“Weekend” as a symbolic sign in motivational counseling sessions in the probation service with substance abusers

Abstract

This study explores the meanings that substance-abusing clients attach to weekend during motivational counseling sessions in Finnish Probation Service. By applying Peirce's semiotic theory of signs, this article studies “weekend” as a symbolic sign, and analyzes: (a) What kind of meanings the clients attach to it? (b) What does weekend mean to the clients' motivation to change? The analyses are based on videotaped and transcribed data consisting of 98 motivational counseling sessions. The results of the study display that the general meaning of weekend is constructed as an obstacle to change. Weekend stands for an excuse to drink, a need to drink, a desire to drink and incapability to change in the clients' talk. The results show that by applying the semiotic approach new and significant meaning constellations can be found in the client's change relevant talk during motivational counseling.

Keywords

Weekend substance abusers probation service motivational interviewing change talk semiotics

Introduction

Motivational interviewing (MI) is a style that has become a well-recognized brand of counseling (Lundahl et al., 2010: 137). It is a style that has spread all over the world since its introduction by William Miller in 1983 (Miller, 1983). MI has been defined as a “client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence” (Miller and Rollnick, 2002: 25) and as a “collaborative, person-centered form of guiding to elicit and strengthen motivation for change” (Miller and Rollnick, 2009: 137). The spirit of MI emphasized the client–counselor collaboration and elicitation of motivation for change from the client, not its imposition upon the client (Miller and Rollnick, 2002).

Numerous studies have supported the use of MI for helping people with substance abuse and other behavioral problems, showing that it is more effective than no treatment and at least as effective as other treatment methods (e.g. Burke et al., 2003; Hettema et al., 2005; Project MATCH Research Group, 1998; UKATT Research Team, 2005). However, the results of the studies give rise to new questions about “what works” in MI. The links between MI's processes and outcomes are not yet fully understood (Apodaca and Longabaugh, 2009; Burke et al., 2003; Lundahl et al., 2010; Miller and Rose, 2009).

Some studies have focused on client language as a predictor of MI outcome. For instance, Amrhein et al. (2003), Moyers et al. (2005, 2007), and Campbell et al. (2010) have shown that MI increases clients' change talk and positive change talk predicts good outcome after MI. Change talk stands for the client's utterances that indicate the recognition of a reason, need, ability, desire, commitment, or taking a step to change (Rollnick et al., 2008: 35–42).

The present study intends to expand on the current understanding of the meaning of the client's change talk during MI. One hitherto unexplored aspect has been the semiotic and cultural aspect of the client's change talk (but see Sarpavaara, 2010, 2013, 2014a, 2014b; Sarpavaara and Koski-Jännes, 2013). There is reason to believe that semiotic features of client's language and client–counselor interaction are relevant to change behavioral problems. Vygotsky (1978) suggested as early as in the nineteen thirties that the regulation of behavior is based on the use of signs and to change behavior one also needs to change the signs relevant to its regulation. The aim of the present study is to apply some ideas of Charles Sanders Peirce's semiotic theory of signs to the analysis of client's change talk during MI sessions by focusing on the cultural aspect of the clients' talk. More specifically, this study examines substance-abusing clients' talk about their weekend drinking. In Finland, as also in other Northern as well as Central European countries, alcohol is mostly consumed on the weekends (Allamani et al., 2002: 197; Heath, 2000: 17–19; Mustonen et al., 2010: 58; National Research and Development Centre for Welfare and Health, 2001: 35). In Finland, this feature of drinking culture has remained the same for decades (see Mustonen et al., 2010; Mäkelä, 1970; Simpura, 1985). For example, in 2008 Finns' drinking was heavily concentrated on the weekends: Out of the total weekly drinking times, 65% took place on the weekends. Nearly 80% of alcohol was consumed on the weekends (Mustonen et al., 2010; Mäkelä et al., 2012).

The purpose of this article is to examine the meanings that substance-abusing clients attach to weekend in their change talk in the context of the MI sessions in Finnish Probation Service. Specific research questions for this study include: (a) What kind of meanings the clients attach to weekend? (b) What does weekend mean to the clients' motivation to change?

