title: Training substance abuse clinicians in motivational interviewing using live supervision via teleconferencing.
abstract: OBJECTIVE
  Training through traditional workshops is relatively ineffective for changing counseling practices. Teleconferencing supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing (MI).
  
  
  METHODS
  Ninety-seven drug treatment counselors completed a 2-day MI workshop and were randomized to live supervision via teleconferencing (TCS; n = 32), standard tape-based supervision (tape; n = 32), or workshop alone (workshop; n = 33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) Coding System pre-workshop and 1, 8, and 20 weeks post-workshop. Mixed-effects linear models were used to test training condition on MI skill at 8 and 20 weeks.
  
  
  RESULTS
  TCS scored better than workshop on the MITI for spirit (mean difference = 0.76; p < .0001; d = 1.01) and empathy (mean difference = 0.68; p < .001; d = 0.74). TCS was superior to workshop in reducing MI non-adherence and was superior to workshop and tape in increasing reflection to question ratio. Tape was superior to TCS in increasing complex reflections. Percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold (spirit and empathy scores ≥ 6).
  
  
  CONCLUSIONS
  TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods to bring more clinicians to high levels of proficiency and facilitate dissemination of evidence-based practices.
authors.affiliation: Department of Psychiatry, Columbia University. smitjen@nyspi.columbia.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Smith
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Carpenter
authors.forename: Paul C
authors.initials: PC
authors.lastname: Amrhein
authors.forename: Adam C
authors.initials: AC
authors.lastname: Brooks
authors.forename: Deborah
authors.initials: D
authors.lastname: Levin
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Schreiber
authors.forename: Laura A
authors.initials: LA
authors.lastname: Travaglini
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Hu
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000193:education*; D003376:Counseling / Q000193:education*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*