title: Sustaining motivational interviewing: a meta-analysis of training studies.
abstract: OBJECTIVE
  Previous research indicates that motivational interviewing (MI) skills decline over time among participants in training workshops when post-workshop feedback and coaching are not provided. This study explored moderators of skill retention among trainees learning MI mainly for substance use disorder treatment in real-world treatment settings, including workshop enhancements and type and dose of post-workshop feedback and coaching.
  
  
  METHODS
  A meta-analysis of training studies was conducted with studies that reported MI skills using observational measures and that included trainees from real-world agency settings. Standardized change scores were calculated to indicate the magnitude of pre-post training change in MI skills; standardized change scores from post-training to 3 and 6+ months follow-up were calculated to indicate the sustainability of training gains over time. Effect sizes were aggregated using random effects models.
  
  
  RESULTS
  Twenty-one papers that reported the effects of MI training on agency staff were included in this review. Across studies, training yielded gains in MI skills (d = 0.76). Studies that did not include feedback and/or coaching reported eroding skills over a 6-month follow-up (d = -0.30), whereas post-workshop feedback/coaching sustained skills (d = 0.03). Effects of post-workshop feedback/coaching were moderated by frequency, duration and length of training. Moreover, studies reporting low levels of attrition from training protocols showed small increases in skills over the 6-month follow-up period (d = 0.12), whereas studies with high attrition showed skill erosion (d = -0.29).
  
  
  CONCLUSIONS
  On average, three to four feedback/coaching sessions over a 6-month period sustain skills among trainees for motivational interviewing, mainly for substance use disorder treatment. However, high rates of attrition from feedback/coaching contributes to post-workshop skill erosion.
authors.affiliation: Columbia University School of Social Work, New York, NY, USA.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Schwalbe
authors.forename: Hans Y
authors.initials: HY
authors.lastname: Oh
authors.forename: Allen
authors.initials: A
authors.lastname: Zweben
mesh_terms: D004493:Education; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D062405:Motivational Interviewing / Q000379:methods*; D019966:Substance-Related Disorders / Q000628:therapy*
keywords: Feedback/coaching; meta-analysis; motivational interviewing; supervision; sustainability; training