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Background Motivational interviewing is hypothesized to operate by enhancing a client's internal motivation to change. Past research operationalizes this process by measuring in-session statements for change (i.e., change talk), yet relationships between change talk and other measures of motivation have yet to be substantiated. This study tested whether in-session change talk predicted subsequent reports of commitment to abstain or moderate drinking assessed via ecological momentary assessment (EMA), and explored each of their contributions to drinking outcomes. Method Secondary data analysis was performed on data from 48 study participants who received therapy within a randomized controlled trial testing mechanisms of actions of MI. Multilevel models were used to test whether in-session commitment statements (strength, frequency, and slope of strength) made in two therapy sessions predicted subsequent daily reports of commitment to abstain or not drink heavily and drinking (21 days of data) in the weeks following each respective session. Results A weak, negative relationship between in-session commitment and average daily commitment to abstain emerged. No relationship between in-session statements and average daily commitment to not drink heavily emerged. Only EMA commitment predicted drinking outcome. Post hoc analyses demonstrate a moderating impact of EMA commitment to abstain on in-session commitment strength: low pre-treatment commitment to abstain and increasing commitment strength across a session yielded the greatest drink reduction. Conclusion In-session change talk and EMA commitment may represent distinct aspects of motivation, yet their interaction appears important to treatment prognoses. Commitment to abstain may be important for treatment selection and successful drink reduction.

The psycholinguistic analysis of client– counselor interactions indicates that how individuals talk about their substance use is associated with treatment outcome. However, the processes by which client speech influences out-of-session behaviors have not been clearly delineated. This study investigated the relationships between deriving relations–a key behavioral process by which language and cognition may come to influence behavior, shifts in the strength of client talk in favor of change, and treatment outcome among 75 cocaine-dependent participants (23% Female). Participants were trained to relate cocaine words, nonsense syllables, and negative-consequence words and were then assessed for a derived relation of equivalence before starting treatment. The DARN-C coding system was used to quantify the strength of participant speech during an early cognitive behavior therapy counseling session. Cocaine use during treatment was the outcome of interest. The analyses (a) characterized the process of deriving relations among individuals seeking help for their misuse of cocaine, (b) tested the relationships between shifts in the strength of participants’ speech in favor of change and treatment outcome, and (c) tested if deriving equivalence relations moderated the relationship between shifts in the strength of in-session speech and treatment response. Results indicated that a minority of participants derived equivalence relations, however increases in the strength of commitment language predicted less cocaine use during treatment only among those who did. The findings suggest deriving relations may be an important process by which changes in the strength of commitment language comes to influence substance use.

The objective of this study was to investigate the relation between self-report and objective assessment of Motivational Interviewing (MI) skills following training and supervision. After an MI workshop, 96 clinicians from 26 community programs (age 21–68, 65% female, 40.8% Black, 29.6% Caucasian, 24.5% Hispanic, 2.0% Asian, 3.1% other) were randomized to supervision (tele-conferencing or tape-based), or workshop only. At four time points, trainees completed a self-report of MI skill, using items from the MI Understanding questionnaire (MIU), and were objectively assessed by raters using the Motivational Interviewing Treatment Integrity (MITI) system. Correlations were calculated between MIU and MITI scores. A generalized linear mixed model was tested on MIU scores, with MITI scores, supervision condition and time as independent variables. MIU scores increased from pre-workshop (Mean = 4.74, SD = 1.79) to post-workshop (Mean = 6.31, SD = 1.03) (t = 8.69, p < .0001). With supervision, scores continued to increase, from post-workshop to week 8 (Mean = 7.07, SD = 0.91, t = 5.60, p < .0001) and from week 8 to week 20 (Mean = 7.28, SD = 0.94, t = 2.43, p = .02). However, MIU scores did not significantly correlate with MITI scores, with or without supervision. Self- reported ability increased with supervision, but self-report was not an indicator of objectively measured skill. This suggests that training does not increase correspondence between self-report and objective assessment, so community treatment programs should not rely on clinician self- report to assess the need for ongoing training and supervision and it may be necessary to train clinicians to accurately assess their own skill.

