Significant Others Play a Big Role in Change Talk

It has long been known that having the support of family or social ties is an important part of treatment. Individuals who feel that their loved ones support their efforts to get better have better treatment outcomes than those who do not have support. Seeking treatment for alcohol and drinking problems is on area that has shown to be heavily impacted by social support. For instance, if an individual’s family members support their efforts to quit, they will be more likely to try. However, if their friends and family members encourage their drinking behaviors, quitting may be far more challenging. Along with the influence of support systems, the therapist working with the client also influences the level of change talk. However, until now, few studies have explored how the presence of significant others during treatment effects a client’s level of change talk.

Timothy R. Apodaca of the Department of Pediatrics at the University of Missouri wanted to gauge the impact of significant others (SOs) on clients’ change talk during motivational interviewing (MI) conducted after clients were admitted to an emergency room. Apodaca looked at the consistency of therapist MI as an indicator of change talk. He also evaluated the therapists’ acceptance and spirit. He found that therapists’ consistency did not affect client change talk, but higher levels of therapist spirit and acceptance did affect change talk negatively.

Not surprisingly, Apodaca found that clients whose SOs supported their willingness to change had more positive change talk than clients whose SOs wanted them to continue drinking. Also, the SOs who demonstrated behaviors that clearly indicated they were unsupportive of the drinking in the months leading up to hospitalization had the biggest effect on producing positive change talk in the clients. Although it is well known that SO support is integral to a client’s recovery, this study now sheds light on the significance of their presence during initial interviewing sessions. Additionally, even though the therapists did not directly impact change talk in the clients in this study, their role was vital in the process of change. “In the presence of an SO, the therapist’s role may become that of facilitator, reinforcing supportive behavior and reframing confrontational or unsupportive behavior on the part of the SO,” said Apodaca.

Apodaca, T. R., Magill, M., Longabaugh, R., Jackson, K. M., and Monti, P. M. (2012). Effect of a significant other on client change talk in motivational interviewing. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0030881

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  • Henry


    January 31st, 2013 at 2:09 PM

    Sorry, but what kind of significant other would actually want you to continue drinking if it is a problem that you struggle with?
    And why would you ever want to keep someone like this in your life, who means you harm?
    Even if they don’t see it this way, that’s exactly what they are doing and no one needs an enabler in their life.

  • Cathy


    January 31st, 2013 at 2:21 PM

    It could be the moral support. Or it could even be the shame of seeming like you’re not in control to your significant other that encourages positive change. Whatever it is, as long as it is providing positive change this is an encouraging aspect. Presence in the talk session may help you see things from a different viewpoint, from a viewpoint of someone who spends a lot of time with you. And if that person, your significant other, says you need to quit then I can see how it has positive effects. Good to know about this.

  • katelyn


    January 31st, 2013 at 3:49 PM

    If you are trying to stop any behavior then you have to stay far away from those people who encourage that behavior and make it possible for you to continue.

    You have to lose some friends along the way, and I get it that that is a tough thing to do especially during a time when you need your friends the most. But the kicker is that you need real friends and those who just choose to enable your bad choices because they are afraid that it will cramp their own lifestyles to have you stop, those are definitely not people that you need in your life.



    February 1st, 2013 at 12:29 AM

    Maybe a good thing for some, but I’d hate to have my partner present when I’m discussing a problem with my therapist. Makes it so much more difficult to concentrate on the issue. Yes a partner can play a supporting role but then and there? I’d have to reconsider that.

  • Ross


    February 1st, 2013 at 4:02 AM

    Depending on just how supportive or not that your partner is, it may become even more important to look at the positive ways that the therapist is helping.
    I would hate to think that the role of the therapist is being relegated to just that of a facilitator, because my therapist has meant much more to me.
    She has been my life support even at times when I had significant other people in my life but they could not fully understand the broad scope of the pain that I was going through.
    Yes I know that we have to have those people in our lives and probably having your partner with you in some sessions of therapy could be beneficial. But I would never be able to make the progress that I have personally made without the help of my therapist too.

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