Look who's talking: A Motivational Interviewing based observation study of one-on-one conversations between residential care workers and adolescents

Despite its relevance and effectiveness in adjoining fields, still surprisingly little attention has been paid to Motivational Interviewing (MI) in the context of residential youth care. This study aims to analyse observed interactions between adolescents and group care workers during one-on-one conversations from a MI perspective. We specifically focused on the MI adherent and MI non-adherent behaviours of care workers on the one hand, and motivation for change in terms of ‘change talk’ and ‘sustain talk’ by adolescents on the other. Audio recordings of 27 conversations show that care workers most often use the MI non-adherent behaviours ‘persuasion without permission’ and ‘confronting’ when they try to change adolescents’ attitudes or behaviours. MI adherent behaviours, i.e. ‘being affirming’, ‘seeking collaboration’ with and ‘emphasizing autonomy’ of the adolescent, are rarely used during the conversations. In terms of motivation for change, adolescents equally use ‘change talk’ and ‘sustain talk’ and often respond ‘neutrally’ to care workers. ‘Change talk’ and ‘sustain talk’ by the adolescent does not consistently follow MI adherent and non-adherent behaviours of care workers, and vice versa. The results suggest that MI training of care workers and more research on MI in residential youth care is wanted.