Differences in the delivery of motivational interviewing across three countries

Schmidt, Lotte Kramer; Andersen, Kjeld; Nielsen, Anette Søgaard

doi:10.1080/15332640.2020.1824838

Cited by 7 publications

(2 citation statements)

References 40 publications

(55 reference statements)

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“…Thirdly, interventions were mostly delivered by GPs and/ or nurses within the context of primary care and providers tended to be female. Given that the delivery of MI may vary according to country (Schmidt et al, 2022 ), profession (Cook et al, 2016 ), and that gender differences in patient‐centred communication have been noted (Jefferson et al, 2013 ), generalisation beyond the current sample is unclear. Thirdly, BCC was delivered alongside other intervention components.…”

Section: Discussionmentioning

confidence: 94%

Adapted motivational interviewing for brief healthcare consultations: A systematic review and meta‐analysis of treatment fidelity in real‐world evaluations of behaviour change counselling

Beck

Baker

Britton

et al. 2023

British J Health Psychol

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BackgroundBehaviour change counselling (BCC) is an adaptation of motivational interviewing (MI) designed to maximize the effectiveness of time‐limited health behaviour change consultations. To improve intervention quality and understanding of treatment effects, it is recommended that evaluations of health behaviour change interventions incorporate existing fidelity frameworks (e.g. The National Institutes of Health [NIH] Behaviour Change Consortium) and ensure that treatment fidelity is assessed and reported.PurposeThis systematic review was designed to examine (a) adherence to NIH fidelity recommendations, (b) provider fidelity to BCC and (c) impact of these variables on the real‐world effectiveness of BCC for adult health behaviours and outcomes.Methods and ResultsSearches of 10 electronic databases yielded 110 eligible publications describing 58 unique studies examining BCC delivered within real‐world healthcare settings by existing providers. Mean study adherence to NIH fidelity recommendations was 63.31% (Range 26.83%–96.23%). Pooled effect size (Hedges g) for short‐term and long‐term outcomes was .19 (95% CI [.11, .27]) and .09 (95% CI [.04, .13]), respectively. In separate, random‐effects meta‐regressions, neither short‐term nor long‐term effect sizes were significantly modified by adherence to NIH fidelity recommendations. For the subgroup of short‐term alcohol studies (n = 10), a significant inverse relationship was detected (Coefficient = −.0114, 95% CI [−.0187, −.0041], p = .0021). Inadequate and inconsistent reporting within the included studies precluded planned meta‐regression between provider fidelity and BCC effect size.ConclusionsFurther evidence is needed to clarify whether adherence to fidelity recommendations modifies intervention effects. Efforts to promote transparent consideration, evaluation and reporting of fidelity are urgently needed. Research and clinical implications are discussed.

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Section: Discussionmentioning

confidence: 94%

Adapted motivational interviewing for brief healthcare consultations: A systematic review and meta‐analysis of treatment fidelity in real‐world evaluations of behaviour change counselling

Beck

Baker

Britton

et al. 2023

British J Health Psychol

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“…These variations have called for a better understanding of which MI features are associated with client behavior change. This has resulted in extensive quantitative research on therapist skills and what specific therapist behaviors produce change statements from the patient, which in turn is predictive of positive clinical outcomes [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

A qualitative interview study of patient experiences of receiving motivational enhancement therapy in a Swedish addiction specialist treatment setting

Ingesson Hammarberg,

Sundbye,

Tingvall

et al. 2023

Addict Sci Clin Pract

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Background Motivational enhancement therapy (MET) has shown to be efficacious as treatment of alcohol use disorder (AUD), in reducing alcohol consumption and related consequences. However, qualitative research on how patients perceive this treatment is lacking. The aim of this study was to explore how patients experience MET as a treatment for AUD. Methods Fifteen patients (8/7 female/male) participated in semi-structured interviews after receiving MET at a specialized addiction outpatient clinic in Sweden. Data were analyzed by thematic analysis. Results Five themes were identified: the therapist conveyed the MI-spirit, the therapist did not guide on how to reach the goal, participants were committed to change before starting treatment, participants were uncertain if treatment was enough to maintain change, and significant others were not wanted in sessions. Participants appreciated the supportive relationship with their therapist, but some experienced therapy as overly positive, with no room to talk about failure. Further, they experienced a low level of guidance in goal-setting. For some, this was empowering, while others requested more direction and advice. Participants perceived their motivational process to have started before treatment. MET was considered to be too brief. None of the participants brought a significant other to a session. Conclusions Therapist behaviors in line with MI spirit were emphasized as key to the development of a positive therapeutic relationship. More specific advice on goal-setting may be effective for supporting change in some patients. Longer treatment is requested among patients to support the patient’s self-efficacy for change. Significant others can support change without necessarily being present in sessions. Trial registration: The current trial was retrospectively registered at isrtcn.com (14539251).

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