Clinician acquisition and retention of Motivational Interviewing skills: a two-and-a-half-year exploratory studyReport as inadecuate

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Substance Abuse Treatment, Prevention, and Policy

, 5:8

First Online: 13 May 2010Received: 15 November 2009Accepted: 13 May 2010DOI: 10.1186-1747-597X-5-8

Cite this article as: Forsberg, L., Forsberg, L.G., Lindqvist, H. et al. Subst Abuse Treat Prev Policy 2010 5: 8. doi:10.1186-1747-597X-5-8


BackgroundMotivational interviewing MI is a collaborative, client-centred counselling style aimed at eliciting and strengthening clients- intrinsic motivation to change. There is strong research evidence supporting the efficacy of MI, notably in its application among alcohol and drug abuse populations. MI interventions in smoking cessation may yield modest but significant increases in quitting. The present study sought to assess the acquisition and retention of MI skills in counsellors at the Swedish National Tobacco Quitline.

MethodsThree audio-recorded sessions from each of three counsellors were assessed using the Motivational Interviewing Treatment Integrity MITI Code Version 3.0 over 11 assessment periods at fixed intervals in a two-and-a-half year period during which counsellors received ongoing supervision.

ResultsThe mean skill for all counsellors improved throughout the study period in most MITI variables. However, great variations in MI skill between counsellors were observed, as well as fluctuations in performance in counsellors over time.

ConclusionThe present exploratory study covers a longer time period than most evaluations of MI training, and has several advantages with regard to study design. It may provide a basis for larger sample replication to test MI skill as measured by the MITI in relation to behaviour change in clients, to evaluate MI training, and to assess the acquisition and retention of MI skill over time. Difficulties in acquiring and retaining MI skill may raise the issue of a selection policy for MI training. Moreover, fluctuations in MI skill over time emphasise the greater importance of continuous feedback and supervision over initial MI training, and the need for the use of validated treatment integrity assessment instruments in ordinary clinical implementations of MI.

AbbreviationsC1 Counsellor 1

C2 Counsellor 2

C3 Counsellor 3

ICC Intra-class correlation

MI Motivational interviewing

MIC Lab Motivational Interviewing Coding Laboratory

MITI Motivational interviewing treatment integrity

MISC Motivational Interviewing Skills Code

OARS Open questions, affirmations, reflections, summaries

RCT Randomised Controlled Trial

SNTQ Swedish National Tobacco Quitline.

Electronic supplementary materialThe online version of this article doi:10.1186-1747-597X-5-8 contains supplementary material, which is available to authorized users.

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Author: Lisa Forsberg - Lars G Forsberg - Helena Lindqvist - Asgeir R Helgason


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