UBC researcher adopts play-by-play method to understand how counselors can promote health

A University of British Columbia (UBC) researcher has come up with a dynamic systems method to analyze behavior change counseling sessions and determine what makes them work, according to a new study published in the British Journal of Health Psychology.

Heather Gainforth, PhD, assistant professor at UBC’s Okanagan campus in Kelowna, British Columbia, researched behavior changes with the School of Health and Exercise Sciences. Her new research explains an approach to understanding the play-by-play of counseling sessions to help patients make positive changes in their lives.

It's common for sports psychologists to use audio and video recordings of practices to analyze and closely examine the relationship between a coach and a player, she explains. They study every word, every move, and every reaction to determine how the coach supports the athlete to have a positive or negative experience during training.

"I realized when I was working with sports psychologists that they are studying every single interaction of the coaches and the athletes," says Gainforth.

It's an idea she wanted to try in her own field of expertise.

"When a person goes for behavior change counseling it either works or it doesn't," she says. "But we couldn't actually determine exactly why. What makes it work? Why did it fail? And I kept thinking, how can we figure out what makes these interventions work?"

While working with clients hoping to quit smoking, Gainforth tried the video play-by-play analysis. With permission, she used audio and video recordings to scrutinize minuscule details of sessions between a client and counselor.

By examining behavior change counseling second-by-second, she looked at the frequency, sequence, and duration of each interaction between a client and a counselor. Behavior change happens, she explains, during a conversion between a client and a practitioner.

"I wanted to know what happens in that conversation," she adds. "I wanted a second-by-second analysis of these interactions to understand what works to help clients change their behavior."

Gainforth developed a method to analyze these videotaped sessions verbatim.

She then used state-space grids to map each interaction in real time and monitor how the practitioner and the client interact together. Gainforth says the grids allow researchers to examine the dynamics between the client and the practitioner. It's the first time in behavioral science, she adds, that researchers have been able to understand how these interactions actually make a difference.

"We have created a new method for people working in behavioral science," she says. "By coding the interactions second-by-second, we've created a method to visualize the counseling sessions over time. We can map everything the practitioner says and how the client reacts and then we examine how they interact with each other over time."