“Does training in Motivational Interviewing affect the ability to build working alliance? – an intervention study”

A systematic review of motivational interviewing training for general health care practitioners

Objective: Healthcare training has increasingly focused on interprofessional education (IPE) to provide students opportunities to gain competencies and learn accountability. IPE was incorporated into the curriculum by creating a course for all health science. Motivational interviewing (MI) training was added to enhance the IPE process. The purpose of this study was to determine the effectiveness of MI training in patient counselling simulations. Methods: A cohort of students enrolled in an IPE course were evaluated on MI skills before and after receiving training. MI performance was coded using the Motivational Interviewing Treatment Integrity (MITI) 4.2.1 scoring system. A student perception survey was also administered. Results: A total of 210 students were included in the study. Results from the MITI indicate an improvement in the four global ratings after MI training in individual and group cohorts. For example, for the Cultivating global score, 0% reached at least a fair benchmark in the pre-training groups while 90% (individual) and 50% (group) reached the benchmark post-training. Student perceptions of IPE improved following MI training with more students strongly agreeing that working together was better for patients post-training (66.2% vs 75.5%). Conclusion: The use of MI training in the setting of IPE setting appears to be beneficial. MI gives students a common language and approach to working with patients in an interprofessional setting.

The purpose of this study was to examine the effects of motivational interviewing (MI) training on diabetes educators’ counseling skills and self-efficacy. Diabetes educators were randomly allocated to the MI training group or control group. The experimental group was provided with a one-day course on MI. Pre-, post-, and follow-up (F/U) measurements were compared. Twenty-four diabetes educators participated in this study. Scores on the counseling skills post-test and F/U-test increased significantly compared to pre-test in the MI training group, as did scores on the helping skill self-efficacy post-test and F/U-test. Session management self-efficacy post-test scores also increased significantly compared to pre-test in the MI training group. There were no significant differences in pre-post and pre-F/U scores in the control group. Diabetes educator-patient communication is an important factor affecting the management of diabetes. MI training increases the counseling skills & self-efficacy of diabetes educators. Diabetes educators should use MI to facilitate patient health behavior changes in diabetes education.

Many health conditions are preventable or modifiable through behavioral changes. Motivational interviewing (MI) is an evidence-based communication technique that explores a patient's reasons for behavioral changes. This study assesses the current landscape of MI training in North American Family Medicine (FM) clerkships. We analyzed data gathered as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of FM clerkship directors (CDs). The survey was distributed via email invitation to 159 US and Canadian FM CDs in June 2022. Of the 94 responses received, 61% indicated that MI training is provided in their FM clerkship. Medical school type, class size, and location were associated with MI training priority, offerings, and duration in the clerkship, respectively. CD experience correlated with MI training duration; student MI skill training level was associated with MI training duration and priority; the rigor of student MI skills evaluation was correlated with MI teaching methods and training duration; self-reported student MI competency was associated with the length of time students spent with FM community preceptors as well as MI training priority and teaching methods; and several items emerged as predictors of student, CD, and FM faculty MI training expansion. Opportunities exist to enhance the volume, content, and rigor of MI training in North American FM clerkships as well as to improve self-reported student MI competency within those clerkships.

This chapter presents approaches to incorporating motivational interviewing (MI) training in a rehabilitation clinic, department, or organization. It discusses the importance of connecting MI to the organizational mission and offers recommendations on how to determine the most effective approach to implementation of MI training and integrating MI practices into clinical work. The chapter discusses assessment of organizational readiness for MI training and implementation and offers ideas for who to train, when to train, and how to train. This chapter outlines different types and combinations of MI teaching formats and training resources, including strategies to support skill maintenance and the sustainability of training programs. The importance of and how to evaluate training effectiveness and learner knowledge and attitudes are also covered in this chapter.

