A Practical Instrument to Document the Process of Motivational Interviewing

Abstract

Motivational interviewing is a client centred behavioural therapy for addictive behaviours. It is an intervention designed to help all addicts, not just those ready to change. It is therefore suitable for use as an opportunistic intervention for clients whose main reason for contact may not be their addiction. A pilot randomized controlled trial of home-based motivational interviewing by a specially trained midwife to help pregnant smokers reduce their habit was performed in Glasgow from February 1997 to January 1998. Did motivational interviewing take place? All 171 counselling interviews from 48 intervention clients were audio-taped. Forty-nine interviews from 13 randomly selected clients were transcribed for content analysis. A rating scale established for feedback to trainee psychologists was used by three experienced analysts. Thirty-two interviews were scored independently to validate the rating scale in this setting. More than 75% of interviews showed satisfactory motivational interviewing. Therapist utterances were motivational, and client responses included many self-motivational statements. Few episodes of client resistance were recorded. Rating took 160 mins per half hour interview. This instrument provided a valid measure of intervention quality for a randomized controlled trial. It would not be practical to document process outside a research environment.

Panic disorder and smoking.

“…Research testing motivational interviewing tactics in smoking have found some evidence that individuals who were in precontemplation at baseline had a significantly higher quit rate with a motivational intervention when compared PANIC DISORDER AND SMOKING • ZVOLENSKY ET AL. 43 AQ21 AQ22 AQ23 AQ24 to those in a self-help condition (e.g., Colby et al, 1998;Tappin et al, 2000). Over time, such efforts may facilitate smoking cessation efforts.…”

Psychometric properties of the Peer Proficiency Assessment (PEPA): A tool for evaluation of undergraduate peer counselors' motivational interviewing fidelity

“…First, there are distinguishable clinical skill differences between highly trained professional counselors and undergraduate student counselors, yet the standards for competency are not weighted by the counselor type. Second, although each tool offers important components of evaluation for MI adherence or skill acquisition, they have been validated when the interventions were delivered by counselors with masters or higher educational training (Tappin, McKay, McIntyre, Gilmour, Cowan, Crawford et al, 2000) and not with undergraduate student counselors. Third, training for use of the MI evaluation tools vary from five hours to 3 days while session reviews for intervention integrity range from 20 to 50 minutes.…”

Development of a tool to assess fidelity to a psycho‐educational intervention

“…To evaluate an hour-long single session using this tool, it typically took 2·5 hours for coding and 30 minutes for completing the tool for an experienced coder/rater. Tappin et al (2000) reported that the Motivational Interviewing Skill Code could take up to 4 hours to evaluate a single session.…”

“…To evaluate an hour-long single session using this tool, it typically took 2AE5 hours for coding and 30 minutes for completing the tool for an experienced coder/rater. Tappin et al (2000) reported that the Motivational Interviewing Skill Code could take up to 4 hours to evaluate a single session. Questions remain concerning whether variations in intervention delivery should be assessed as part of treatment fidelity or by taking patients' characteristics into account as moderators of the intervention effects on outcomes, or both.…”