The Motivational Interviewing Skill Code (MISC) codes both clinician and client speech in MI sessions. This scale focuses on client language — the utterances that reveal a client's motivation relative to a target behavior change, classified as change talk, sustain talk, or follow/neutral. Tracking the balance of change vs sustain talk is central to MI process research.
All three codes ship with a curated agent skill. Severity records the strength of the language in the coded direction (1 weak/hedged, 2 moderate, 3 strong or action-backed), so a run yields both the change/sustain balance and how forcefully each side was voiced. Coding targets the client's utterances; the clinician's speech is left to the MITI scale.
Specify the target behaviour. Change and sustain talk only exist relative to a particular behaviour change, so the skills first establish the target behaviour from the session itself and name it in every rationale. Make the target behaviour explicit in your transcript or study description — when none can be established, an utterance is coded Follow / Neutral rather than guessed either way.