Motivational Interviewing (MI) is an evidence-based practice shown to be effective when working with people in treatment for substance use disorders. However, MI is a complex treatment modality optimized by training with feedback. Feedback, assessment and monitoring of treatment fidelity require measurement, which is typically done using audiotaped sessions. The gold standard for such measurement of MI skill has been an audiotaped interview, scored by a rater with a detailed structured instrument such as the Motivational Interviewing Treatment Integrity 2.0 (MITI 2.0) Coding System (Moyers, et al., 2005). The Helpful Responses Questionnaire (HRQ) (Miller, Hedrick, & Orlofsky, 1991) is a pen-and-paper test of empathy (a foundational MI skill) that does not require an audiotaped session. A randomized trial of three different regimens for training counselors in MI (live supervision using Teleconferencing, Tape-based supervision and Workshop only) (Smith et al., 2012) offered the opportunity to evaluate the performance of the HRQ as a measure of MI ability, compared to the several MITI 2.0 global scores and subscales. Participants were counselors (N = 97) working at community-based substance use treatment programs, whose MI proficiency was measured at four time points: baseline (before an initial 2-day MI workshop), post-workshop, 8 weeks post-workshop (i.e., post-supervision), and 20 weeks post-workshop with both MITI 2.0 and HRQ. HRQ total scores correlated significantly with the Reflection to Question Ratio from the MITI 2.0 at post-workshop (r = 0.33), week 8 (r = 0.34), and week 20 (r = 0.38), and with the Spirit (r = 0.32) and Empathy (r = 0.32) global scores at week 20. Correlations of HRQ with other MITI 2.0 subscales and time points after workshop were small and not significant. As predicted, HRQ scores differed between training conditions (X2(2) = 7.88, p = 0.02), with counselors assigned to live supervision achieving better HRQ scores than those in Workshop only. In summary, HRQ is a modestly accurate measure, mainly of the Reflection to Question Ratio, considered a core marker of MI skill. It is sensitive to training effects and may help identify counselors needing more intensive supervision. Given its ease of administration and scoring, HRQ may be a useful marker of MI skill during training efforts.

Motivational Interviewing (MI) is an effective treatment for substance use disorders (SUD) that focuses on resolving ambivalence and increasing commitment to positive behavior change. While MI has a well developed clinical theory, research findings have been mixed in supporting its view of how change occurs. The primary aim of this pilot study was to test hypothesized MI active ingredients and mechanisms of change in reducing drinking during the initiation of a behavior change episode. Problem drinkers (N=89) seeking treatment were randomly assigned to MI, relational MI without directive elements (Spirit-Only MI, SOMI), or a self-change (SC) control condition. Participants were followed during an eight week treatment period. The first two of four treatment sessions were videotaped and coded for fidelity, discriminability, and change talk. Overall, conditions demonstrated high fidelity. As predicted, change talk significantly increased in MI relative to the SOMI condition. Drinking was significantly reduced at end treatment, but the reduction was equivalent across conditions. Post-hoc analyses found that MI reduced drinking more rapidly than SOMI and SC and that increased change talk mediated the effects of MI relative to SOMI during the week immediately following the first session. Findings are discussed in the context of the pilot nature of the study and the relative absence of experimental tests of mechanisms of behavior change in SUD treatment research.

