Psychology ETDs

Jon Houck

Publication Date

8-31-2011

Abstract

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, to date the neural substrate of change talk has been largely uncharted. Participants were 10 individuals who were ambivalent about their substance use. Each participant had a recorded MI session with an expert therapist. Following each participant's session the precise time of each change talk (CT) or sustain talk (ST) utterance was noted, and these utterances were extracted from the recording as separate files. During a MEG scan participants heard approximately 200 repetitions of these utterances, intermingled and presented in a random order. MEG and MRI data were analyzed using the Freesurfer, MNE, and AFNI software packages. Time frequency analysis of MEG data was conducted using MATLAB. Results suggest that early processing of CT occurs in a right-hemisphere network that includes inferior frontal gyrus, insula, and superior temporal cortex. In addition, time frequency analysis revealed significant activity in the theta band in both IFG and insula. These results support a representation of change talk at the neural level, and are consistent with the role of these structures in cognitive dissonance processing. In general, these findings suggest that during MI treatment sessions, therapists who are able to evoke this special kind of language are tapping into neural circuitry that could be essential for behavior change.

Degree Name

Psychology

Level of Degree

Doctoral

Department Name

Psychology

First Committee Member (Chair)

Yeo, Ronald

Second Committee Member

Bogenschutz, Michael

Third Committee Member

Moyers, Theresa

Sponsors

National Institute on Drug Abuse R21DA025135

Language

English

Keywords

Motivational interviewing, Change (Psychology), Substance abuse--Treatment, Clinical neuropsychology, Magnetoencephalography.

Document Type

Dissertation

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