Rolling With Resistance: A Client Language Analysis Of Deliberate Practice In Continuing Education For Psychotherapists

Continuing education workshops have been criticised for focusing on knowledge rather than skill acquisition by a focus on didactic teaching methods. A recent randomised controlled trial conducted by Westra et al. (in press) demonstrated that a deliberate practice (DP) training workshop for responding to ambivalence and resistance resulted in longer-lasting skill acquisition than the same workshop in a traditional, more didactic format. The present study examined whether this same DP workshop was also efficacious at the level of client motivational language in 4-month post-testing interviews used to assess trainee skill in the Westra et al. parent study. Sixty therapists from the community (30 = DP and 30 = traditional) conducted an interview with either an ambivalent simulator or an ambivalent community volunteer. Interviews were coded for interviewee motivational language using the Motivational Interviewing Skills Code (MISC 1.1; Glynn & Moyers, 2009). Counterchange talk (CCT) was further classified into either Ambivalent-CCT (uttered to disclose conflict about change) or Resistant-CCT (statements against change uttered to oppose the therapist). Results revealed a significant difference between training groups, with the DP group eliciting less Resistant-CCT than the traditional training group. This study provides further support for the use of DP training for potentially creating more productive conversations by minimising Resistant-CCT; a form of speech that has been found to be negatively associated with client outcomes.