Objective: Change talk has been proposed as a mechanism of change in motivational interviewing (MI) by mediating the link between MI technical skills and behavioral outcomes. We tested the influence of therapists' relational skills on this mediation model. Method: Secondary analysis of a randomized controlled trial of individual brief MI for heavy drinking among 20-year-old-Swiss young men, where the MI group (n = 179) significantly reduced drinking compared to an assessment-only control. We coded MI sessions and derived: therapists' MI technical skills, clients' change talk (CT) and sustain talk (ST), and global relational ratings (empathy and MI spirit). We tested moderated mediation models with technical skills as the independent variable, CT and ST as parallel mediators, predicting drinking at 3-month follow-up (controlling for baseline drinking), and relational skills as moderators of the path from technical skills to client mediators. Results: Conditional indirect effects were significant for overall MI technical skills, open questions, and simple reflections (i.e., more of these behaviors related to more ST, which was related to more drinking) when relational skills were low. In contrast, there was a significant conditional indirect effect for complex reflections when relational skills were high (i.e., more complex reflections related to less ST). Conclusions: This study provides partial support for the MI technical and relational process models. Interestingly, support was found regarding the negative side of client ambivalence (ST) in this highly precontemplative sample. Accordingly, MI therapists should work cautiously with ST when clients are at early stages of motivational readiness. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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动机面试技术和关系技能、改变谈话和酒精结果 - 一个有调节的中介分析。

目标：通过调节 MI 技术技能与行为结果之间的联系，变革谈话已被提议作为动机访谈 (MI) 的一种变革机制。我们测试了治疗师的关系技能对这种中介模型的影响。方法：对 20 岁瑞士年轻男性大量饮酒的个人短暂 MI 的随机对照试验的二次分析，其中 MI 组（n = 179）与仅评估对照组相比显着减少了饮酒。我们对 MI 会话进行编码并得出：治疗师的 MI 技术技能、客户的改变谈话 (CT) 和维持谈话 (ST) 以及全球关系评级（同理心和 MI 精神）。我们测试了以技术技能为自变量、CT 和 ST 作为平行中介的调节中介模型，预测 3 个月随访时的饮酒情况（控制基线饮酒），以及作为从技术技能到客户调解人的路径的调节者的关系技能。结果：当相关技能较低时，条件性间接效应对整体 MI 技术技能、开放式问题和简单反思（即，更多的这些行为与更多的 ST 相关，这与更多的饮酒相关）显着。相比之下，当关系技能高时（即，更复杂的反射与更少的 ST 相关），复杂反射有显着的条件间接效应。结论：本研究为 MI 技术和关系过程模型提供了部分支持。有趣的是，在这个高度预先考虑的样本中发现了关于客户矛盾心理 (ST) 的负面影响的支持。因此，当客户处于动机准备的早期阶段时，MI 治疗师应与 ST 谨慎合作。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。