Despite the high prevalence of anxiety and depression in youths with chronic medical conditions (CMCs), physicians encounter substantial barriers in motivating these patients to access mental health care services. To determine the efficacy of motivational interviewing (MI) training for pediatricians in increasing youths' use of mental health care. The COACH-MI (Chronic Conditions in Adolescents: Implementation and Evaluation of Patient-Centered Collaborative Healthcare-Motivational Interviewing) study was a single-center cluster randomized clinical trial at the University Children's Hospital specialized outpatient clinics in Düsseldorf, Germany. Treating pediatricians were cluster randomized to a 2-day MI workshop or treatment as usual (TAU). Patient recruitment and MI conversations occurred between April 2018 and May 2020 with 6-month follow-up and 1-year rescreening. Participants were youths aged 12 to 20 years with CMCs and comorbid symptoms of anxiety and depression; they were advised by their MI-trained or untrained physicians to access psychological counseling services. Statistical analysis was performed from October 2020 to April 2021. MI physicians were trained through a 2-day, certified MI training course; they recommended use of mental health care services during routine clinical appointments. The primary outcome of uptake of mental health care services within the 6-month follow-up was analyzed using a logistic mixed model, adjusted for the data's cluster structure. Uptake of mental health services was defined as making at least 1 appointment by the 6-month follow-up. Among 164 youths with CMCs and conspicuous anxiety or depression screening, 97 (59%) were female, 94 (57%) had MI, and 70 (43%) had TAU; the mean (SD) age was 15.2 (1.9) years. Compared with patients receiving TAU, the difference in mental health care use at 6 months among patients whose physicians had undergone MI training was not statistically significant (odds ratio [OR], 1.96; 95% CI, 0.98-3.92; P = .06). The effect was moderated by the subjective burden of disease (F2,158 = 3.42; P = .04). Counseling with an MI-trained physician also led to lower anxiety symptom scores at 1-year rescreening (F1,130 = 4.11; P = .045). MI training was associated with longer conversations between patients and physicians (30.3 [16.7] minutes vs 16.8 [12.5] minutes; P < .001), and conversation length significantly influenced uptake rates across conditions (OR, 1.03; 95% CI, 1.01-1.06; P = .005). In this study, use of MI in specialized pediatric consultations did not increase the use of mental health care services among youths with CMCs but did lead to longer patient-physician conversations and lower anxiety scores at 1 year. Additional research is required to determine whether varying scope and duration of MI training for physicians could encourage youths with CMCs to seek counseling and thus improve integrated care models. German Trials Registry: DRKS00014043.

The purpose of this study was to develop a motivational interviewing (MI) training program to improve competency in communication and to effect the evaluated changes that would occur in dental students’ counseling techniques as result of the training in the program. The study proceeded through the program via role-play practice, which was explained effectively during the MI program training process. A convenience sample of 43 fourth-year dental hygiene students was recruited. Twenty-two students were randomly assigned to the intervention group and 21 to the control group in the order of recruitment. The theoretical lecture was delivered over 3 hours and the practice was done in parallel by applying cases occurring in clinic settings. The practice was technical training, partner practice, and small group practice. The intervention group received three hour MI lecture while the control group received no lecture. Evaluation through role-play practice was separated according to “researcher’s viewpoint,” “counselor’s role viewpoint,” and “patient’s role viewpoint.” The results of the analysis showed that the intervention group had higher MI skills and ability than the control group. Furthermore, program participants showed positive impressions to the MI training program. The use of coaching sessions improved the MI techniques and counseling skills of dental hygiene students learning MI. The effect of the application of the MI training program was that the MI training improved counseling skills and interviewing abilities. Moreover, continuous training and feedback enhanced MI techniques and core skills. Training using lectures in parallel with practice rather than education through theory alone improved students’ techniques. Application of role play through the combined method of the MI program was confirmed by an effective training method.

Effectiveness of asynchronous motivational interviewing training for pediatric nurse practitioner students: A mixed-methods evaluation.

