Assessing competence in the use of motivational interviewing
TL;DR: Comparison of MITI scores before and after MI workshops indicate good sensitivity for detecting improvement in clinical practice as result of training, and implications for the use of this instrument in research and supervision are discussed.
About: This article is published in Journal of Substance Abuse Treatment.The article was published on 2005-01-01. It has received 723 citations till now. The article focuses on the topics: Motivational interviewing.
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TL;DR: An emergent theory of MI is proposed that emphasizes two specific active components: a relational component focused on empathy and the interpersonal spirit of MI, and a technical component involving the differential evocation and reinforcement of client change talk.
Abstract: The widely disseminated clinical method of motivational interviewing (MI) arose through a convergence of science and practice. Beyond a large base of clinical trials, advances have been made toward "looking under the hood" of MI to understand the underlying mechanisms by which it affects behavior change. Such specification of outcome-relevant aspects of practice is vital to theory development and can inform both treatment delivery and clinical training. An emergent theory of MI is proposed that emphasizes two specific active components: a relational component focused on empathy and the interpersonal spirit of MI, and a technical component involving the differential evocation and reinforcement of client change talk. A resulting causal chain model links therapist training, therapist and client responses during treatment sessions, and posttreatment outcomes.
1,390 citations
Book•
01 Jan 2007TL;DR: Motivational Interviewing (MI), a method of interacting with patients to enhance behavior change, is a welltested and established method with over 160 randomized clinical trials demonstrating its efficacy across an array of medical trials.
Abstract: Behavior change is a critical part of effective health care. The final decision to become healthier, however, is that of the patient and not the practitioner. Anyone who has treated patients knows ...
1,026 citations
TL;DR: This review critiques the extant research on training in EBP from an systems-contextual (SC) perspective and suggests that therapist knowledge improves and attitudinal change occurs following training.
Abstract: Evidence-based practice (EBP), a preferred psychological treatment approach, requires training of community providers. The systems-contextual (SC) perspective, a model for dissemination and implementation efforts, underscores the importance of the therapist, client, and organizational variables that influence training and consequent therapist uptake and adoption of EBP. This review critiques the extant research on training in EBP from an SC perspective. Findings suggest that therapist knowledge improves and attitudinal change occurs following training. However, change in therapist behaviors (e.g., adherence, competence, and skill) and client outcomes only occurs when training interventions address each level of the SC model and include active learning. Limitations as well as areas for future research are discussed.
882 citations
TL;DR: A single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data, providing a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms.
Abstract: Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants’ responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly follo...
657 citations
Cites background or methods from "Assessing competence in the use of ..."
...The first and third MET sessions were coded using the Motivational Interviewing Treatment Integrity (MITI 3.1) coding system (Moyers et al., 2005) by a rater trained to reliability....
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...1) coding system (Moyers et al., 2005) by a rater trained to reliability....
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TL;DR: Methods of preservation of treatment fidelity in health behavior change trials conducted in public health contexts and strategies for assessment, monitoring, and enhancing treatment fidelity within each of the five treatment fidelity domains are discussed.
Abstract: OBJECTIVES: To discuss methods of preservation of treatment fidelity in health behavior change trials conducted in public health contexts. METHODS: The treatment fidelity framework provided by the NIH's Behavioral Change Consortium (BCC) (1) includes five domains of treatment fidelity (Study Design, Training, Delivery, Receipt, and Enactment). A measure of treatment fidelity was previously developed and validated using these categories. RESULTS: Strategies for assessment, monitoring, and enhancing treatment fidelity within each of the five treatment fidelity domains are discussed. The previously created measure of treatment fidelity is updated to include additional items on selecting providers, additional confounders, theory testing, and multicultural considerations. CONCLUSIONS: Implementation of a treatment fidelity plan may require extra staff time and costs. However, the economic and scientific costs of lack of attention to treatment fidelity are far greater than the costs of treatment fidelity implementation. Maintaining high levels of treatment fidelity with flexible adaptation according to setting, provider, and patient is the goal for public health trials.
619 citations
References
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TL;DR: In this paper, the authors provide guidelines, guidelines, and simple rules of thumb to assist the clinician faced with the challenge of choosing an appropriate test instrument for a given psychological assessment.
