MOVING MOTIVATIONAL INTERVIEWING INTO PRACTICE

将动机访谈付诸实践

• 批准号: 6174542
• 负责人: WILLIAM R. MILLER
• 金额: $ 33.08万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6174542
• 关键词: behavior therapy; behavioral /social science research tag; clinical research; clinical trials; drug abuse therapy; education evaluation /planning; health care personnel education; human subject; interview; motivation; patient care planning; training; workshop

Treatments with evidence of efficacy do not readily transfer into routine clinical practice. A particular challenge is changing established practice behaviors through continuing professional education. The average clinician practices for 30 years or more, during which time optimal practice is likely to undergo major changes. The usual continuing education format of a one-time workshop is unlikely to modify stable practice behavior substantially. The proposed study applies the basic design of a randomized clinical trial to test the efficacy of procedures for disseminating the clinical intervention style of motivational interviewing (MI). MI was selected because (1) there is strong evidence of its efficacy in addressing substance use disorders, (2) its procedures are well specified, (3) it is consonant with current trends in managed care, and (4) it has many of the attributes specified by Everett Rogers as promoting adoption of an innovation into established practice. A pilot study showed that a 2-day workshop alone was insufficient to change counselors' practice behavior enough to make a difference for clients. Two promising training enhancement procedures (individualized feedback to clinicians, and reinforced practice through individual consultations) will be evaluated via a design combining between-group and within-group effects with 140 substance abuse practitioners. Two well-developed systems for process coding of tapes will be used both to evaluate the efficacy of training, and to advance theory-relevant knowledge of active processes operating in motivational interviewing. A parallel substudy will implement and evaluate MI training of Spanish-speaking clinicians.

具有疗效证据的治疗不易于转移到常规临床实践中。 一个特别的挑战是通过继续专业教育改变既定的实践行为。 临床医生平均执业30年或更长时间，在此期间，最佳实践可能会发生重大变化。 通常的持续教育形式的一次性讲习班是不太可能改变稳定的实践行为大幅。 拟议的研究采用了随机临床试验的基本设计，以测试传播动机访谈（MI）的临床干预风格的程序的有效性。 选择MI是因为（1）有强有力的证据表明其在解决物质使用障碍方面的疗效，（2）其程序明确规定，（3）其符合管理式护理的当前趋势，以及（4）其具有埃弗雷特罗杰斯指定的许多属性，以促进将创新纳入既定实践。 一项试点研究表明，仅仅一个为期2天的研讨会不足以改变辅导员的实践行为，足以为客户带来改变。 两个有前途的培训增强程序（个性化的反馈给临床医生，并通过个人咨询加强实践）将通过一个设计相结合的组间和组内的影响与140个药物滥用从业者进行评估。 两个开发良好的系统的过程编码的磁带将被用来评估培训的效果，并推进理论相关的知识，积极的过程中运作的动机面试。 一项平行的子研究将实施和评估西班牙语临床医生的MI培训。