Purpose: The purpose of this study was to examine the effects of Motivational Interviewing(MI) training program on communication skill and self-efficacy of home visiting nurses(HVNs). Methods: This study has a mixed-methods design that includes a one-group pre-post test study and focus group interviews(N=23). From April 16th to June 11th in 2014, total six two-hour sessions of MI training program were provided to the participants. The quantitative outcomes were collected using Global Interpersonal Communication Competence Scale(GICC-15) and Self-efficacy Scale, and the qualitative data were obtained by 5 focus group interviews. Group pre-post changes were evaluated by paired t-tests and the qualitative data were analyzed by content analysis method. Results: MI training program led to significant enhancement in communication skills(Z=-3.62, p<.001) and self-efficacy(Z=-3.67, p<.001). The qualitative study revealed that the participants had positive experiences to express empathy, support self-efficacy, and respect autonomy for their clients applying reflective-listening and affirmation skill. Conclusion: The HVNs who participated in the MI training program showed improved communication skills and self-efficacy in the quantitative and qualitative studies. A randomized clinical trial is needed to confirm the value of MI training program for HVNs.

Technology to Support Motivational Interviewing

Training in motivational interviewing for pediatricians was associated with a higher uptake of health behavior and lifestyle treatment: Results from the KP Wellness Coaching for Families and Kids (WC4K) Program.

To examine whether a 3-day training course in motivational interviewing, which is an approach to helping people to change, could improve the communication skills of obstetric healthcare professionals in their interaction with obese pregnant women. Intervention study. The Region of Southern Denmark. Eleven obstetric healthcare professionals working with obese pregnant women underwent a 3-day course in motivational interviewing techniques and were assessed before and after training to measure the impact on their overall performance as well as the effect on specific behavioral techniques observed during interviews. With a few exceptions, the participants changed their behavior appropriate to the motivational interviewing technique. The participants made more interventions towards the principles of motivational interviewing (adherent and nonadherent interventions). Furthermore, the participants asked fewer closed and more open questions before training in motivational interview. In the assessment of proficiency and competency, most of the participants scored higher after the training in motivational interviewing. Training in motivational interviewing improves healthcare professionals' proficiency and competency when communicating with obese pregnant women, albeit that the effect was not universal.

A randomized controlled trial of training in Motivational Interviewing for child protection

This study assessed a brief 6-week motivational interviewing (MI) training program for extension field specialists (EFS) involved in supporting a statewide school wellness initiative called SWITCH. A total of 16EFS were instructed in MI principles to support the programming and half (n = 8) volunteered to participate in the hybrid (online and in-person) MI training program. Phone calls between EFS and school staff involved in SWITCH were recorded and coded using the Motivational Interviewing Treatment Integrity (MITI) system to capture data on utilization of MI principles. Differences in MI utilization between the trained (n=8) and untrained (n=8) EFS were evaluated using Cohen’s d effect sizes. Results revealed large differences for technical global scores (d=1.5) and moderate effect sizes for relational global components (d=0.76) between the two groups. This naturalistic, quasi-experimental study indicates a brief MI training protocol is effective for teaching the spirit and relational components of MI to EFS.

Purpose: The study’s aim was to describe the experience of motivational interviewing (MI) training for parents with adolescents. Methods: Focus group interviews were carried out with 12 mothers in 3 groups who participated in the MI training. The study had a qualitative descriptive design, and qualitative content analysis was used. Results: Data analysis was separated into 4 domains: acceptance, relational skills, self-reflection, and rebuilding relationships. Seven categories and 11 subcategories included (1) enhancing acceptance and empathy, (2) recognizing the importance of the MI spirit and applying core skills, (3) improving self-expression and self-control of negative emotions and behavior, (4) recognizing self-problems, and (5) true communication and recovery of trust. Conclusion: Through MI training, participants have experienced not only the enhancement of their communication skills but also personal modifications (in self-acceptance, self-reflection, and self-control) and positive interpersonal relationships (rebuilding relationships). In addition, participants have realized the importance of listening and reflection in such experiences. Reflection training has provided participants meaningful experiences. Our key insight from these findings is that skill is not most important in communication training. MI elements such as acceptance, collaboration, and a respectful attitude are more likely to be used than conventional communication skills.