Motivational Interviewing Process Research Articles

Training of Peer Coaches to Assist Individuals with Knee Osteoarthritis Prepare and Recover From Total Knee Replacement.

The objective of this study is to outline the training of peer coaches in the Moving Well intervention, which was designed to reduce anxiety, depression, and pain catastrophizing in patients before and after total knee replacement (TKR). Selected peer coaches had a history of knee osteoarthritis (KOA), a TKR of 12 months or more before training, and were 60 or older. Training was primarily conducted virtually, with a later addition of one in-person session. Training centered on developing skills in motivational interviewing (MoI), encompassing techniques like open-ended questions, affirmations, reflective listening, and summarization. It also covered the MoI processes of engagement, focus, evocation, and planning. Coaches were required to discuss at least 90% of session-specific topics, which were monitored using checklists for each certification, and to complete individual MoI training, which was not graded. The evaluation of peer coach training involved surveys and a focus group. Three women and two men, averaging 75 years in age, completed the peer coach training for the Moving Well intervention. An in-person training session was added to address technology and MoI skill concerns, greatly enhancing their grasp of MoI skills and their ability to guide others through the program effectively. Peer coaches stressed the importance of live feedback, in-person training, and incorporating personal experiences into the program content during their training. To effectively train older adults as peer coaches for the Moving Well intervention, flexibility in learning formats, personalized guidance, peer support, and regular evaluations were essential in building the necessary MoI competencies to guide research participants in the program.

Facilitating Behavior Change in Plastic Surgery Patients Who Inject Drugs Through Motivational Interviewing.

Background: Plastic surgeons treat a large volume of patients with upper limb morbidity resulting from intravenous drug use. The use of motivational interviewing by health care providers has demonstrated effectiveness in eliciting behavioral change, leading to improved health outcomes. This paper aims to explore the concept and process of motivational interviewing and its role in facilitating behavior change in the plastic surgery setting. Methods: The authors reviewed the literature on motivational interviewing in various health care settings. Results: Motivational interviewing, first developed in the field of psychology, has demonstrated effectiveness in facilitating behavior change in various clinical contexts, including brief clinical encounters. Using motivational interviewing guides the patient as they move through the stages of readiness for change in dealing with unhealthy behaviors. The authors demonstrate these techniques in a supplemental instructional video. Conclusions: Motivational interviewing is an evidence-based method for facilitating behavior change. All plastic surgeons should be prepared to use this person-centred counselling method in clinical practice.

Leveraging Motivational Interviewing to Coach Teachers in the Implementation of Preventive Evidence-Based Practices: A Sequential Analysis of the Motivational Interviewing Process.

Though emerging research supports the effectiveness of school-based coaching models utilizing motivational interviewing (MI), an examination of the specific drivers behind these effects is notably lacking in the prevention field. This study leveraged sequential analysis to examine how teachers' verbalization of change talk (i.e., language in support of change) and sustain talk (i.e., language in support of maintaining the status quo) was influenced by coaches' use of MI-consistent (i.e., collaborative language supportive of change) and MI-inconsistent (e.g., confrontational, directive) language, respectively. We also examined whether teacher and coach factors were related to coach-teacher language dynamics. Data were collected from 87 teachers in 16 elementary and middle schools randomized in a trial to the Double Check preventive intervention (see Bradshaw et al., 2018). Audio-recorded coaching feedback sessions were coded using an adapted version of the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE). Sequential analyses indicated that MI-consistent and change talk were significantly more likely than chance to occur consecutively. Teachers' sustain talk was also more likely to occur sequentially with coach use of MI-consistent language and teacher change talk; the latter suggests teacher ambivalence. Coaches rarely used MI-inconsistent language, and its occurrence was only associated with more MI-inconsistent language. Regression analyses indicated that teacher age, efficacy, burnout, classroom organization, and some design features (i.e., cohort, coach, coach-teacher racial match) were associated with different coach-teacher language dynamics. This novel school-based study illustrates how coaching MI evoked teacher change talk related to use of evidence-based programs.

Motivational interviewing technical process and moderated relational process with underage young adult heavy drinkers.

