Testing a modified motivational interviewing counseling program

Growing attention to research has recently become prominent in enhancing individuals' ability to change harmful, maladaptive, and unhealthy behaviors by promoting motivation (Kowitlawakul et al., 2022; Vanovenberghe et al., 2022). We usually target what is frequently called socially significant behaviors. Socially significant behvaibehaviors contain a set of behavioral classes that may affect individuals' well-beingpact humanity at varying levels (Heward et al., 2022). Thus, it looks impartimperative to employ effective means and interventions to tackle socially significant behaviors to minimizersonal, social, or broader impactsver, the existing research studies have certain lns that could weaken the effectiveness of the interventions designed to enhance behavior change. At the top of such limitations is the scarcity of theory-based interventions in promoting behavioral change (Prestwich et al., 2015). There is also a lack of consistency in using classified behavioral change techniques (BCTs) (Michie et al., 2013). Furthermore, the literature shows that utilizing person-centered counseling approaches in promote positito life changes is limited (Samdal et al., 2017). The main premise of pcentraln-centered cthe person-centered counseling approauniquely seeing peopleon their untapped abilities instead of thinking of them only in terms of their illnesses (Joseph & Murphy, 2013). Such limitations could significantly impact achieving comprehensive operationalization and measurement of harmful, maladaptive, and unhealthy behaviors.

Hence, there is a dire need to conduct systematic research to advance the field of behavioral change. One of the most frequently used behavioral change counseling approaches is Motivational Interviewing (MI). The MI is a person-centered counseling approach that has been used withations. MI consists of complex techniques employing behavioral change (Langlois & Goudreau, 2022). The techniques of the MI are directed toward proportionally increasing the amount of change talk compared to resistance talk using a set of techniques that requires a well-trained professional to ensure the person-centered approach of counseling and avoid confrontational counseling style (Vanovenberghe et al., 2022). Thus, MI professionals must have an arsenal of interviewing techniques and the ability to implement them consistently throughout interviews. These skills include asking open questions, affirming, reflecting, and summarizing, which must be carefully applied to increase change-talk at the expense of resistance (non-change) talk (Miller & Rollnick, 2012). Thus, implementing MI in its original form requires a well-trained professional.

Change talk is best described as any talk favoring behavioral change, such as the advantages of change, reasons for change, and the disadvantages of the status quo (Miller & Rollnick, 2012). Resistance talk is any patient verbalizations against the behavioral change, such as advantages of the status quo, disadvantages of change, and reason for maintaining the status quo (Miller & Rollnick, 2012). The literature shows that change talk is the main predictor of behavioral change (Gaume et al., 2010; Magill et al., 2018). On the contrary, resistance talk is related to poor outcomes (Apodaca et al., 2016).

MI has been used to promote change of socially significant behaviors with various socially significant behaviors in patients with chronic illnesses and adolescents (Howard & Williams, 2016; Wang et al., 2022). It is noteworthy that MI counseling interventions are associated with sustained behavioral changes (Samdal et al., 2017). As mentioned, MI is a counseling approach with specific skills requiring extensive training and practice (Miller & Rollnick, 2012). Thus, its application requires trained and qualified professionals, which, in turn, can be costly and time-consuming (Rimayanti et al., 2021). Thus, MI can be costly and cannot be self-administered (Rababah & Al-Hammouri, 2022). Another limitation is time. It has been reported that the inability to fit the MI intervention within the intervention recipient's daily life routine can hinder its use (Boom et al., 2022). Thus, the authors of this study developed a modified motivational interviewing (MMI) as an adapted version of the theory-based MI, explained in more detail in the method sections. The development of the MMI aimed at addressing the limitations and barriers of the original MI.

The MMI approach maintained the primary theoretical basis and principles of the original version of the MI. For example, the original MI was based on the self-perception theory with the central premise that individuals learn what they believe as they hear themselves talk. Another theoretical principle from social psychology that supports the original MI approach is that as individuals argue on behalf of a specific idea or position, they become more committed to it (Miller & Rollnick, 2012). Thus, the main goal of the current study was to explore the potential of an innovative intervention (namely, modified motivational interviewing) to address the limitations associated with the original form of MI while maintaining the theoretical support of the original format of MI.

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