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Gill I, Oster C, Lawn S. Assessing competence in health professionals' use of motivational interviewing: A systematic review of training and supervision tools. PATIENT EDUCATION AND COUNSELING 2020; 103:473-483. [PMID: 31585819 DOI: 10.1016/j.pec.2019.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/19/2019] [Accepted: 09/21/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To conduct a systematic review of instruments for assessing the competency of therapists in motivational interviewing (MI) for training purposes. METHODS A search of Medline, Emcare, CINAHL, Scopus, Proquest, and Web of Science databases yielded 20,313 articles, of which 105 were included in the review. Data were summarised in terms of the instruments' development, adherence to MI principles, administration characteristics, psychometric properties, advantages, and disadvantages. RESULTS Twelve instruments were identified. Tools tended to be better at covering simpler MI techniques. Differences in administration burden allow users to choose between briefer but cheaper and more detailed yet costly tools. Psychometric testing was often limited, and even if more extensive, the quality was often inconsistent. Although each tool tended to have relatively unique advantages (e.g. use of client ratings), they shared common disadvantages (e.g. lack of psychometric testing). CONCLUSION A number of tools can be used to assess MI competency, each with their own strengths but notable weaknesses that should be considered by potential users. PRACTICE IMPLICATIONS There is a need to further test existing tools before creating new ones, due to the repetition of the same limitations. Standardised guidelines should also be created to ensure each tool meets the same quality standards.
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Affiliation(s)
- Isabelle Gill
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Candice Oster
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Flinders Human Behaviour and Health Research Unit, Margaret Tobin Centre, Flinders University, Adelaide, South Australia, Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Flinders Human Behaviour and Health Research Unit, Margaret Tobin Centre, Flinders University, Adelaide, South Australia, Australia.
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Kramer Schmidt L, Andersen K, Nielsen AS, Moyers TB. Lessons learned from measuring fidelity with the Motivational Interviewing Treatment Integrity code (MITI 4). J Subst Abuse Treat 2019; 97:59-67. [DOI: 10.1016/j.jsat.2018.11.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/12/2018] [Accepted: 11/18/2018] [Indexed: 11/26/2022]
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Serrano SE, Serafini K, Eller N, Torres VN, Donovan D, Ornelas IJ. Vida PURA: An assessment of the fidelity of promotor-delivered screening and brief intervention to reduce unhealthy alcohol use among Latino day laborers. J Ethn Subst Abuse 2018; 17:519-531. [PMID: 28375699 PMCID: PMC7141813 DOI: 10.1080/15332640.2017.1300557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We assessed the fidelity of promotores conducting screening and brief intervention (SBI) to reduce unhealthy alcohol use among Latino immigrant day laborers in the Vida PURA study. We reviewed 32 audio-recorded brief interventions to assess promotor adherence to the intervention protocol and to evaluate their motivational interviewing (MI) technique with the Motivational Interviewing Treatment Integrity (MITI) 4.2.1 tool. Promotores delivered three core intervention steps in 78% of recordings and achieved basic MI competence across all domains and proficiency in 50% of measures. Our results suggest that promotores can be trained to deliver SBI in community settings with fidelity.
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Affiliation(s)
| | - Kelly Serafini
- b Swedish Family Medicine Residency , Seattle , Washington
| | - Nikki Eller
- a University of Washington , Seattle , Washington
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Grodensky C, Golin C, Parikh MA, Ochtera R, Kincaid C, Groves J, Widman L, Suchindran C, McGirt C, Amola K, Bradley-Bull S. Does the quality of safetalk motivational interviewing counseling predict sexual behavior outcomes among people living with HIV? PATIENT EDUCATION AND COUNSELING 2017; 100:147-153. [PMID: 27567497 PMCID: PMC5489346 DOI: 10.1016/j.pec.2016.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/05/2016] [Accepted: 08/13/2016] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention. METHODS We used a structured instrument (the MISC 2.0 coding system) as well as a client-reported instrument to rate intervention sessions on aspects of MI quality. Then we correlated client-reported UAVI with specific counseling behaviors and the proportion of interactions that achieved MI quality benchmarks. RESULTS/CONCLUSION Higher MISC-2.0 global ratings and a higher ratio of reflections to questions both significantly predicted fewer UAVI acts at 8-month follow-up. Analysis of client ratings, which was more exploratory, showed that clients who rated their sessions higher in counselor acceptance, client disclosure, and relevance reported higher numbers of UAVIs, whereas clients who selected higher ratings for perceived benefit were more likely to have fewer UAVI episodes. PRACTICE IMPLICATIONS Further research is needed to determine the best methods of translating information about MI quality into dissemination of effective MI interventions with people living with HIV.