This study tested technical and relational processes hypothesized to explain the therapeutic benefit of an efficacious brief motivational interview (BMI). A randomized controlled trial compared the efficacy of a BMI to an attention-matched control (i.e., relaxation training [REL]) for reducing heavy alcohol consumption and associated negative consequences. Participants were underage, past-month heavy drinkers recruited from community settings (N = 167; ages 17-20; 62% female; 59% White). Data were collected on session recordings, using established motivational interviewing process measures. Statistical analyses followed 3 steps. First, a latent class model determined the optimal class solution for characterizing proportion change talk means within BMI and REL. Next, the probability of proportion change talk class membership was examined as a mediator and then as a moderated mediator of BMI efficacy. The latent class model yielded a 3-class solution, including a low-increasing proportion change talk class (n = 61), a moderate-increasing proportion change talk class (n = 97), and a nonlinear proportion change talk class (n = 7). Across the outcomes examined, membership in the moderate-increasing class rather than the low-increasing class mediated BMI effects on alcohol-related consequences at 6 weeks. Mediation tests for consequences at 3 months and heavy drinking were nonsignificant. Moderated mediation results for therapist empathy and MI Spirit were nonsignificant. Findings suggest that moderate increases in prochange statements, relative to anti- or neutral-change statements, help explain BMI effects on reducing alcohol-related negative consequences soon after intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

THE ROLE OF MOTIVATIONAL INTERVIEWING TECHNIQUES IN OVERCOMING INTERFERENCE PECANDU DRUGS AT AR-RAHMAN DRUG REHABILITATION PANTI AR-RAHMAN PLAJU DARAT PALEMBANG

One of the problems experienced by drug addicts is the loss of confidence due to the effects of consuming drugs. To overcome this one of the techniques used dip re-rehabilitation of Ar rahman drugs is to use motivational interviewing techniques. This technique aims to provide motivation for addicts to change. This study aims to determine the confidence of drug addicts when they enter the rehabilitation of drugs Ar-Rahman, to know the process of motivational techniques Interviewing (MI) in Arrangman Drug Rehabilitation and to know the role from motivational interviewing (MI) techniques. The type of data used is qualitative data. The subjects of this study amounted to 3 people drug addicts, and 1 counselor. Sources of data taken in this study are primary and secondary data sources. Data obtained by using interview methods, observation methods and documentation methods. Data analysis techniques of qualitative data analysis consists of four stages, namely: data reduction (data reduction), presentation data (display data), conclusion drawing and verification. From the research results obtained confidence drug addicts when new re-entry rehabilitation Ar-Rahman drugs that is, often solitary, be closed to others, silent, embarrassed, insecure and always negative thingking (thinking negative) to others, fear, to himself, always be negative, no matter to the environment, reluctant to communicate, not serious, irresponsible, closed and pessimistic about what he does. The process of motivational interviewing (MI) technique carried out by the counselor at Ar-Rahman drug rehabilitation center and the four principles is run, expressing empathy, developing discrepancy, accepting resistance and supporting efficacy. Motivational Interviewing Technique (MI) is very instrumental in overcoming the confidence of drug addicts with the change of attitude behavior and way of thinking, the changes experienced are, the client is more serious, responsible, think and be positive, open to others, optimistic, thinking that is rational, and better understand the feelings of self and others.

A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change.

In the present meta-analysis, we test the technical and relational hypotheses of Motivational Interviewing (MI) efficacy. We also propose an a priori conditional process model where heterogeneity of technical path effect sizes should be explained by interpersonal/relational (i.e., empathy, MI Spirit) and intrapersonal (i.e., client treatment seeking status) moderators. A systematic review identified k = 58 reports, describing 36 primary studies and 40 effect sizes (N = 3,025 participants). Statistical methods calculated the inverse variance-weighted pooled correlation coefficient for the therapist to client and the client to outcome paths across multiple target behaviors (i.e., alcohol use, other drug use, other behavior change). Therapist MI-consistent skills were correlated with more client change talk (r = .55, p < .001) as well as more sustain talk (r = .40, p < .001). MI-inconsistent skills were correlated with more sustain talk (r = .16, p < .001), but not change talk. When these indicators were combined into proportions, as recommended in the Motivational Interviewing Skill Code, the overall technical hypothesis was supported. Specifically, proportion MI consistency was related to higher proportion change talk (r = .11, p = .004) and higher proportion change talk was related to reductions in risk behavior at follow up (r = -.16, p < .001). When tested as two independent effects, client change talk was not significant, but sustain talk was positively associated with worse outcome (r = .19, p < .001). Finally, the relational hypothesis was not supported, but heterogeneity in technical hypothesis path effect sizes was partially explained by inter- and intrapersonal moderators. This meta-analysis provides additional support for the technical hypothesis of MI efficacy; future research on the relational hypothesis should occur in the field rather than in the context of clinical trials. (PsycINFO Database Record

