Name: Motivating substance abusers for change – Semiotic perspectives to client-counselor interaction

Responsible director: Academy Research Fellow Harri Sarpavaara

Funding: Academy of Finland

Duration: 08/2011 – 08/2016

In English

The aim of this project is to conduct a detailed semiotic study of the client-counselor interaction in initial Motivational Interviewing based consultations with substance abusers to find out their proximal and distal effects on the clients’ treatment response.

Motivational Interviewing (MI) is a widely recommended style of counseling. It is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. MI is one of the leading evidence based methods for helping people with substance abuse and other behavioral problems. However, the research done in this area gives rise to new questions about ”what works” in MI.

In this research project I examine the process and outcome of initial MI sessions from a perspective that complements the previous MI research with a new aspect. The basic idea is to map the semiotic features of MI sessions, which might be predictive of clients’ willingness to change their addictive behaviors during the follow-up year. The project will contribute new information as to why MI “works” by applying the methods in the field of semiotic analysis to the study of this popular therapeutic approach.

I hypothesize that some semiotic features in client-counselor interaction predict the clients’ MI treatment outcome. The focus of my research will be on a detailed semiotic analysis of the use of signs in client-counselor interaction in MI sessions and on an outcome of these sessions. My main research questions are:

1) How the client-counselor interaction and clients’ change talk in the MI sessions is constructed by semiotic features?

2) Which semiotic features of the client-counselor interaction in the initial MI sessions increase or decrease clients’ commitment to change?

3) Do these semiotic features in the initial MI sessions predict clients’ later behaviors?

The data for this study have been collected from an MI based structured BIC program for clients in Finnish probation service. Altogether 25 counselors and 50 clients have volunteered to participate. Their first two sessions have been videotaped and transcribed. The outcome is measured by interviewing the clients on their use of psychoactive substances 6 and 12 months later.

Successful treatment engagement is based on creating a good working alliance. Consequently, I study, what kinds of signs are used to develop the sense of cooperation and direction in the initial sessions. Semiotic methods are here used to analyze, e.g. the role of metaphors in client-counselor interaction as the tools of change and as a means of creating rapport between the communicating partners. My goal is to apply some ideas of Charles Sanders Peirce’s pragmatic theory of signs. This semiotic theory offers the relevant methodological point of view to the interaction analysis because it pays special attention to the action and the effect of signs.