Objective The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their motivational interviewing (MI) skills before, during, and after training were investigated. Method Fifty-eight community-based addiction clinicians (M = 42.1 years, SD = 10.0; 66% Female) were assessed prior to enrolling in a 2-day MI training workshop and being randomized to one of three post-workshop supervision programs: live supervision via tele-conferencing (TCS), standard tape-based supervision (Tape), or workshop training alone. Audiotaped sessions with clients were rated for MI skillfulness with the Motivational Interviewing Treatment Integrity (MITI) coding system v 2.0 at pre-workshop and 1, 8, and 20 weeks post-workshop. Correlation coefficients and generalized linear models were used to test the relationships between clinician characteristics and MI skill at each assessment point. Results Baseline MI skill levels were the most robust predictors of pre- and post-supervision performances. Clinician characteristics were associated with MI Spirit and reflective listening skill throughout training and moderated the effect of post-workshop supervision method on MI skill. TCS, which provided immediate feedback during practice sessions, was most effective for increasing MI Spirit and reflective listening among clinicians with no graduate degree and stronger vocabulary performances. Tape supervision was more effective for increasing these skills among clinicians with a graduate degree. Further, TCS and Tape were most likely to enhance MI Spirit among clinicians with low average to average verbal and abstract reasoning performances. Conclusions Clinician attributes influence the effectiveness of methods used to promote the acquisition of evidence-based practices among community-based practitioners.

The dissemination of new, evidence-based treatment methods into widespread clinical practice is a substantial challenge for the medical and mental health fields generally, and addiction treatment in particular (Institute of Medicine, 1998). Continuing education programs have traditionally used printed materials and didactic conferences for disseminating treatment advances. However, evidence suggests that these traditional approaches to training are relatively ineffective at changing actual medical or counseling practices. Training procedures that include interactive role-plays relevant to the clinical context allow opportunities for further practice, and provide feedback and reminders are more likely to enhance clinical skills in medical settings (Grol, 2001; Grol & Grimshaw, 2003). Similarly, Motivational interviewing (MI) workshop training procedures that include practice and feedback have been shown to increase the MI skill levels of counselors (Madison, Loignon, & Lane, 2009; Walters, Matson, Baer, & Ziedonis, 2005). Unfortunately, skill levels have been demonstrated to diminish after workshop training, indicating workshop training alone does not produce sustained improvement in MI skillfulness (Baer et al., 2004; Miller & Mount, 2001; Walters et al., 2005). Further, following workshop training, counselors tend to rate their MI proficiency more positively than their objectively assessed skill ratings (Miller & Mount, 2001). These findings suggest that training workshops may successfully expose clinicians to new treatment approaches and increase their confidence in the use of these techniques, but may not promote long-term proficiency, an important outcome that has direct implications for improving clinical practice. Thus, alternative training methods are needed to facilitate a more robust transfer of new treatment strategies to the clinical context. Accordingly, studies have begun to examine supervision offered after workshop training (Miller, Yahne, Moyers, Martinez, & Pirritano, 2004; Moyers et al., 2008; Martino, Ball, et al., 2011), and generally support the conclusion that methods involving objective feedback and coaching will improve acquisition of MI skill (Miller & Rose, 2009). The importance of approximating a counselor's clinical context during MI training has been emphasized (Miller & Rollnick, 2002), and the evidence suggests that feedback should be based on ratings of actual therapy sessions (Miller et al., 2004; Miller & Rose, 2009). This has generally been achieved through audiotaping of clinical encounters, which provides a direct window into a clinician's counseling style, and facilitates remote supervision, an important feature for disseminating empirically based treatment strategies when time and distance limit the availability of expert trainers. However, audiotaping also has disadvantages including limited adherence and tape selection issues such as counselors may not make tapes, or may select sessions that went relatively well, limiting the ability to address problems with skill (Miller et al., 2004). Further, the use of audio recordings entails a delay between the clinical encounter and the provision of feedback to the counselor; the tape must be mailed and then reviewed by the supervisor before discussion and feedback can take place. This misses the opportunity for immediate feedback, a potentially powerful intervention for helping individuals learn new behavioral skills (Balcazar, Hopkins, & Suarez, 1986). Independent lines of evidence highlight three training parameters that may be particularly useful for guiding the learning of new counseling skills. First, immediate feedback is an important component in training programs that aim to bring behaviors to a particular performance level (Balcazar et al., 1986). Thus, supervisory practices that provide feedback to counselors closer in time to their clinical encounter may help promote the acquisition and retention of new counseling skills (Kivlighan, Angelone, & Swafford, 1991). Second, practice sessions distributed over time are more likely to produce lasting skill acquisition than training sessions of a longer duration but conducted over a shorter period of time (e.g., workshop training) (Donovan & Radosevich, 1999; Prescott et al., 2002). Third, differential reinforcement of specific behaviors from amongst a larger repertoire can be particularly effective at shaping new skills (Skinner, 1953). Differential reinforcement procedures may be particularly effective for developing proficiency in specific MI skills, while simultaneously reducing the use of counseling strategies that are incompatible with an MI style. Reducing the frequency of MI non-adherent (MINA) behaviors is of particular importance, since evidence suggests that therapist MINA behavior can increase client resistance and negatively influence treatment outcomes (Apodoca & Longabaugh, 2009; Guame, Bertholet, Faouzi, Gmel, & Daeppen, 2010; Guame, Gmel, Faouzi, & Daeppen, 2009; Miller, Benefield, & Tonigan, 1993; Moyers & Martin, 2006). Tele-conferencing supervision (TCS) was designed to address the limitations of workshop training and post-workshop supervision based on recordings of clinical encounters, by incorporating the principles of immediate feedback, distributed practice, and differential reinforcement. TCS provides real-time, live feedback to counselors while they interview standardized clients (actors) in their treatment clinics. Supervisors, located remotely, listen to the interview through telephone lines and provide immediate feedback and modeling through an earpiece worn by the clinician. TCS was constructed, tested, and then adjusted based on the favorable results of an uncontrolled pilot study (Smith et al., 2007). The present study employed a randomized controlled trial to test the efficacy of workshop training plus TCS for training clinicians in MI, compared to two control conditions, workshop training followed by tape review supervision (Tape), and workshop training only (Workshop).