Supplemental Material for A Meta-Analysis of Motivational Interviewing Process: Technical, Relational, and Conditional Process Models of Change

Supplemental Material for A Meta-Analysis of Motivational Interviewing Process: Technical, Relational, and Conditional Process Models of Change

Motivational interviewing with alcohol-dependent patients

Motivational interviewing with alcohol-dependent patients Alcohol-dependent patients do not need to be motivated from the outside. They are mostly ambivalent, and the inner voice, which already speaks for change (change talk), is heard through motivational interviewing, carefully strengthened and developed together with the patient. The practitioner has to deal with the human spirit of motivational interviewing and should be able to communicate with empathy, respect, congruence, and openness. The patient's autonomy should always be maintained. Advice is only given upon request. The conversation style is directive-guiding instead of authoritariansteering. OARS and the EPE principle are the motivational interviewing basics, which are consistently applied over 4 processes of motivational interviewing: engaging, focusing, evocing, and planning. The likelihood of change talk increases as soon as discrepancies between life goals and alcohol consumption emerge. An increased rate of change talk makes a change in behavior more likely. If a patient argues against change (sustain talk), one should not confront, but should consistently work with reflections, reframing, and an emphasis on autonomy. Motivational interviewing can be applied in different settings and populations, should be learned by the entire team (best professional guidance) in teamwork, and be subjected to a critical and constant evaluation.

A multivariate meta-analysis of motivational interviewing process and outcome.

Motivational interviewing (MI) theory proposes a process whereby a set of therapist behaviors has direct effects on client outcomes and indirect effects through in-session processes (e.g., client change talk). Despite clear empirical support for the efficacy of MI across settings, the results of studies evaluating proposed links between MI process and outcome have been less clear. In the present study, we used a series of multivariate meta-analyses to test whether there are differential relationships between specific MI-consistent and MI-inconsistent therapist behaviors, MI therapist global ratings, client change language, and clinical outcomes. Based on 19 primary studies (N = 2,614), we found a significant relationship between MI-consistent therapist behaviors and greater client change talk, as well as greater client sustain talk. Higher therapist global ratings (empathy and MI spirit) were significantly related to increased MI-consistent behaviors, decreased MI-inconsistent behaviors, increased client change talk, yet also increased client sustain talk. Therapist global ratings were not significantly related to clinical outcomes. Client sustain talk was a significant predictor of worse clinical outcomes, while client change talk was unrelated to outcome. Variability within the correlations indicated that MI-consistent and MI-inconsistent therapist behaviors were differentially related to therapist global ratings of empathy and MI spirit. Similar to past research, present findings provide equivocal support for hypothesized MI process outcome relationships. Clinical implications and future areas of MI mechanism research are discussed. (PsycINFO Database Record

Strengthening the Planning Process of Motivational Interviewing Using Goal Attainment Scaling

Client-centered, outcomes-based mental health counseling is driving the behavioral health field toward identifying mechanisms to facilitate specific, measurable goal setting and tracking with clients. Motivational interviewing (MI) is an evidence-based, collaborative, goal-oriented style of counseling; however, the fourth process of MI, planning, is not as well defined as the other MI processes, especially related to goal setting. Goal attainment scaling (GAS) is a method for setting measurable goals and assessing clinical progress. The combination of MI and GAS has potential to be a valuable clinical tool to establish client-centered goals, monitor goal attainment, and provide feedback within clinical mental health settings. Therefore, we propose that the MI planning process can be enhanced by incorporating GAS. However, research is needed to substantiate the feasibility of the proposed integration. A brief case study is provided to illustrate key concepts.

An examination of the process of motivational interviewing in anxiety disorders

An examination of the process of motivational interviewing in anxiety disorders

Relational Skills and Client Language Predict Outcome in Smoking Cessation Treatment

