Abstract
Treatment fidelity and proficiency of a nurse-led motivational interviewing (MI)-based pre-treatment and control condition was evaluated. A random sample was scored by means of the Motivational Interviewing Treatment Integrity (MITI) scale, and a second rater was in charge. MI fidelity was satisfactory for three out of five ratings. Most mean ratings were higher in the MI-based intervention, but differences were not statistically significant. The threshold for beginning MI proficiency was only exceeded for one score and one additional measure. In general, higher levels of fidelity in the intervention condition confirmed that MI was partially applied there. Although the quality of MI delivery as well as mixed inter-rater reliabilities of the fidelity scores leaves room for improvement, robust findings between the two raters were found. These results suggest the need for rigor selection of MI counselors on beforehand, and continuous supervision. Furthermore, fidelity check in studies using MI is needed.
Highlights
Motivational interviewing (MI) is a person-centered form of counseling to elicit and strengthen motivation for change.[1]
The quality of MI delivery as well as mixed inter-rater reliabilities of the fidelity scores leaves room for improvement, robust findings between the two raters were found. These results suggest the need for rigor selection of MI counselors on beforehand, and continuous supervision
MI has two components: (1) the relational component consists of the so-called MI spirit, a counselor-attitude characterized by genuine interest in the client and empathy; (2) the technical component consists of techniques to evocate, elicit, and reinforce change talk[13]
Summary
Motivational interviewing (MI) is a person-centered form of counseling to elicit and strengthen motivation for change.[1]. MI has two components: (1) the relational component consists of the so-called MI spirit, a counselor-attitude characterized by genuine interest in the client and empathy; (2) the technical component consists of techniques to evocate, elicit, and reinforce change talk[13] (by, e.g., the use of open questions and reflections). MI has mostly been emphasized as a spirit rather than a technique.[14] At first sight, MI principles—asking open questions, giving reflections—look simple. The underlying principles resulting in MI spirit like empathy are a complex mix of skills that take considerable time to learn.[1] As a consequence, the quality of MI delivery can vary tremendously. It is very important to check and accurately test whether MI is delivered as intended,[16,17] or, in other words, to check its treatment fidelity (sometimes referred to as treatment integrity)
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