Two cultivars of Matthiola incana (L.) R. Br. (`Cheerful White' and `Frolic Carmine') were grown in greenhouse sand cultures to determine the effect of salt stress on growth, ion relations, and flower quality. Two types of irrigation waters, differing in ion composition, were prepared to simulate saline wastewaters commonly present in two inland valley locations in California. Solution ICV was typical of saline tailwaters frequently found in the Imperial and Coachella Valleys and contained Cl–, Na+, SO42–, Mg2+, Ca2+, predominating in that order. Solution SJV was dominated by Na+ and SO42– and simulated saline drainage effluents often present in the San Joaquin Valley. Five treatments of each salinity type were imposed; each was replicated three times. Electrical conductivities of the irrigation waters (ECi) were 2.5, 5, 8, 11, and 14 dS·m–1. Plant heights were determined weekly. Seedlings were sampled for ion analysis 9 weeks after planting. Flowering stems were harvested when about 50% of the florets in the inflorescence were open. Total stem length, weight and diameter, numbers of florets and buds, and inflorescence length were measured at final harvest. All plants remained healthy throughout the experimental period with no visible signs of ion toxicity or deficiency. Although length of the flowering stems decreased with increasing salinity, stems were of marketable quality even at the highest salinity level. Mineral ion composition of the vegetative tissues generally reflected ion concentrations in the irrigation waters. Shoot Mg2+ and Cl– were higher and shoot Na+ lower in seedlings irrigated with ICV waters than with SJV waters. Shoot P was reduced over control levels once salinity exceeded 11 dS·m–1. Both cultivars were highly selective for K+ over Na + and selectivity coefficients (SK, Na) increase about 60% as salinity increased from 2.5 to 14 dS·m–1. This study illustrates that commercially acceptable cut flowers of stock may be produced under irrigation with moderately saline wastewaters.