Data

The data for this study have been gathered in the counseling sessions of the Finnish Probation Service (current: Criminal Sanctions Agency). The Probation Service is part of the criminal sanctions system of Finland. It “is in charge of the enforcement of community sanctions and other activities related to sanctions served in freedom. (…) Community sanctions consist of the supervision of conditionally sentenced young offenders, juvenile punishment, community service, and supervision of parolees”. In community sanction work, particular attention is paid to evaluating substance abuse problems and to increasing the use of programs for substance abusers (Criminal Sanctions Agency, 2007).

In 2007, a Swedish motivational interviewing-based program called Beteende–Samtal–Förändring (BSF, translated as Behaviour-Interviewing-Change) developed specifically for the needs of the probation service was introduced also in the Finnish Probation Service. The BSF program is a structured adaptation of MI where the employees of the probation service are expected to use the skills of MI to motivate clients to change as regards to offending and substance abuse. The employee acts as a counselor who helps clients to enhance intrinsic motivation to change by working in a client-centered but directive manner. The BSF program is a semi-structured five-session MI-based intervention focusing on drug use and criminal behavior. During sessions, the client is encouraged to examine different stages of change, to see the positive side of change, to elicit change talk, to explore the discrepancies between his or her values and current behavior, to map his or her social network, and to discover his or her personal strengths (Farbring and Berge, 2006; Farbring and Johnson, 2008: 308–311).

Even though the criminal justice context due to its oppressive, directive, and autonomy limiting features is not perhaps an ideal environment for MI (Ashton, 2005), the BSF program is designed to be as open as possible for client autonomy. The clients were volunteers to this particular program and the counselors were not required to report to legal authorities of possible drug use revealed by the client.

The analyses presented here are based on viewing 98 videotaped BSF sessions, and studying the transcripts of these sessions. This database involves the first two counseling sessions of 49 client–counselor pairs. Sessions were videotaped in 12 probation services offices in Finland in 2007–2009. All clients who participated in this study had either an alcohol or a drug abuse problem. Informed, written consent was obtained from all participating clients and counselors and the approval for the study was obtained from the Finnish Criminal Sanctions Agency. In this article, I concentrate on those 15 clients whose change talk utterances concern a weekend. The mean age of these clients was 38 years (range, 20–62 years) and all of them were men.

Methods

The first step in the data analysis was to identify the client's goal in regard to their use of alcohol and drugs (e.g. to reduce the use of alcohol or to quit amphetamine). Identifying the goal was fairly easy because it was usually discussed at the beginning of the videotaped sessions.

The next step was to search for sequences that are central from the point of view of this goal, and to code the client's change talk in these central sequences. As guides to coding this talk I relied on A training manual for coding client commitment language (Amrhein, 2007) and the Manual for the motivational interviewing skill code (MISC 2.1) (Miller et al., 2008). After some experimentation with the videotaped and transcribed data, I combined the core ideas of these manuals by focusing on the following categories of clients' change talk utterances. The first one is, however, a new category that was not included in either of the reference manuals.

Problem recognition. The client makes an utterance that shows she/he is aware or unaware of the problem or she/he considers or does not consider the problem.

Reasons. The client states a particular motive, rationale, basis, or incentive to change or not to change.

Need. The client makes an utterance that indicates a necessity, urgency, or requirement for change or nonchange.

Desire. Client's utterance indicates a wanting, wishing, and willing to change or nonchange.

Ability. Client's utterance indicates the personal perceptions of capability or incapability of change.

Commitment. Client's utterance implies an agreement, intention, or obligation to change or not to change.

Taking steps. The client states that s/he has taken specific behavioral steps toward or away from change in the recent past.

In positive change talk utterances client moves toward to change, in negative change talk utterances s/he tells about her/his intention to maintain the status quo.

The coding of the client's change talk sequences was carried out by first watching through the videotaped BSF session and making preliminary notes on the transcription at any utterances representing change talk. After this I examined these utterances in more detail and labeled them with the above-mentioned categories.

