Supervision in Motivational Interviewing: An Exploratory Study

Rehabilitation Coordinators' Experiences of Group Supervision and Training in Motivational Interviewing: A Qualitative Study in Primary Health Care

The goals of this study were to describe how rehabilitation coordinators experienced regular group supervision and training in motivational interviewing and to evaluate whether the supervision and training influenced their self-efficacy in using the communication style. Four sessions that included supervision and training in motivational interviewing were offered to primary health care rehabilitation coordinators in Sweden. Focus group interviews were performed with eight participants, and data were analyzed with thematic analysis. Group supervision and training seemed to increase self-efficacy in using motivational interviewing. Components that contributed to enhancing perceived self-efficacy included a safe group climate, collegial feedback, and time between sessions to reflect on and practice motivational interviewing skills. Submitting motivational interviewing dialogues to a coding lab for objective feedback can be challenging but also can increase self-efficacy. The dropout rate was high. Thus, in the future, the sessions should be modified to reach more professionals while retaining the components that participants said could enhance their self-efficacy. [J Contin Educ Nurs. 2023;54(11):533-540.].

A Behavior-based Coding Tool for Assessing Supervisors' Adherence and Competence: Findings From a Motivational Interviewing Implementation Study

Supervision seems to be an essential part of therapist training, and thus also of implementing evidence-based practices. However, there is a shortage of valid and reliable instruments for objective assessment of supervision competence that include both global measures and frequency counts of behavior - two essential aspects of supervisory competence. This study tests the internal consistency and inter-rater reliability of an assessment tool that includes both these measures. Additionally, strategies and techniques used by ten supervisors in 35 Motivational interviewing supervision sessions are described. Codings were conducted after two separate coding training sessions. The internal consistency across the global measures was acceptable (α = 0.70; 0.71). After the second training, the inter-rater reliabilities for all frequency counts were in the moderate to good range, except for two that were in the poor range; inter-rater reliability for one of the four global measures was in the moderate range, and three were in the poor range. A prerequisite for identifying specific supervisor skills central to the development of therapist skills, teaching these skills to supervisors, and performing quality assurance of supervision, is to create instruments that can measure these behaviors. This study is a step in that direction.

Ongoing supervision as a method to implement Motivational interviewing: Results of a randomized controlled trial

OBJECTIVE

To assess skills in Motivational interviewing (MI) at the Swedish National Board of Institutional Care (SiS), and to evaluate different ways to provide MI supervision.

METHODS

SiS practitioners (n = 134) were randomized to regular group supervision, or individual telephone supervision based on only the behavioral component of a feedback protocol, or the full protocol. Participant's mean age was 43.2 (SD =10.2), and the majority (62.7%) were females.

RESULTS

Many participants showed beginning proficiency already at baseline, indicating a successful implementation. Still, results varied widely. The regular supervision and the supervision based on objective feedback were equally effective, and the group receiving feedback based on fewer variables of the protocol performed better on only one of the seven skill measures. The objective feedback did not provoke supervisee discomfort/distress, or negatively affect the supervisory relationship.

CONCLUSIONS

Extensive MI implementation can increase practitioners' skills in MI, but the question of the best mode of ongoing supervision needs further attention.

PRACTICE IMPLICATIONS

Objective feedback does not seem to negatively affect the supervisee's skill acquisition or the supervisor-supervisee working alliance, but the question of how to most efficiently provide feedback from multifaceted feedback tools remains unanswered.

Effects of Fidelity-Focused Consultation on Clinicians' Implementation: An Exploratory Multiple Baseline Design

Identification of effective consultation models could inform implementation efforts. This study examined the effects of a fidelity-focused consultation model among community-based clinicians implementing Attachment and Biobehavioral Catch-up. Fidelity data from 1217 sessions from 7 clinicians were examined in a multiple baseline design. In fidelity-focused consultation, clinicians received feedback from consultants' fidelity coding, and also coded their own fidelity. Clinicians' fidelity increased after fidelity-focused consultation began, but did not increase during other training periods. Fidelity was sustained for 30 months after consultation ended. Findings suggest that consultation procedures involving fidelity coding feedback and self-monitoring of fidelity may promote implementation outcomes.

Providing objective feedback in supervision in motivational interviewing: results from a randomized controlled trial

BACKGROUND

The effects of the use of objective feedback in supervision on the supervisory relationship and skill acquisition is unknown.

AIMS

The objective of this study was to evaluate the effects of two different types of objective feedback provided during supervision in motivational interviewing (MI) on: (a) the supervisory relationship, including potential feelings of discomfort/distress, provoked by the supervision sessions, and (b) the supervisees' skill acquisition.

METHOD

Data were obtained from a MI dissemination study conducted in five county councils across five county councils across Sweden. All 98 practitioners recorded sessions with standardized clients and were randomized to either systematic feedback based on only the behavioral component of a feedback protocol, or systematic feedback based on the entire protocol.

RESULTS

The two different ways to provide objective feedback did not negatively affect the supervisory relationship, or provoke discomfort/distress among the supervisees, and the group that received the behavioural component of the feedback protocol performed better on only two of the seven skill measures.

CONCLUSIONS

Objective feedback does not seem to negatively affect either the supervisor-supervisee working alliance or the supervisees' supervision experience. The observed differences in MI skill acquisition were small, and constructive replications are needed to ascertain the mode and complexity of feedback that optimizes practitioners' learning, while minimizing the sense of discomfort and distress.