Previous evidence indicates that bilinguals are slowed when an unexpected language switch occurs when they are reading aloud. This anticipation effect was investigated using a picture-word translation task to compare English monolinguals and Spanish-English bilinguals functioning in “monolingual mode.” Monolinguals and half of the bilinguals drew pictures or wrote English words for picture or English word stimuli; the remaining bilinguals drew pictures or wrote Spanish words for picture or Spanish word stimuli. Production onset latency was longer in cross-modality translation than within-modality copying, and the increments were equivalent between groups across stimulus and production modalities. Assessed within participants, bilinguals were slower than monolinguals under intermixed but not under blocked trial conditions. Results indicate that the bilingual anticipation effect is not specific to language-mixing tasks. More generally, stimulus-processing uncertainty prevents establishment of a “base” symbolic-system procedure (concerning recognition, production, and intervening translation) and the inhibition of others. When this uncertainty is removed, bilinguals exhibit functional equivalence to monolinguals.

Patients' cognitive abilities and verbal expressions of commitment to behavioral change predict different aspects of substance abuse treatment outcome, but these 2 traits have never been examined conjointly. The authors therefore investigated patients' cognitive abilities and verbal expressions of commitment to behavioral change as predictors of retention and drug use outcomes in an outpatient cognitive behavioral treatment (CBT) of adult cocaine-dependent patients. A neuropsychological battery was administered at baseline. Two independent raters used recordings of CBT sessions to code commitment language strength across the temporal segments (e.g., beginning, middle, and end) of 1 session per patient. Better cognitive abilities predicted treatment retention (p < .01) but not drug use, whereas mean commitment strength across the session segments predicted reduced drug use (p = .01). Results indicate that although commitment to behavioral changes such as abstinence may occur independently of patients' cognitive abilities, engagement in the behavioral intervention process appears to depend on cognitive abilities. Future clinical studies should further investigate the relations between cognition and commitment to change and their differential contributions to treatment processes and outcome.

'Contaminated groundwater and surface waters are a problem throughout the US and the world. In many instances, the types of contamination can be directly attributed to man''s actions. For instance, the burial of wastes, casual disposal of solvents in unlined pits, and the development of irrigated agriculture have all contributed to groundwater and surface water contamination. The kinds of contaminants include chlorinated solvents and toxic trace elements that are soluble and mobile in soils and aquifers. Oxyanions of selenium, chromium, uranium, arsenic, and chlorine (as perchlorate) are frequently found as contaminants on many DOE sites. In addition, the careless disposal of cleaning solvents, such as carbon tetrachloride and trichloroethylene, has further contaminated many groundwaters at these sites. Oxyanions of selenium, nitrogen, arsenic, vanadium, uranium, chromium, and molybdenum are contaminants in agricultural areas of the Western US. The management of these waters requires treatment to remove the contaminants before reuse or surface water disposal. In one instance in the Central Valley of California, the discharge of selenate-contaminated shallow groundwater to a wildlife refuge caused catastrophic bird deaths and deformities of embryos. A potential remediation method for many of these oxyanions and chlorinated-solvents is to react the contaminated water with zero-valent iron. In this reaction, the iron serves as both an electron source and as a catalyst. Elemental iron is already being used on an experimental basis. Both in-situ reactive barriers and above-ground reactors are being developed for this purpose. However, the design and operation of these treatment systems requires a detailed process-level understanding of the interactions between the contaminants and the iron surfaces. Only limited success has been achieved in the field, partly because the basic surface chemical reactions are not well understood. The authors are performing fundamental investigations of the interactions of the relevant chlorinated solvents, and trace element-containing compounds with single- and poly-crystalline Fe surfaces. The aim of this work is to develop the fundamental physical and chemical understanding that is necessary for the development of cleanup techniques and procedures. As of May 1998, they have performed both bulk chemical measurements of the reduction reactions and surface science studies of model chemical systems. During these first two years of funding, the authors have made significant progress in both areas. Initially, they focused primarily on the reduction of selenate by elemental iron. They also performed some work with chromate, perchlorate, uranyl, and carbon tetrachloride. In the following sections some of the progress is described.'

