The Language of Change Among Individuals With Mild Intellectual Disability or Borderline Intellectual Functioning: Client Responses to Therapist Motivational Interviewing Skills.

The study included only four participants, which severely limits generalisability. Only the immediate next response (lag-1) was analysed, so delayed responses to therapist language were not captured. The study did not test whether client change talk actually led to reduced substance use; it only looked at language patterns. Sessions were limited to the first 6-12 sessions, so later stages of treatment where commitment might increase were not observed. The presence of confidants (caregivers) in some sessions was not analysed, though it may have influenced client language.

Funded by the Netherlands Organisation for Health Research and Development (ZonMw). The authors declare no conflicts of interest.

Do not assume that general MI-consistent skills like affirming or supporting are effective at eliciting change talk in this population, as the study found no significant association for these broad categories. Additionally, do not interpret the presence of change talk as evidence that the client's substance use decreased, as the study did not measure clinical outcomes.