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This group asked him to demonstrate how he might respond to clients they were treating, and in the role-play process frequently stopped him to ask why he had said what he did, where he was going, and what was guiding his thinking. He had been invited to lecture on behavioral treatment for alcohol problems, and also was asked to meet regularly with a group of young psychologists. His original clinical description of motivational interviewing ( Miller, 1983) was an unanticipated product of interacting with a group of colleagues there. With these surprising findings, Miller went on sabbatical leave to Bergen, Norway. Later studies likewise showed large differences in drug use outcomes depending upon the counselor to whom clients had been randomly assigned ( Luborsky, McLellan, Woody, O'Brien, & Auerbach, 1985 Luborsky, McLellan, Diguer, Woody & Seligman 1997 McLellan, Woody, Luborsky, & Goehl, 1988). Valle (1981) similarly reported that alcoholism counselors’ client-centered interpersonal functioning accounted for a substantial proportion of variance in the relapse rates of randomly assigned clients. This effect of therapist style was far larger than differences among the behavioral interventions being compared.

51) of the variance in behavioral outcomes, respectively ( Miller & Baca, 1983). Even 12 and 24 months after treatment, counselor empathy continued to account for one-half ( r =. Therapist empathy during treatment predicted a surprising two-thirds of the variance in client drinking 6 months later ( r =. After initial certification of the counselors, three supervisors observed them delivering the behavioral intervention with self-referred outpatients and independently rank ordered the extent to which they had manifested empathic understanding while delivering behavior therapy. In preparing for a clinical trial of behavior therapy for problem drinking ( Miller, Taylor, & West, 1980), Miller trained nine counselors both in techniques of behavioral self-control training ( Miller & Muñoz, 2005) and in the client-centered skill of accurate empathy ( Rogers, 1959). An unanticipated finding drew attention to the impact of interpersonal processes on behavior change.