'Contaminated groundwater is a problem throughout the US and the world. In many instances the tvpes of contamination can be directly attributed to man''s actions. For instance, the burial of wastes, casual disposal of solvents in unlined pits, and the development of irrigated agriculture have all contributed to groundwater contamination. The kinds of contaminants include chlorinated solvents and toxic trace elements that are soluble and mobile in soils and aquifers. Oxyanions of selenium. chromium. uranium. arsenic. and chlorine (as perchlorate) are frequently found as contaminants on many DOE sites. In addition. the careless disposal of cleaning solvents. such as carbon tetrachloride and trichloroethylene. has further contaminated many groundwaters at these sites. In agricultural areas of the western US, shallow groundwaters have become contaminated with high levels of selenate, chromate, and uranyl. The management of these waters requires treatment to remove the contaminants before reuse or surface water disposal. In one instance in the Central Valley of California. the discharge of selenate-contaminated shallow groundwater to a wildlife refuge caused catastrophic bird deaths and deformities of embryos. At sites where solid-propellant rocket motors were tested or disposed of, high concentrations of perchlorate and trichloroethylene are being found in the groundwater. A potential remediation method for many of these oxyanions and chlorinated-solvents is to react the contaminated water with zero-valent iron. In this reaction, the iron serves as both an electron source and as a catalyst. Elemental iron is already being used, on an experimental basis, for the reductive dechlorination of solvents and the removal of toxic trace elements. Both in situ reactive barriers and above-ground reactors are being developed for this purpose. However, the design and operation of these treatment systems requires a detailed process-level understanding of the interactions between the contaminants and the iron surfaces. Only limited success has been achieved in the field, partly because the basic surface chemical reactions are not well understood. The authors are performing fundamental investigations of the interactions of the relevant chlorinated solvents, trace elements, and trace element-containing compounds with single- and poly-crystalline Fe surfaces. The aim of this work is to develop the fundamental physical and chemical understanding that is necessary for the development of cleanup techniques and procedures. The authors are perforrming both bulk chemical measurements of the reduction reactions and surface science studies of model chemical systems. During this first year of funding, the authors have already made significant progress in both areas. Initially, they have focused primarily on the reduction of selenate by elemental iron. They have also performed some work with chromate, perchlorate, uranyl, and carbon tetrachloride, as well. In the following sections, some of the progress is described.'

In two experiments, picture-word processing was investigated using graphic (drawing-writing) and verbal (naming-reading) production tasks. In both experiments, the subjects drew a picture or wrote a word upon presentation of a picture or a word stimulus. Additionally, the subjects in Experiment 2 named a picture or read a word stimulus. Production onset latency was assessed. In both experiments, drawing production was initiated more slowly than was writing production. In Experiment 2, graphic production was initiated more slowly than was verbal production. Equivalent latency increases were found for cross-modality trials (e.g., drawing a picture given a word stimulus) relative to within-modality trials (e.g., drawing a picture given a picture stimulus), independent of stimulus modality (word or picture), production modality (word or picture), or task (graphic or verbal production). These results strongly support a mathematical model which incorporates temporal invariance for pictures and words concerning encoding, cross-modality transfer, and retrieval.

Shallow groundwaters in the western U.S. often contain elevated levels of trace oxyanions such as selenate, chromate, and uranyl. A potential remediation method is to react the water with zero-valent iron. Both in-situ permeable reactive barrier walls and pump-n-treat technologies are being used for to treat these contaminated waters (Wilson, 1995). In this reaction, the iron serves as both an electron source and as a catalyst. The objectives of this research were to determine the factors that affect the rate of reaction and the types of secondary products formed, including the iron hydroxide mineralogy and the fate of the trace elements. Variables that we studied included pH, ionic strength, 02, competitive ions and forms of iron.