The dissemination of motivational interviewing in Swedish county councils: Results of a randomized controlled trial

Abstract

ObjectiveA significant number of Swedish practitioners are offered workshop trainings in motivational interviewing through community-based implementation programs. The objective of this randomized controlled trial was to evaluate to what extent the practitioners acquire and retain skills from additional supervision consisting of feedback based on monitoring of practice.Materials and methodsA total of 174 practitioners in five county councils across Sweden were randomized to one of the study's two groups: 1) Regular county council workshop training, 2) Regular county council workshop training followed by six sessions of supervision. The participant’s mean age was 43.3 years, and the majority were females (88.1%).ResultsRecruiting participants proved difficult, which may have led to a biased sample of practitioners highly motivated to learn the method. Although slightly different in form and content, all the workshop trainings increased the participants’ skills to the same level. Also, consistent with previous research, the additional supervision group showed larger gains in proficiency compared to the group who received workshop training only at the six-month follow-up. However, analyses showed generally maintained levels of skills for all the participants at the follow-up assessment, and the majority of participants did not attain beginning proficiency levels at either post-workshop or follow-up.ConclusionsThe results of this study address the real-life implications of dissemination of evidence-based practices. The maintained level of elevated skills for all participants is a promising finding. However, the low interest for obtaining additional supervision among the Swedish practitioners is problematic. In addition, neither the workshop trainings nor the additional supervision, although improving skills, were sufficient for most of the participants to reach beginning proficiency levels. This raises questions regarding the most efficient form of training to attain and sustain adequate practice standards, and how to create incentive and interest among practitioners to participate in such training.

Training in motivational interviewing improves cattle veterinarians’ communication skills for herd health management

“…The improvement in MI skills reached by our participants is similar to that reported in other studies on training of professionals in routine work situations 23 32–34. Only 29 per cent of participants reached ‘moderate competency’ and only 6 per cent reached overall ‘fair competency’ according to the classification suggested by Moyers et al 29.…”

Providing objective feedback in supervision in motivational interviewing: results from a randomized controlled trial

“…In the original study, a total of 174 self-selected practitioners were randomized to either regular county council MI training or regular county council MI training with six sessions of subsequent supervision. All the MI training increased the participants' MI skills to about the same level, but the group that received subsequent supervision had gained more MI skills at follow-up (Beckman et al, 2017b). Analyses also showed generally preserved MI proficiency levels for all participants at follow-up, but the majority did not reach the beginning proficiency levels at either the postworkshop or at the follow-up assessment (Beckman et al, 2017b).…”

“…1): (1) supervision including systematic feedback based on only the behaviour counts part of the MITI (MITI BC), or (2) supervision including systematic feedback based on both the five global dimensions and the behaviour counts of the MITI (MITI GD BC). The randomization procedure was conducted across all participants, and are described in detail elsewhere (Beckman et al, 2017b). The participants recorded seven 20-minute telephone sessions with actors playing standardized clients: the first one after the MI training (baseline), and the following with monthly intervals.…”

“…Ten minutes before the sessions, the coder emailed the protocol to the participant. All sessions were manual-based (please see 'Supplementary material'), and are described in detail elsewhere (Beckman et al, 2017b).…”

Is fidelity to motivational interviewing associated with alcohol outcomes in treatment-seeking 60+ year-old citizens?

“…We do not know how the fidelity to MI changes according to different languages. Several studies have been performed outside North America and in languages other than English with previous versions of the MITI (Beckman et al, 2017;Brueck et al, 2009;Eno Persson et al, 2016;Jamieson, Bradshaw, Lawrence, Broughton, and Venner, 2016;Kouwenhoven-Pasmooij et al, 2018; Lee, Tavares, Popat-Jain, and Naab, 2015; Lindqvist et al, 2017; McCambridge, Day, Thomas, and Strang, 2011; Mesters, Keulen, de Vries, and Brug, 2017; Thyrian et al, 2007). At eye sight, differences in the fidelity to MI is not striking as compared to the differences across North American studies and even between different sites (Dunn et al, 2015;Kevin A. Hallgren et al, 2018;Osilla, Watkins, D'Amico, McCullough, and Ober, 2018;Palfai et al, 2016;Pollak et al, 2014;Spohr, Taxman, Rodriguez, and Walters, 2016;Woodin, Sotskova, and O'Leary, 2012).…”