The third step was to search for all the utterances about weekend from the sequences of client's change related talk. By applying Peirce's theory of signs, I explored “weekend” as a symbolic sign. According to Peirce (1965), the action of signs, semiosis, is a triadic process whose components include sign, object, and interpretant:

A Sign, or Representamen, is a First which stands in such a genuine triadic relation to a Second, called its Object, as to be capable of determining a Third, called its Interpretant, to assume the same triadic relation to its Object in which it stands itself to the same Object. (CP 2.274)

Therefore, any sign is in a triadic relation with an object and an interpretant. This triad belongs to the category Peirce calls “thirdness” and is what constitutes mind: signs are medium for thought and all thought is in signs (Houser, 2010: 92). The first division of the triad focuses on the sign as such. Peirce calls this division into Qualisigns, Sinsigns, and Legisigns. The second division focuses the reference of signs to objects. Peirce calls this division into Icons, Indexes, and Symbols. The third division focuses on the interpretation of signs or on the effects of signs on interpreters. Peirce calls this division into Rhemes, Dicents, and Arguments (CP 2.243–2.250; Liszka, 1996; Short, 2007).

The second division of signs is relevant from the viewpoint of this study. Icons refer to their object by means of similarity (e.g. an image, a diagram or a metaphor); indexes refer by means of contiguity, causality or by some other actual connection (e.g. smoke as the sign for fire); symbols refer by means of a habit, convention, disposition or law (e.g. words and numbers) (CP 2.247–2.249, 2.292–2.307; Liszka, 1996; Short, 2007). In this study, I concentrate on symbols by investigating the utterances about weekend as a symbolic sign. I explore “weekend” as a symbol (sign), and analyze what kind of conventions and habits (objects) the clients attach to it.

Results: Weekend as an obstacle to change

All in all, there were 15 clients (out of total of 49 clients) who produced change talk utterances that concern weekend. In these utterances, weekend is strongly connected with the use of alcohol. When the clients talk about weekend, they talk about drinking alcohol, but not the use of other substances. It could be seen that this is a reflection of Finnish and even wider substance use culture in which particularly alcohol is mostly consumed on the weekends. This kind of weekend culture has not formed around the use of drugs.

Weekend appeared as an obstacle or threat to change in all 15 clients' talk. None of the clients referred to weekend as a factor, which motivates, helps or encourages changing. In other words, the general meaning of weekend is constructed as an obstacle to change in the clients' talk. On the basis of the change talk coding and of the semiotic analysis, it seems that weekend means diverse obstacles and threats to change. These obstacles can be classified into four types (Table 1).

Table 1.

“Weekend” as a symbolic sign.

Sign	Object	Client #
“Weekend”	Excuse to drink	6, 14, 23, 40, 45, 46
	Need to drink	20, 21, 24, 29, 35, 39
	Desire to drink	41, 45
	Incapability to change	8, 20, 21, 24, 32, 35, 40, 41

As can be seen in Table 1 and in Figure 1, “weekend” as a symbolic sign stands for an excuse to drink (6 clients), a need to drink (6 clients), a desire to drink (2 clients) and incapability to change (8 clients) in the clients' talk.

Figure 1.

“Weekend” as a symbolic sign by number of clients.

In what follows, I examine each type with illustrative examples from the data corpus. The extracts are translated from Finnish original data. The translations are as exact as possible but the sentence structure of the spoken language has been edited to a more comprehensible form. It should be noted that Finnish-speaking addiction clients very often use the “zero-person construction” instead of the more active first person language when talking about themselves. In this construction there is no stated subject or object, or agent (Halonen, 2008). CO stands for the counselor, CL for the client.

Excuse to drink

An example of an excuse to drink type change talk appears in Extract 1. It involves a client with a reduced drinking goal who has told in the session that he has promised to his girlfriend that he does not drink on weekdays any more. He has not drunk for a week. Now he has, however, got so nervous that he intends to get drunk next weekend.

Extract 1 (CL #14)

CO: So, what's up?

CL: Not much. Nerves are so fucking tight.

CO: Yeah, I can see it. What makes you nervous?

CL: Been without drinking a single beer for a week. Damn, I have not drunk at all.

CO: It makes nervous?