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Affiliation(s)
- Catherine Grodensky
- Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA.
| | - Carol Golin
- Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA; UNC Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB# 7590 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590, USA; Department of Health Behavior, UNC School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC 27516, USA.
| | - Megha A Parikh
- Johns Hopkins University, Bloomberg School of Global Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
| | - Rebecca Ochtera
- Spark Policy Institute, 2717 Welton St., Denver, CO 80205, USA, USA.
| | - Carlye Kincaid
- Silber Psychological Services, 1340 SE Maynard Rd, Suite 201, Cary, NC 27511, USA.
| | - Jennifer Groves
- UNC Cecil G. Sheps Center for Health Services Research, University of North Carolina, CB# 7590 725 Martin Luther King Jr. Blvd. Chapel Hill, NC 27599-7590, USA.
| | - Laura Widman
- Department of Psychology, University of North Carolina, 235 E Cameron Ave, Chapel Hill, NC 27514, USA; NC State Department of Psychology, 640 Poe Hall, Campus Box 7650, Raleigh, NC 27695-7650, USA.
| | - Chirayath Suchindran
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, UNC 135 Dauer Dr, Chapel Hill, NC 27516, USA.
| | - Camille McGirt
- Department of Health Behavior, UNC School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, NC 27516, USA.
| | - Kemi Amola
- Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA; Voice Therapeutic Solutions, 3712 Benson Dr, Raleigh, NC 27609, USA.
| | - Steven Bradley-Bull
- Department of Medicine, UNC School of Medicine, University of North Carolina, CB# 7030 130 Mason Farm Rd. Chapel Hill, NC 27599-7030, USA.
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Spohr SA, Taxman FS, Rodriguez M, Walters ST. Motivational Interviewing Fidelity in a Community Corrections Setting: Treatment Initiation and Subsequent Drug Use. J Subst Abuse Treat 2016; 65:20-5. [PMID: 26365536 PMCID: PMC4732927 DOI: 10.1016/j.jsat.2015.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 07/06/2015] [Accepted: 07/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although substance use is common among people in the U.S. criminal justice system, treatment initiation remains an ongoing problem. This study assessed the reliability and predictive validity of the Motivational Interviewing Treatment Integrity 3.1.1. (MITI) coding instrument in a community corrections sample. METHODS We used data from 80 substance-using clients who were participating in a clinical trial of MI in a probation setting. We analyzed 124 MI counseling sessions using the MITI, a coding system for documenting MI fidelity. Bivariate associations and logistic regression modeling were used to determine if MI-consistent behaviors predicted substance use or treatment initiation at a 2-month follow-up. RESULTS We found a high level of agreement between coders on behavioral utterance counts. Counselors met at least beginning proficiency on most MITI summary scores. Probationers who initiated treatment at 2-month follow-up had significantly higher ratings of clinician empathy and MI spirit than clients who did not initiate treatment. Other MITI summary scores were not significantly different between clients who had initiated treatment and those who did not. MI spirit and empathy ratings were entered into a forward logistic regression in which MI spirit significantly predicted 2-month treatment initiation (χ(2) (1)=4.10, p<.05, R(2)=.05) but counselor empathy did not. MITI summary scores did not predict substance use at 2-month follow-up. CONCLUSIONS Counselor MI-consistent relational skills were an important predictor of client treatment initiation. Counselor behaviors such as empathy and MI spirit may be important for developing client rapport with people in a probation setting.
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Affiliation(s)
- Stephanie A Spohr
- University of North Texas Health Science Center, School of Public Health, Department of Behavioral and Community Health, Fort Worth, TX.
| | - Faye S Taxman
- George Mason University, Department of Criminology, Fairfax, VA
| | - Mayra Rodriguez
- University of North Texas Health Science Center, School of Public Health, Department of Behavioral and Community Health, Fort Worth, TX
| | - Scott T Walters
- University of North Texas Health Science Center, School of Public Health, Department of Behavioral and Community Health, Fort Worth, TX.
