Motivational Interviewing Training Program Research Articles

Implementing a workflow-integrated motivational interviewing training program for psychiatry trainees on an inpatient consultation-liaison rotation: lessons learned.

Effective consultation-liaison psychiatry (CLP) is proactive, collaborative, and requires providers to have proficiency with therapeutic skills beyond nosology and medication management. Motivational interviewing (MI) is an evidenced-based intervention that should be considered essential for CLP trainees to learn. Given that the demands of training and patient care are already experienced as stressful for many psychiatry trainees, the authors endeavored to create a MI training program that was integrated into trainees' normal CLP workflow. Twenty-two trainees on an inpatient CLP rotation participated in a six-week MI training program that was incorporated into their regular workflow. The program included didactic sessions with role-playing, as well as on-demand between-session coaching via an expert in MI. Trainee participation and perceptions of MI were measured via a questionnaire that was administered prior to each training session. Trainee participation in the didactic sessions was inconsistent. Questionnaire data revealed positive baseline perceptions of motivational interviewing and its usefulness in inpatient medical settings. Additionally, as trainees participated in the program, perceived knowledge of motivational interviewing as well as awareness of motivational issues among their patients increased. Finally, participation in program was not perceived as disruptive to daily workflow for the participants. This the first documented attempt at implementing a MI training program for CLP trainees that was integrated into their regular workflow. Preliminary data identified some encouraging trends, but also unexpected challenges. These lessons could inform how these types of training programs are implemented moving forward.

Brief Motivational Interviewing Training for Outreach in School Health Programming

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.

Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study

ObjectiveTo assess the impact of a training program targeted to Primary Care (PC) professionalson the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use. MethodsA quasi-experimental, pre- and post-intervention study was performed in PC centers of Cordoba (Spain). Family doctors, residents and nurses participated in the study. The intervention was based on a motivational interviewing training program, which consisted in a workshop on learning skills, attitudes and knowledge about the alcohol management. PC providers were videotaped with a standardized patient in order to check the clinical and communication competencies acquired. A descriptive, bivariate and multivariate analysis was carried out (p < 0.05). ResultsPC providers’ communication skills and attitudes showed significant improvements in the variables studied (p < 0.001), as well as in the clinical interview evaluation parameters. ConclusionThe present study reveals the impact of a training program targeted to PC professionals on communication skills, attitudes, and knowledge about the prevention and management of patients with unhealthy alcohol use. Practice implicationsTraining activities targeted to PC providers represent a valuable strategy to improve communication skills, attitudes and knowledge of these professionals in their clinical practice.

A Brief Motivational Interviewing Training Program for First-Year Medical Students

Motivational interviewing (MI), a patient-centered counseling technique, has been effective for modifying personal health behaviors. MI has most often been taught during clinical training. This study describes a brief interactive student-developed workshop designed to train first-year medical students in this communication skill.

Motivational Interviewing Training Using Role Play in Dental Hygiene Students

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.

Training Primary Care Providers in the Use of Motivational Interviewing for Youth Behavior Change.

Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express discomfort with learning and adopting MI practices and with addressing patient weight issues. PCP proficiency in using MI to discuss body mass index, health screening results, and nutrition and physical activity behaviors after receiving training and coaching from an MI expert and practicing the technique was evaluated. We hypothesized that comfort with MI would increase consistently over time. Self-assessment surveys in MI proficiency were administered to PCPs after every youth participant MI session. MI comfort as determined by proficiency was categorized into low, medium, and high comfort according to survey Likert scale responses. Data were analyzed using analysis of variance (ANOVA) and Fisher's exact tests. Two hundred twenty-seven youth were seen for MI-based discussions by 4 PCPs. Two hundred twenty-six surveys had complete data for analysis. As anticipated, overall PCPs reported significantly more comfort with MI from the first to the final MI session over a 2- to 3-month period (p< .001). Comfort scores did not increase linearly over time for all PCPs. Despite standard training practices, overall MI proficiency as measured by comfort scores varied by PCP (p< .01). This type of MI training program should be considered for clinical nurses and nurse practitioners during their nursing education training to facilitate their ability to consistently and effectively support youth behavior change for conditions such as obesity (ClinicalTrials.gov Number NCT02502383).

동기강화상담 교육훈련 프로그램이 가정방문간호사의 의사소통능력과 직무효능감에 미치는 효과

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.

Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care

ObjectiveTo evaluate the effectiveness of motivational interviewing (MI) in improving medication adherence in older patients being treated by polypharmacy. MethodsCluster randomized clinical trial in 16 primary care centers with 27 health care providers and 154 patients. Thirty-two health care providers were assigned to an experimental (EG) or control group (CG). Interventions: MI training program and review of patient treatments. Providers in the EG carried out MI, whereas those in the CG used an “advice approach”. Three follow-up visits were completed, at 15 days and at 3 and 6 months. Medication adherence in both groups was compared (p<0.05). ResultsPatients recruited: 70/84 (EG/CG). Mean age: 76 years; female: 68.8%. The proportion of subjects changing to adherence was 7.6% higher in the EG (p<0.001). Therapeutic adherence was higher for patients in the EG (OR=2.84), women (OR=0.24) and those with high educational levels (OR=3.93). ConclusionA face-to-face motivational approach in primary care helps elderly patients with chronic diseases who are being treated by polypharmacy to achieve an improved level of treatment adherence than traditional strategies of providing information and advice. Practice implicationsMI is a patient-centered approach that can be used to improve medication adherence in primary care.Trial registration: This trial is registered at ClinicalTrials.gov (NCT01291966)

The development of instruments to measure motivational interviewing skill acquisition for school-based personnel

As specialized instructional support personnel begin learning and using motivational interviewing (MI) techniques in school-based settings, there is growing need for context-specific measures to assess initial MI skill development. In this article, we describe the iterative development and preliminary evaluation of two measures of MI skill adapted from the substance abuse field for use in school-based settings. We developed the Video Assessment of Simulated Encounters for School-Based Applications and the Written Assessment of Simulated Encounters for School-Based Applications to evaluate the initial MI skill development of school-based personnel participating in a multi-component, MI training program. Preliminary psychometric evidence supports continued development and refinement of the measures.

Development and Results of a Motivational Interviewing Program for Health Education to Facilitate Osteoporosis Self-Management

Introduction: Medication adherence is poor for many chronic conditions, including osteoporosis. Few proven interventions exist to improve Osteoporosis (OP) medication adherence. We report on methods to develop a telephonic motivational interviewing-based counseling program for health educators to promote osteoporosis medication adherence in elderly. Methods: Five health educators participated in an initial day and a half education training session. Motivational Interviewing techniques were reinforced by a behavioral scientist via semi-monthly calls over one year. At trial midpoint, two 20-30 minute client conversations were recorded. A certified Motivational Interview trainer evaluated performance using the Motivational Interviewing Treatment Integrity code (MITI) and provided feedback (scale: 0=poor to 5=excellent) to determine the extent of motivational interviewing “spirit” incorporated by the health educators during interactions with clients. Results: All health educators were female, mean age of 42 years. The range of health counseling experience was 7 to 15 years in varied healthcare areas. Scores across the five MITI domains suggest performance was strongest in providing direction and empathy. Domains needing improvement included evocation, collaboration, and autonomy/ support. On average, the total reflection to question ratio was 1.3, suggesting the need for more client reflections. Conclusion: Among health educators without substantial prior motivational interviewing experience, a year-long, multi-faceted motivational interviewing training program resulted in suboptimal competence in use of motivational interviewing counseling behaviors. This program serves as a novel, instructive model to inform the development and maintenance of MI intervention integrity among health educators using telephonic counseling.

An Evaluation of Training in Motivational Interviewing for Nurses in Child Health Services

Acquiring proficiency in motivational interviewing (MI) may be more difficult than generally believed, and training research suggests that the standard one-time workshop format may be insufficient. Although nurses represent one of the professions that have received most training in MI, training in this group has rarely been systematically evaluated using objective behavioral measures. To evaluate an enhanced MI training program, comprising a 3.5-day workshop, systematic feedback on MI performance, and four sessions of supervision on practice samples. Nurses (n = 36) in Swedish child health services were trained in MI. Skillfulness in MI was assessed using the Motivational Interviewing Treatment Integrity (MITI) Code. Effects of training were compared to beginning proficiency thresholds. Participants did not reach beginning proficiency thresholds on any of the indicators of proficiency and effect sizes were small. The present study adds to a growing body of literature suggesting that the current standard MI training format may not provide practitioners with enough skillfulness. Moreover, the results indicate that even enhanced training, including systematic feedback and supervision, may not be sufficient. Suggestions for improved MI training are made.

Motivational Interviewing as a Supervision Strategy in Probation: A Randomized Effectiveness Trial

Motivational interviewing (MI) has been recommended as a supervision style in probation. This project examined the effectiveness of an MI training curriculum on probation officer MI skill and subsequent probationer outcome. Twenty probation officers were randomized to receive MI training, or to a waiting list control, while an additional group of 10 officers served as a supervision-as-usual group; officer outcomes included questionnaires and standardized interactions at baseline, 2 months, and 6 months. A total of 380 probationers were assigned to officers during a 4-month period; offender outcomes included the probability of having a drug-positive urinalysis or an otherwise poor outcome after 6 months. The MI training program improved officer skill as measured by standardized interactions. However, after controlling for baseline characteristics, probationer outcome did not vary by training group, nor did officer MI competence predict outcome. Results are discussed in terms of the role of MI in the overall probation system.