title: Self-Report After Randomly Assigned Supervision Does not Predict Ability to Practice Motivational Interviewing.
abstract: The objective of this study was to investigate the relation between self-report and objective assessment of motivational interviewing (MI) skills following training and supervision. After an MI workshop, 96 clinicians from 26 community programs (age 21-68, 65% female, 40.8% Black, 29.6% Caucasian, 24.5% Hispanic, 2.0% Asian, 3.1% other) were randomized to supervision (tele-conferencing or tape-based), or workshop only. At four time points, trainees completed a self-report of MI skill, using items from the MI understanding questionnaire (MIU), and were objectively assessed by raters using the Motivational Interviewing Treatment Integrity (MITI) system. Correlations were calculated between MIU and MITI scores. A generalized linear mixed model was tested on MIU scores, with MITI scores, supervision condition and time as independent variables. MIU scores increased from pre-workshop (mean = 4.74, SD = 1.79) to post-workshop (mean = 6.31, SD = 1.03) (t = 8.69, p < .0001). With supervision, scores continued to increase, from post-workshop to week 8 (mean = 7.07, SD = 0.91, t = 5.60, p < .0001) and from week 8 to week 20 (mean = 7.28, SD = 0.94, t = 2.43, p = .02). However, MIU scores did not significantly correlate with MITI scores, with or without supervision. Self-reported ability increased with supervision, but self-report was not an indicator of objectively measured skill. This suggests that training does not increase correspondence between self-report and objective assessment, so community treatment programs should not rely on clinician self-report to assess the need for ongoing training and supervision and it may be necessary to train clinicians to accurately assess their own skill.
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, Room 3732, Box 120, New York, NY, 10032, USA. Electronic address: morgan.wain@gmail.com.
authors.forename: R Morgan
authors.initials: RM
authors.lastname: Wain
authors.affiliation: Division of Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, Room 3732, Box 120, New York, NY, 10032, USA. Electronic address: bkutner@gmail.com.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Kutner
authors.affiliation: Department of Psychiatry, Columbia University, 1051 Riverside Drive, Room 3732, Box 120, New York, NY, 10032, USA. Electronic address: smitjen@nyspi.columbia.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Smith
authors.affiliation: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, Room 3732, Box 120, New York, NY, 10032, USA. Electronic address: carpent@nyspi.columbia.edu.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Carpenter
authors.affiliation: Department of Psychiatry, Columbia University, 1051 Riverside Drive, Unit 20, New York, NY, 10032, USA. Electronic address: mh2236@columbia.edu.
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Hu
authors.affiliation: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive #120, New York, NY, 10032, USA. Electronic address: pa2146@columbia.edu.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Amrhein
authors.affiliation: Department of Psychiatry, Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 51, New York, NY, 10032, USA. Electronic address: nunesed@nyspi.columbia.edu.
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D055317:Evidence-Based Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D057566:Self Report; D016320:Substance Abuse Treatment Centers; D055815:Young Adult
keywords: Community-based supervision; Dissemination; Evidence-based practice; Motivational interviewing; Training