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Jelsma JGM, Mertens VC, Forsberg L, Forsberg L. How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations. Contemp Clin Trials 2015; 43:93-9. [PMID: 25962891 DOI: 10.1016/j.cct.2015.05.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/30/2015] [Accepted: 05/02/2015] [Indexed: 11/30/2022]
Abstract
Many randomized controlled trials in which motivational interviewing (MI) is a key intervention make no provision for the assessment of treatment fidelity. This methodological shortcoming makes it impossible to distinguish between high- and low-quality MI interventions, and, consequently, to know whether MI provision has contributed to any intervention effects. This article makes some practical recommendations for the collection, selection, coding and reporting of MI fidelity data, as measured using the Motivational Interviewing Treatment Integrity Code. We hope that researchers will consider these recommendations and include MI fidelity measures in future studies.
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Affiliation(s)
- Judith G M Jelsma
- Department of Public and Occupational Health, EMGO(+) Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands.
| | - Vera-Christina Mertens
- Department of Rehabilitation Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands
| | - Lisa Forsberg
- Department of Clinical Neuroscience, MIC Lab, Karolinska Institutet, Stockholm, Sweden
| | - Lars Forsberg
- Department of Clinical Neuroscience, MIC Lab, Karolinska Institutet, Stockholm, Sweden
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Lovejoy TI, Heckman TG. Depression moderates treatment efficacy of an HIV secondary-prevention intervention for HIV-positive late middle-age and older adults. Behav Med 2015; 40:124-33. [PMID: 25090365 DOI: 10.1080/08964289.2014.893982] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
An estimated one-third of HIV-positive older adults continues to engage in sexual behaviors that risk HIV transmission or the acquisition of other sexually transmitted infections. A recently completed pilot randomized controlled trial of telephone-administered motivational interviewing (Tele-MI) targeting sexual risk behavior in 100 HIV-positive late middle-age and older adults found that a four-session Tele-MI intervention reduced episodes of non-condom-protected anal and vaginal intercourse. This secondary analysis examined the moderating effect of baseline depressive symptoms on intervention efficacy. When compared to one session of Tele-MI or standard of care, four sessions of Tele-MI produced greater reductions in sexual risk behavior in participants with subsyndromal depression at baseline but was no more efficacious than the other two conditions for participants with no or elevated baseline depressive symptoms. Large-scale studies that further elucidate the role of depression in sexual risk reduction interventions for HIV-positive persons are needed.
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Affiliation(s)
- Travis I Lovejoy
- a Portland VA Medical Center and Oregon Health & Science University
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Dobber J, van Meijel B, Barkhof E, Scholte op Reimer W, Latour C, Peters R, Linszen D. Selecting an optimal instrument to identify active ingredients of the motivational interviewing-process. J Psychosom Res 2015; 78:268-76. [PMID: 25466386 DOI: 10.1016/j.jpsychores.2014.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 10/08/2014] [Accepted: 10/20/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Motivational Interviewing (MI) can effectively stimulate motivation for health behavior change, but the active ingredients of MI are not well known. To help clinicians further stimulate motivation, they need to know the active ingredients of MI. A psychometrically sound instrument is required to identify those ingredients. The purpose of this study is to describe and evaluate the capability of existing instruments to reliably measure one or more potential active ingredients in the MI process between clients and MI-therapists. METHODS We systematically searched MedLine, Embase, Cinahl, PsycInfo, Cochrane Central, specialised websites and reference lists of selected articles. RESULTS We found 406 papers, 60 papers were retrieved for further evaluation, based on prespecified criteria. Seventeen instruments that were specifically designed to measure MI or aspects of MI were identified. Fifteen papers met all inclusion criteria, and reported on seven instruments that assess potential active ingredients of the interactive MI process. The capability of these instruments to measure potential active ingredients in detail and as a part of the interactive MI process varies considerably. Three of these instruments measure one or more potential active ingredients in a reliable and valid way. CONCLUSION To identify the potential active ingredients in the interactive MI process, a combination of the SCOPE (which measures potential technical active ingredients) and the GROMIT or the global ratings of the MISC2 (to measure potential relational ingredients) seems favourable.
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Affiliation(s)
- Jos Dobber
- Amsterdam School of Health Professions, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
| | - Berno van Meijel
- Inholland University of Applied Sciences, Department of Health, Sports & Welfare, Cluster Nursing, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Parnassia Academy, The Hague, the Netherlands; VU University Medical Center, Department of Psychiatry, EGO Institute for Health and Care Research, Amsterdam, the Netherlands
| | - Emile Barkhof
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Wilma Scholte op Reimer
- Amsterdam School of Health Professions, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Corine Latour
- Amsterdam School of Health Professions, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Ron Peters
- Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Don Linszen
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
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