Abstract: In the context of the development of prototypic assessment instruments in the areas of cognition, personality, and adaptive functioning, the issues of standardization, norming procedures, and the important psychometrics of test reliability and validity are evaluated critically. Criteria, guidelines, and simple rules of thumb are provided to assist the clinician faced with the challenge of choosing an appropriate test instrument for a given psychological assessment. Clinicians are often faced with the critical challenge of choosing the most appropriate available test instrument for a given psychological assessment of a child, adolescent, or adult of a particular age, gender, and class of disability. It is the purpose of this report to provide some criteria, guidelines, or simple rules of thumb to aid in this complex scientific decision. As such, it draws upon my experience with issues of test development, standardization, norming procedures, and important psychometrics, namely, test reliability and validity. As I and my colleagues noted in an earlier publication, the major areas of psychological functioning, in the normal development of infants, children, adolescents, adults, and elderly people, include cognitive, academic, personality, and adaptive behaviors (Sparrow, Fletcher, & Cicchetti, 1985). As such, the major examples or applications discussed in this article derive primarily, although not exclusively, from these several areas of human functioning.
7,254 citations
"Assessing competence in the use of ..." refers background in this paper
...Cicchetti (1994) has proposed a categorization system for evaluating the usefulness of ICCs in clinical instruments: below ....
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Book•
01 Jan 1991
TL;DR: The second edition of the Motivational Interviewing (MI) has been published by as mentioned in this paper, which includes 25 nearly all-new chapters, including guidelines for using their approach with a variety of clinical populations and reflect on the process of learning MI.
Abstract: Since the initial publication of this classic text, motivational interviewing (MI) has been used by countless clinicians in diverse settings. Theory and methods have evolved apace, reflecting new knowledge on the process of behavior change, a growing body of outcome research, and the development of new applications within and beyond the addictions field. Including 25 nearly all-new chapters, this revised and expanded second edition now brings MI practitioners and trainees fully up to date. William R. Miller and Stephen Rollnick explain how to work through ambivalence to facilitate change, present detailed guidelines for using their approach with a variety of clinical populations, and reflect on the process of learning MI. Chapters contributed by other leading experts then address such special topics as MI and the stages-of-change model; using the approach with groups, couples, and adolescents; and applications to general medical care, health promotion, and criminal justice settings.
4,155 citations
TL;DR: There is encouraging evidence that the course of harmful alcohol use can be effectively altered by well-designed intervention strategies which are feasible within relatively brief-contact contexts such as primary health care settings and employee assistance programs.
Abstract: Relatively brief interventions have consistently been found to be effective in reducing alcohol consumption or achieving treatment referral of problem drinkers. To date, the literature includes at least a dozen randomized trials of brief referral or retention procedures, and 32 controlled studies of brief interventions targeting drinking behavior, enrolling over 6000 problem drinkers in both health care and treatment settings across 14 nations. These studies indicate that brief interventions are more effective than no counseling, and often as effective as more extensive treatment. The outcome literature is reviewed, and common motivational elements of effective brief interventions are described. There is encouraging evidence that the course of harmful alcohol use can be effectively altered by well-designed intervention strategies which are feasible within relatively brief-contact contexts such as primary health care settings and employee assistance programs. Implications for future research and practice are considered.
1,561 citations
01 Jan 1999
TL;DR: The Empirical Case for the Common Factors in Therapy - Quantitative Findings Qualitative Inquiry in Psychotherapy - Research on the Common factors.
Abstract: The Empirical Case for the Common Factors in Therapy - Quantitative Findings Qualitative Inquiry in Psychotherapy - Research on the Common Factors The Client as a Common Factor - Clients as Self-Healers The Therapeutic Relationship Hope as a Psychotherapeutic Foundation of Common Factors, Placebos and Expectancies The Contribution of Models and Techniques to Therapeutic Efficacy - Contradictions Between Professional Trends and Clinical Research How Do People Change and How Can We Change to Help Many More People? From Placebo to Alliance - the Role of Common Factors in Medicine Common Psychosocial Factors in Psychiatric Drug Therapy Common Factors and Other Non Model Driven Technique Variables in Marriage and Family Therapy Common Factors of School-Based Change What Really Makes a Difference in Psychotherapy Outcome? and Why Does Managed Care Want to Know? Directing Attention to What Works.
1,368 citations
TL;DR: This article seeks to define motivational interviewing and to characterize its essential nature, differentiating it from other approaches with which it may be confused.
Abstract: Motivational interviewing is a directive, client-centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style for interpersonal relationship. This article seeks to define motivational interviewing and to characterize its essential nature, differentiating it from other approaches with which it may be confused. A brief update is also provided regarding (1) evidence for its efficacy and (2) new problem areas and populations to which it is being applied.
1,359 citations