ABSTRACTBackground: We currently lack insight into the predictive processes of Motivational Interviewing (MI) in smoking cessation treatment. More knowledge is necessary to be able to further enhance the treatment effect in smoking cessation interventions. Objectives: To examine certain hypothesized active components of MI in smoking cessation treatment delivered in an ordinary clinical setting. Methods: Audio-recordings of 106 smoking cessation treatment sessions were analyzed using the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE) Coder's Manual and the Motivational Interviewing Treatment Integrity code (MITI) Manual, version 3.1. The outcome measure was self-reported 6-month continuous abstinence at 12-month follow-up. Results: Client Activation utterances in favor of change were positively associated with smoking cessation at follow-up. The combined category of client language expressing a Desire or a Need to continue to smoke was negatively predictive of smoking cessation. In addition, we found preliminary support for a negative interaction effect between counselors' demonstration of the spirit of MI and clients Activation utterances in favor of change. Conclusions/Importance: Our data suggest that if smoking cessation counselors cultivate client Activation utterances in favor of abstinence and softening client utterances expressing desire or perceived need to smoke, this could contribute to higher rates of treatment success. In addition, counselors' demonstration of the spirit of MI was a statistically significant predictor of outcome when the negative interaction effect between Activation utterances in favor of change and MI spirit was taken into account. These findings should be evaluated in larger studies in the future.

Understanding the process of motivational interviewing: A review of the relational and technical hypotheses

Objective: The current study systematically reviews evidence for a causal chain model suggested by Miller and Rose to account for the efficacy of Motivational Interviewing (MI). Method: Literature searches were conducted to identify studies delivering MI in an individual format to treat various problem areas. Results: Thirty-seven studies met inclusion criteria. The results suggest that when clinicians utilise MI consistent behaviours, clients are more likely to express language in favour of change. Furthermore, this client language was consistently related to positive client outcome across studies. Conclusions: While the results support some parts of the Miller and Rose model, additional research is needed to confirm the findings in diverse populations. Understanding the mechanisms of MI's effectiveness may maximise the implementation of MI, potentially contributing to better client outcomes.

A Systematic Review of Psychometric Evaluation of Motivational Interviewing Integrity Measures

The Motivational Interviewing Skills Code (MISC) has been developed to measure motivational interviewing skill, but a need has been identified for more economical instruments. This study expands on a previous systematic review by Madson and Campbell (2006) and examines the extent to which motivational interviewing integrity measures other than the MISC have been developed and psychometrically tested. Seven studies were reviewed that tested 5 such measures: the Motivational Interviewing Process Code (MIPC), the Motivational Interviewing Supervision and Training Scale (MISTS), the Motivational Interviewing Treatment Integrity Code (MITI), the Behaviour Change Counselling Index (BECCI), and the Video Assessment of Simulated Encounters (VASE). Although these instruments are promising, further psychometric testing is required and current findings should be judged as preliminary. Furthermore, external validity criteria and additional information that would facilitate consumer decision making are lacking. Recomm...

The use of motivational interviewing in weight loss

Within the past two decades, motivational interviewing has emerged as a useful strategy to help individuals develop motivation to change health behavior and sustain those efforts. This article reviews the preliminary but burgeoning literature that supports the effectiveness of motivational interviewing strategies in promoting positive changes in a variety of health behaviors, including dietary change, activity increases, and regimen adherence. A variety of adaptations of the motivational interviewing process are discussed as relevant to making this treatment strategy increasingly applicable to a variety of health care settings.

P99: Motivation toward Consumer Messages from the Dietary Guidelines for Americans among College Students

The motivational interviewing process focuses on strategies to improve motivation and build commitment to behavior change. This process builds on the Stages of Change Model and has been used previously in nutrition interventions. The purpose of this research project was to explore motivation toward four statements from the 2005 Dietary Guidelines for Americans consumer pamphlet among college students, ages 18-30 years. Selected statements included: focus on fruits, vary your vegetables, get your calcium-rich foods, and make half your grains whole. Using a scale of 1 (not motivated) to 12 (highly motivated), 344 college students attending general health or nutrition classes were presented with each of the four statements and asked to describe their motivation toward each statement. Students were classified into 3 levels of motivation based on the Motivational Nutrition Counseling Algorithm; level 1 (not motivated/Pre-contemplation Stage), level 2 (unsure/Contemplation Stage), and level 3 (motivated/ Preparation or Action Stage). The percentage of individuals falling into level 3 for the fruit, vegetable, whole grain, and calcium messages were surprisingly high or 47%, 47%, 49%, and 50%, respectively. The percentages of the sample classified as level 1 for the four messages was low or 8%, 9%, 13%, 16%, respectively. A large percentage of college students participating in nutrition and health classes were highly motivated toward reaching goals set by the Dietary Guidelines for Americans. These students would benefit from tailored nutrition education materials directed toward individuals in the preparation or action stage from the Stages of Change Model.