“Old dogs” and new skills: How clinician characteristics relate to motivational interviewing skills before, during, and after training.

Abstract

Objective The relationships between the occupational, educational, and verbal-cognitive characteristics of health care professionals and their Motivational Interviewing (MI) skills before, during, and after training were investigated. Method Fifty-eight community-based addiction clinicians (M = 42.1 yrs., SD =10.0; 66% Female) were assessed prior to enrolling in a two-day MI training workshop and being randomized to one of three post-workshop supervision programs: live supervision via tele-conferencing (TCS), standard tape-based supervision (Tape), or workshop training alone. Audiotaped sessions with clients were rated for MI skillfulness with the Motivational Interviewing Treatment Integrity (MITI) coding system v 2.0 at pre-workshop and 1, 8, and 20 weeks post-workshop. Correlation coefficients and generalized linear models were used to test the relationships between clinician characteristics and MI skill at each assessment point. Results Baseline MI skill levels were the most robust predictors of pre- and post-supervision performances. Clinician characteristics were associated with MI Spirit and reflective listening skill throughout training and moderated the effect of post-workshop supervision method on MI skill. TCS, which provided immediate feedback during practice sessions, was most effective for increasing MI Spirit and reflective listening among clinicians with no graduate degree and stronger vocabulary performances. Tape supervision was more effective for increasing these skills among clinicians with a graduate degree. Further, TCS and Tape were most likely to enhance MI Spirit among clinicians with low average to average verbal and abstract reasoning performances. Conclusions Clinician attributes influence the effectiveness of methods used to promote the acquisition of evidence-based practices among community-based practitioners.

Healthcare professionals experience with motivational interviewing in their encounter with obese pregnant women

“…It has been shown that prior counselling experience may prevent HCPs from appreciating the benefits of MI, as they may continue to rely upon or revert to previously learned techniques. Another challenge is maintaining the skills of the MI method in order not to fall back to old communication habits (Bohman et al, 2013;Carpenter et al, 2012) since supervision and coaching must continue to maintain MI skills at required level (Brobeck et al, 2011). Only a few studies describe how HCPs experience the use of MI in healthcare and they describe lack of time as an essential factor (Brobeck et al, 2011).…”

Training Primary Care Physicians to Employ Self-Efficacy-Enhancing Interviewing Techniques: Randomized Controlled Trial of a Standardized Patient Intervention

“…1 While research indicates primary care providers can be trained to enhance patients' behavioral motivation, [2][3][4][5] evidence-based methods such as motivational interviewing are broad in scope, difficult to learn, and lengthy to apply. [6][7][8][9][10][11][12][13][14] As a result, the approaches are not widely employed in practice, where primary care providers must address multiple issues in office visits, seldom limited to behavioral change. [15][16][17] There is an urgent need for effective, focused, time-efficient interviewing approaches that busy practitioners can routinely employ to motivate healthy behaviors.…”

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

“…Most previously conducted RCTs report that 4%-32% of sessions were double-coded (e.g. [38] (32%; n = 11); [32] (4%; n = 6); [39] (20%; n = 19); [27] (8%; n = 115); [25] (30%; n = 54); [40] (10%; n unknown); [22] (25%; n unknown) [36] (27%: n = 15)). However, in some studies, all sessions were coded by at least two of the coders [28,31,41,42].…”