CL: Well, my nerves are so fucking bad all the time. I would like to go for a drink of beer but I have now made an agreement (with the girlfriend that I do not drink on weekdays any more).

CO: So you are the man of honor who keeps his promise. Okey, but now, how do you intend to spend next weekend?

CL: I will get drunk next weekend if I don't have to work then. But even in that case I will get drunk after work.

CO: Mmm, ok.

In this discussion, the client produces both positive and negative utterances about commitment to change. In positive utterances he tells that he has agreed with his girlfriend (not drink on weekdays), which he intends to follow. In negative commitment utterances he talks about weekend and his intention to maintain the status quo. Here “weekend” is a symbolic sign that refers to an excuse to drink. The client also expresses with change talk his desire (“I would like to drink beer”) and his need (“Nerves are so fucking tight”) to drink. However, the object of “weekend” in a Peircean sense is an excuse to drink next weekend. The client is “the man of honor who keeps his promise” but the agreement applies only to weekdays. Weekend means the reason and the excuse to get drunk. It appears also as a threat to reach the goal, as a factor, which does not motivate or help change.

Need to drink

Extract 2 is taken from a BSF session between a counselor and a client with a reduced drinking goal. During the session, the counselor and the client have discussed the client's ability to reach his goal. The discussion turns to the meaning of the weekend.

Extract 2 (CL #20)

CO: Does it depend on the day… whether it is weekend or not… Are there some days when you feel like it (reducing drinking) can succeed? On the other hand, are there…

CL: Yeah, that's the way it really is. There's an internal clock for the weekend. It can truly be noticed.

CO: Quite so.

CL: It is such a small thing.

CO: So, the risk that you suddenly find yourself standing next to the beer shelves in a supermarket, that risk always increases before the weekend.

CL: Well, yeah, yes.

In Extract 2, the counselor brings up the topic of weekend and asks the client to tell about his experiences. We can see that the client doubts his ability to reach his goal of reducing drinking. This doubt is related to the experienced need to drink and it appears when the client talks about weekend. In the negative change talk utterances “There's an internal clock for the weekend”, “It is such a small thing”, and “Well, yeah, yes”, the client talks about his experienced need to drink on weekends. In this extract, “weekend” as a symbolic sign refers to the client's need to drink—the object of “weekend” is a need to drink.

Desire to drink

Extract 3 involves a client with a reduced drinking goal who has told about his life situation during the session. He has been unemployed for months. In addition, his relationship with his wife has become distant and they do not live together anymore.

Extract 3 (CL #45)

CL: If things would have gone better, I would not need alcohol.

CO: So because of your work and marital situation, you feel that you need it (to drink alcohol) on weekends.

CL: It is wrong to say that I need it on weekends. It's not quite so. However, it's like having a desire to drink during the weekend. In the current situation, I could drink anytime I want. But when I am employed, then I can not drink on weekdays.

CO: Mmm. Yes. Well, what now prevents you from drinking then? Now you have a chance to drink any day you want.

CL: The point is that now I've promised this. And yes, I want to show that I have some spine left, that I am able to refrain from drinking.

In Extract 3, the client produces many kinds of change related talk. In this Extract the client mentions the need to drink (“If things would have gone better, I would not need alcohol”), but he disagrees with the counselor's interpretation “So because of your work and marital situation, you feel that you need it (to drink alcohol) on weekends”. The client rejects the interpretation and emphasizes that it is a question of desire rather than need (“It is wrong to say that I need it on weekends. It's not quite so. However, it's like having a desire to drink during the weekend”). He also emphasizes that he is able to control his drinking (“I am able to refrain from drinking”). The client also expresses his commitment and his desire to change with positive change talk (“The point is that now I've promised this. And yes, I want to show that I have some spine left”). However, the weekends are some kind of threat to the change. Weekend means the excuse to drink and as a symbolic sign it refers especially to the client's desire to drink.

Incapability to change

An example of an incapability type change related talk appears in Extract 4. It involves a client with a reduced drinking goal who has told in the session that he has already managed to considerably cut down his drinking. He only drinks beer nowadays and no more strong alcoholic beverages.

