Strengthening motivational interviewing skills following initial training: a randomised trial of workplace-based reflective practice.

AIM: The study assesses whether a workplace-based educational intervention helps professionals who had trained in Motivational Interviewing (MI) become more competent in it. DESIGN: Randomised controlled trial. PARTICIPANTS: Professionals in health and social services in Dorset, UK, who had received training in MI (n=54). INTERVENTION: (a) CONTROL: Update day in MI (b) THEME (Twelve Hours to Enhance Motivational Effectiveness): Update day plus 12 weekly worksheets to stimulate reflection on practice of MI, feedback to audiotaped sessions with clients, and three 30 minute sessions of telephone coaching. MEASUREMENTS: Degree of competence in MI, as assessed from videotapes of interviews with simulated patients, carried out at entry to the study and 4 months later. Each videotape was coded independently by two trained coders using the Motivational Interviewing Treatment Integrity (MITI) system. FINDINGS: Of the 44 participants who completed the second assessment, those in THEME showed significantly (p<0.05) greater increases in the Spirit of MI and overall competence in MI. CONCLUSIONS: Workplace based interventions may enhance the effectiveness of brief training in MI and other psychological therapies.

Evaluating a method of assessing competence in Motivational Interviewing: a study using simulated patients in the United Kingdom.

In this evaluation of a method of assessing competence in Motivational Interviewing (MI), participants were asked to interview an actor simulating a substance abuser who was ambivalent about an important issue. The interviews were videotaped and subsequently rated for competence in MI using the Motivational Interviewing Treatment Integrity code (MITI). Ratings of 43 interviews made independently by trained judges found high levels of inter-rater agreement. Ratings of 11 pairs of interviews carried out by the same interviewer with different simulated patients, a mean of 26days apart, resembled each other closely. Participants who had been trained in MI were significantly more competent than others. There was a significant association between researchers' and patients' ratings of the extent to which the interviewer demonstrated the spirit of MI. These findings imply that the assessment method produces reasonably reliable and valid ratings of competence in MI and can be used for both clinical and research purposes.