substrate of change talk during an actual MI session using magnetoencephalography (MEG) in a sample of ambivalent alcohol users. In subsequent measurement sessions I will use MEG to measure brain responses to brief utterances of the client's own change talk and sustain talk recorded from that MI session. In this way I can explore differences between brain activity measured when change talk is originally expressed within an MI session, and that measured in follow- up measurements using recordings of the client's change talk. I will also examine differences in brain activity between change talk and sustain talk using independent component analysis, and test for relationships between brain activity and substance use outcomes. In the long term this information could be used to develop refinements to motivational interviewing, targeting the salient brain regions and processes more precisely in order to achieve the most efficient and powerful expressions of change talk, which could ultimately lead to improved substance abuse outcomes.

Public Health Relevance

Motivational interviewing (MI) is a treatment that has been shown to help drug and alcohol users reduce or stop their substance abuse. This project focuses on using neuroimaging to investigate one proposed active ingredient in MI: client change talk, a special type of language that clients use during treatment sessions indicating their desire, ability, reason, or need to change. The study will measure brain activity during treatment sessions to discover how it might relate to treatment outcomes. The use of neuroimaging to investigate the brain processes that underlie change talk in MI will improve our understanding of why MI works and could allow us to refine the technique to employ this method more efficiently, which could potentially translate into substantial savings in public health dollas.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AA021431-02
Application #
8699609
Study Section
Biomedical Research Review Subcommittee (AA)
Program Officer
Matochik, John A
Project Start
2013-07-15
Project End
2018-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of New Mexico
Department
Type
Organized Research Units
DUNS #
City
Albuquerque
State
NM
Country
United States
Zip Code
87106
Thoma, Robert J; Haghani Tehrani, Poone; Turner, Jessica A et al. (2018) Neuropsychological analysis of auditory verbal hallucinations. Schizophr Res 192:459-460
Houck, Jon M; Manuel, Jennifer K; Moyers, Theresa B (2018) Short- and Long-Term Effects of Within-Session Client Speech on Drinking Outcomes in the COMBINE Study. J Stud Alcohol Drugs 79:217-222
Houck, Jon M; Feldstein Ewing, Sarah W (2018) Working memory capacity and addiction treatment outcomes in adolescents. Am J Drug Alcohol Abuse 44:185-192
Mechanisms of Behavior Change Satellite Committee (2018) Novel Approaches to the Study of Mechanisms of Behavior Change in Alcohol and Other Drug Use Disorders. J Stud Alcohol Drugs 79:159-162
Rodriguez, Mayra; Walters, Scott T; Houck, Jon M et al. (2018) The language of change among criminal justice clients: Counselor language, client language, and client substance use outcomes. J Clin Psychol 74:626-636
Thoma, Robert J; Meier, Andrew; Houck, Jon et al. (2017) Diminished auditory sensory gating during active auditory verbal hallucinations. Schizophr Res 188:125-131
Houck, Jon M; Çetin, Mustafa S; Mayer, Andrew R et al. (2017) Magnetoencephalographic and functional MRI connectomics in schizophrenia via intra- and inter-network connectivity. Neuroimage 145:96-106
D'Amico, Elizabeth J; Houck, Jon M; Tucker, Joan S et al. (2017) Group motivational interviewing for homeless young adults: Associations of change talk with substance use and sexual risk behavior. Psychol Addict Behav 31:688-698
Moyers, Theresa B; Houck, Jon; Glynn, Lisa H et al. (2017) A randomized controlled trial to influence client language in substance use disorder treatment. Drug Alcohol Depend 172:43-50
Moyers, Theresa B; Rowell, Lauren N; Manuel, Jennifer K et al. (2016) The Motivational Interviewing Treatment Integrity Code (MITI 4): Rationale, Preliminary Reliability and Validity. J Subst Abuse Treat 65:36-42

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