Clinician acquisition and retention of Motivational Interviewing skills: a two-and-a-half-year exploratory study.
BACKGROUND
Motivational interviewing (MI) is a collaborative, client-centred counselling style aimed at eliciting and strengthening clients' intrinsic motivation to change. There is strong research evidence supporting the efficacy of MI, notably in its application among alcohol and drug abuse populations. MI interventions in smoking cessation may yield modest but significant increases in quitting. The present study sought to assess the acquisition and retention of MI skills in counsellors at the Swedish National Tobacco Quitline.


METHODS
Three audio-recorded sessions from each of three counsellors were assessed using the Motivational Interviewing Treatment Integrity (MITI) Code Version 3.0 over 11 assessment periods at fixed intervals in a two-and-a-half year period during which counsellors received ongoing supervision.


RESULTS
The mean skill for all counsellors improved throughout the study period in most MITI variables. However, great variations in MI skill between counsellors were observed, as well as fluctuations in performance in counsellors over time.


CONCLUSIONS
The present exploratory study covers a longer time period than most evaluations of MI training, and has several advantages with regard to study design. It may provide a basis for (larger sample) replication to test MI skill (as measured by the MITI) in relation to behaviour change in clients, to evaluate MI training, and to assess the acquisition and retention of MI skill over time. Difficulties in acquiring and retaining MI skill may raise the issue of a selection policy for MI training. Moreover, fluctuations in MI skill over time emphasise the greater importance of continuous feedback and supervision over initial MI training, and the need for the use of validated treatment integrity assessment instruments in ordinary clinical implementations of MI.
Forsberg
Lisa
L
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. lisa.forsberg@ki.se
Forsberg
Lars G
LG
Lindqvist
Helena
H
Helgason
Asgeir R
AR
D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003376:Counseling / Q000193:education*; D015277:Hotlines; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D009042:Motivation; D015397:Program Evaluation; D016540:Smoking Cessation / Q000379:methods; D013997:Time Factors
J Consult Clin Psychol. 2004 Dec;72(6):1050-62
15612851
AIDS Care. 2009 Feb;21(2):189-96
19229688
Addiction. 1994 Jun;89(6):679-88
8069169
Br J Gen Pract. 2005 Apr;55(513):305-12
15826439
Patient Educ Couns. 2006 Mar;60(3):313-25
16242900
Cogn Behav Ther. 2007;36(3):162-9
17852172
J Consult Clin Psychol. 1980 Oct;48(5):590-601
7410657
Cogn Behav Ther. 2008;37(3):183-91
18608316
J Subst Abuse Treat. 2009 Sep;37(2):151-9
19339147
Annu Rev Clin Psychol. 2005;1:91-111
17716083
J Subst Abuse Treat. 2009 Jan;36(1):101-9
18657936
BMJ. 1994 Oct 8;309(6959):937-9
7950669
Drug Alcohol Depend. 2004 Jan 7;73(1):99-106
14687964
Psychol Addict Behav. 2005 Sep;19(3):303-10
16187810
J Subst Abuse Treat. 2005 Jan;28(1):19-26
15723728
J Stud Alcohol Suppl. 2005 Jul;(15):188-95; discussion 168-9
16223070
J Subst Abuse Treat. 2009 Jul;37(1):73-8
19150203
Tob Control. 2007 Dec;16 Suppl 1:i3-8
18048627
Behav Cogn Psychother. 2009 Mar;37(2):129-40
19364414
N Engl J Med. 2002 Oct 3;347(14):1087-93
12362011
Int J Technol Assess Health Care. 2004 Fall;20(4):469-74
15609797
J Subst Abuse Treat. 2005 Dec;29(4):283-93
16311181
Patient Educ Couns. 2005 Feb;56(2):166-73
15653245
J Subst Abuse Treat. 2006 Jul;31(1):67-73
16814012
Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006936
20091612