Numerous clinical trials have shown that Motivational Interviewing (MI;Miller &Rollnick, 2002) is an efficacious treatment for alcohol use disorders (AUD) and related health behavior problems (e.g., Burke, Dunn, Atkins, &Phelps, 2005), but much less is known about the therapy mechanisms of MI (Huebner &Tonigan, 2007). Process research has typically relied on behavioral coding schemes such as the Motivational Interviewing Skills Code (MISC;Miller, Moyers, Ernst, &Amrhein, 2008). Although MI mechanism research with the MISC has produced some of the best data to date (e.g., Moyers et al., 2007), behavioral coding has a number of limitations: 1) it is phenomenally labor intensive, 2) objectivity, reliability, and transportability of coding can be challenging, and 3) it is inflexible (i.e., any new codes require completely new coding). The current proposal brings together a highly interdisciplinary team to develop linguistic processing tools to automate the coding of the MISC and Motivational Interviewing Treatment Integrity (MITI;Moyers, Martin, Manuel, Miller, &Ernst, 2007). The coding of both systems is based on two types of linguistic data: what is said, and how it is said. Our team members in computer science, cognitive science, and electrical engineering are leading researchers in text-mining and speech signal processing, and their methods will be applied to MI transcripts and recordings to automate coding of the MISC/MITI. The core, methodological tool will be topic models (Steyvers &Griffiths, 2007), Bayesian models of semantic knowledge representation. Topic models identify groupings of words that constitute meaning units (or topics), and a recent extension models coded data (e.g., MISC) in which the model learns what specific text is associated with specific tags.
Two specific aims encompass the current proposal: 1) Assess the accuracy of topic models to automatically code the MISC/MITI using transcripts and audiofiles of MI sessions, and 2) Test MI theory (within session and long-term outcome) using approximately 1,167 sessions of MI coded in Aim 1.
These aims will be accomplished using three MI intervention studies: two studies focused on college student drinking and one hospital-based study of drug abuse. The long-term objectives are to use innovative linguistic tools to study therapy mechanisms and develop more efficient systems for collecting psychotherapy process data. Alcohol use disorders continue to represent an incredible societal burden in terms of death, health complications, fractured relationships, and economic costs. The current research will provide innovative tools for studying why therapy works, which in turn can help to ameliorate some of the deleterious effects of AUD.

Public Health Relevance

Research focused on psychotherapy mechanisms of alcohol use disorders (AUD) have often relied upon behavioral observation coding schemes, such as the Motivational Interview Skills Code (MISC), which are time consuming and can present difficulties with reliability. The current, interdisciplinary proposal develops methods for automating behavioral coding through applying recent advances in text-mining and speech signal processing.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Special Emphasis Panel (ZRG1-BBBP-D (52))
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Falk, Daniel
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University of Washington
Schools of Medicine
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