Motivational Interviewing Produces Change Talk in Smokers with Serious Mental Illness

Abstract

Objective

Change talk, or client language that is consistent with making a behavioral change, has been found to improve the efficacy of motivational interviewing (MI). It is not known, however, if change talk helps to explain MI’s effect on instigating a quit attempt in smokers with serious mental illness. Methods: We measured change talk in smokers with a serious mental illness (SMI) randomized to receive either a single session adaptation of motivational interviewing or an interactive education intervention. We evaluated relationships between treatment condition, proportion of change talk, and study outcomes of quit attempts and willingness to follow up on treatment provider referrals. Results: Participants receiving the adaptation of motivational interviewing had higher proportions of change talk than participants in the interactive education condition. However, total proportion of change talk did not mediate the relationship between treatment and outcome, nor did it predict making a quit attempt or following up on a referral to contact a treatment provider. Conclusions: Our study found that motivational interviewing has the same change talk augmenting effect in individuals with SMI as those without SMI. Given that anhedonia, negative affect, and depressive symptoms are a major part of serious mental illnesses, it is encouraging that MI can generate change talk in this population. Future smoking cessation intervention trials with larger samples should investigate whether greater amounts of change talk lead to increased quit attempts in this population.

Keywords:

• Motivational interviewing
• serious mental illness
• smoking
• cessation
• change talk

Acknowledgments

The authors would like to express their appreciation to Ylana Lopez, Savannah Chapa, and Sherese Case for serving as raters on the study, and to Drashya Shah and Nicole Weickert for reading the final version of the manuscript and providing feedback.

Disclosure statement

The authors report no conflict of interests.

Additional information

Funding

Research reported in this publication was supported by National Institute of Drug Abuse (NIDA) of the National Institutes of Health under the following award numbers [R33DA041163, K23DA018203].