Clinician acquisition and retention of Motivational Interviewing skills: a two-and-a-half-year exploratory study

Abstract

BackgroundMotivational interviewing (MI) is a collaborative, client-centred counselling style aimed at eliciting and strengthening clients' intrinsic motivation to change. There is strong research evidence supporting the efficacy of MI, notably in its application among alcohol and drug abuse populations. MI interventions in smoking cessation may yield modest but significant increases in quitting. The present study sought to assess the acquisition and retention of MI skills in counsellors at the Swedish National Tobacco Quitline.MethodsThree audio-recorded sessions from each of three counsellors were assessed using the Motivational Interviewing Treatment Integrity (MITI) Code Version 3.0 over 11 assessment periods at fixed intervals in a two-and-a-half year period during which counsellors received ongoing supervision.ResultsThe mean skill for all counsellors improved throughout the study period in most MITI variables. However, great variations in MI skill between counsellors were observed, as well as fluctuations in performance in counsellors over time.ConclusionThe present exploratory study covers a longer time period than most evaluations of MI training, and has several advantages with regard to study design. It may provide a basis for (larger sample) replication to test MI skill (as measured by the MITI) in relation to behaviour change in clients, to evaluate MI training, and to assess the acquisition and retention of MI skill over time. Difficulties in acquiring and retaining MI skill may raise the issue of a selection policy for MI training. Moreover, fluctuations in MI skill over time emphasise the greater importance of continuous feedback and supervision over initial MI training, and the need for the use of validated treatment integrity assessment instruments in ordinary clinical implementations of MI.

Are Aspects of a Motivational Interview Related to Subsequent Changes in Physical Activity and Regulatory Style? Examining Relationships among Patients with Rheumatoid Arthritis

“…As pointed out in earlier research, therapists' personalities, previous experiences, or strength of counseling habits can impact upon MI fidelity (Gaume et al, 2009;Najavits & Weiss, 1994). Future interventions utilizing MI should ensure that all therapists meet a predefined standard of MI proficiency before delivering motivational interviews within a research setting, and as stated elsewhere, therapists should be provided with regular feedback on their performance (Forsberg, Forsberg, Lindqvist, & Helgason, 2010).…”

How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations

“…It is known that MI skill can vary substantially across practitioners (e.g. [35]). Such inter-practitioner variation in MI fidelity may also hamper discrimination between the MI-based intervention and the control condition in research trials.…”

“…Considering that practitioners will experience changes during this time, and that their level of MI skill may fluctuate [35], it is important to select sessions from different points in time throughout the entire intervention period, to get a complete and representative picture of practitioners' MI skill. In particular, if practitioners receive ongoing supervision or additional training, improvements in MI proficiency could be expected [25,36].…”

Understanding the Human Factor of the Energy Transition: Mechanisms Underlying Energy-Relevant Decisions and Behaviors

“…Traditionally, MI is taught within the helping professions, for example, among therapists, counselors, physicians, or nurses (Madson et al, 2009;Forsberg et al, 2010;de Roten et al, 2013). More recent studies have provided evidence that MI is also teachable to non-helping professions, e.g., for engineers (Klonek and Kauffeld, in press) or for environmental inspectors (Forsberg et al, 2014).…”