Communication & Medicine, Vol 11, No 3 (2014)

The causal attributions of substance use in clients’ change talk during motivational interviewing

Harri Sarpavaara
Issued Date: 27 Apr 2016


The objective of this study is to provide insights into substance users’ beliefs about the causes of substance use, in order to expand the current understanding of the significance of the client’s change-related talk during motivational interviewing (MI) sessions. In particular, it focuses on what kind of causes the substance-using clients attribute their substance use to in change talk during MI. The analyses are based on videotaped and transcribed data consisting of 98 MI sessions in the Finnish Probation Service. By applying Peirce’s semiotic theory of signs, this study investigates clients’ change talk utterances about causal attributions of substance use as an indexical sign. The results show that the clients attributed various causes to substance use, and that five main causes can be discerned: cultural factors, significant others, personal properties, working life, and lifestyle. The study displays that both sociocultural and psychological causes play an important role in substance users’ change talk. Thus, it is suggested that contextual factors should not be overlooked in MI and other substance use treatment.

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DOI: 10.1558/cam.v11i3.29774


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