Clients' perceptions of motivational interviewing with couples: A qualitative examination of male couples' statements to counselors in session.

The past two decades have seen expanding interest in the application of Motivational Interviewing (MI) with couples. Thus far, literature detailing the development of MI with couples has focused primarily on elucidating counseling processes and techniques or on evaluating intervention effects. To date no published studies have examined client-perceptions of the counseling process in MI with couples. This study involved qualitative analysis of 55 sessions from 24 couple (48 individuals) who received short (3-session) courses of MI with couples in the context of a randomized controlled trial. All participants identified as cisgender male and were 18 or older. In each couple, at least one partner was aged 18 to 29, HIV negative, and reported drug use in the past 30 days. Analysis revealed that client couples attributed the benefits of MI with couples to the expectancy-related effects s (merely structuring time to talk) and common factors (the presence of the counsellor as a non-judgmental observer). Clients also conveyed appreciation for techniques and activities that enhanced dyadic functioning through communication skill building and the identification of shared values. Finally, clients appreciated the opportunity to discuss drug use and sexual behavior in an integrated way. Findings indicate the utility of counselor-delivered behavioral interventions. They also align with recent formulations of the counselor's role in MI with couples as well as the introduction of facilitating dyadic functioning as a distinct process. Finally, they highlight the potential value of training counselors to address the intersection of drug use, sexual risk, and sexual pleasure in sessions. These dimensions of practice receive inconsistent attention across counseling training program curricula.