Extract 4 (CL #24)

CL: But even that (drinking beer) has also begun in to bore me so that I am not interested in doing it every weekend any more. I might take (a beer) on a Friday evening if I warm the sauna or something. Or sometimes even a little bit more. Is it a relapse or not? Or is it moderate drinking if I drink six (beers) and then still a few on Saturday?

CO: Mmm. And what do you yourself think about that situation, what it is?

CL: Well, I don't know. There's always a risk, of course, that one starts to drink on weekdays.

In this extract, at the beginning, the client makes an utterance that indicates a desire to change. He states that he no longer wants to drink on every weekend (“But even that (drinking beer) has also begun in to bore me so that I am not interested in doing it every weekend any more”). The weekend, however, appears to be a threat to the realization of this desire to change. It means the risk that the client takes steps away from change (“Or sometimes even a little bit more”). The client's utterance “There's always a risk, of course, that one starts to drink on weekdays” implies that he is not quite certain of his ability to change. This uncertainty is related to the weekend. The weekend includes the risk of relapse. In this extract, “weekend” as a symbolic sign refers primarily to the risk to relapse into drinking and to the client's incapability to change.

It is not uncommon for the clients to attach more than one type of meanings to weekend (see Table 1). For example, in Extract 2 the client #20 talks about his experienced need to drink but also about his incapability to change and the risk to relapse into drinking (CO: So, the risk that you suddenly find yourself standing next to the beer shelves in a supermarket, that risk always increases before the weekend; CL: Well, yeah, yes). In Extract 3, the client's #45 utterances indicate a desire but also an excuse to drink (“If these things would have gone better, …”). Most often (8 clients) “weekend” stands for incapability to change and particularly a risk to start drinking more heavily.

Conclusion

This study investigated what kind of meanings the substance-abusing clients attach to weekend, and what does weekend mean to the clients' motivation to change. The meanings of weekend were analyzed by coding the clients' change talk utterances and by applying Peirce's semiotic theory of signs. I explored “weekend” as a symbolic sign, and analyzed what kind of conventions and habits the clients attach to it.

The results of the analysis suggest that the general meaning of “weekend” is constructed as an obstacle to change in the clients' talk. Yet it seems that “weekend” means diverse obstacles or threats to change: it can stand for an excuse to drink, a need to drink, a desire to drink or incapability to change. It is not uncommon that the clients attach more than one type of meanings to weekend. However, most often “weekend” stands for incapability to change and particularly for a risk to relapse into drinking.

Why does the weekend play such significant role in the clients' negative change talk? Most of the clients had a lot of free time (only two clients were employed), and they do not have any particular reason to drink on weekends. Ultimately, the question is about Finnish drinking culture, where weekend drinking is a cultural norm. It is a more or less informal and implicit norm that guides people's behavior in Finland and many other countries too, and this norm also guides the behavior of those who have opportunities to use alcohol in a different way. It is a cultural convention that the external controls of drinking are weakened on weekends. According to a study of Koski-Jännes and Johansson (1988), the weakening of external controls (e.g. weekend) was one of the common factors, which preceded a relapse in Finland. When it is expected that most people drink, negative attention is not paid to the drinking of substance abusers, either. Against this cultural background, it is not surprising that the clients experience the weekend as a threat to change and a risk to relapse.

This study has demonstrated the importance of the utterances about weekend in the clients' change talk sequences. These utterances seem to play a significant role in the clients' change talk and in the client–counselor interaction. Therefore, paying attention to the clients' utterances about weekend drinking in the practices of motivational counseling could be recommended. The results of this study also show that by applying Peirce's theory of signs it is possible to identify significant cultural signs of change or roadblocks to change in clients' speech, as in this particular case. These signs highlight specific cultural concentrations of meaning related to issues that need to be taken into account when trying to assist clients to change. In a previous research, another such a sign was the use of a journey metaphor in the client–counselor interaction (Sarpavaara and Koski-Jännes, 2013). The theory of signs by C. S. Peirce can thus reveal significant features in the client's change talk not only in MI-interventions but also more generally in any motivational intervention with substance abusers.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Academy of Finland [grant numbers 118424, 25012504623, 25012561453]; and the Finnish Criminal Sanctions Agency [grant number 21126].

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