1 - (SYM 74) the Development of Couples Motivational Interviewing; Illustrating the Role of Qualitative Process Analysis in a Program of Intervention Development Research

While research involving behavioral intervention development and adaptation frequently integrates qualitative methodological components, these are often restricted to formative (pre-intervention) or reflective (post-intervention) feedback gathered through in-depth qualitative interviews with clients and stakeholders. While valuable, this kind of data does not directly examine the direct exchange between the client and the provider. At the same time, innovative quantitative data analyses (e.g., Linguistic Inquiry and Word Count or LIWC and machine learning techniques) have been applied to intervention content; however, these investigations prioritize the study of utterance frequency and are limited in their ability to identify novel counselor strategies.

Established qualitative analytic strategies – when applied to examine the content of intervention sessions directly – have substantial potential to advance discourse on intervention process. They can directly examine whether and how theoretical mechanisms that underlie intervention are enacted in session; identify common intervention challenges and effective counselor responses; and illustrate how counselors and clients react to one another’s utterances.

Dr. Starks provides an overview of deductive and inductive approaches to qualitative analysis as used in the study of intervention process and reviews key methodological differences between session content and other qualitative data sources (e.g., in-depth interviews, open-ended survey questions). The talk will provide an overview of three exemplar qualitative studies that collectively informed a program of research culminating in the development of a comprehensive framework for Motivational Interviewing (MI) with couples.

The first study utilized a framework approach to identify themes related to motivations for (and against) pre-exposure prophylaxis uptake expressed by 70 adult cismale couples during Couples HIV Testing and Counseling sessions. The second study utilized deductive analysis to illustrate how processes hypothesized in interdependence theory were manifest in the context of a multi-session couples MI conducted with 10 cismale couples who reported recent drug use and sexual HIV transmission risk. The third study utilized thematic analysis to identify the common forms of between-partner conflict in couples MI sessions. This study also elucidated counselor strategies that were effective in mitigating the observed conflict.