Testing Theory-Based Training in Motivational Interviewing

描述（由申请人提供）： 该项目将测试在药物滥用治疗环境中实施动机访谈（MI）的两种方法之一培训一线临床医生的策略。使用随机临床试验，我们将分配这些临床医生接受标准MI培训（MIT）或强调识别，强化和引发客户语言变化（MIT+）的能力的培训。最近的研究表明，以这种方式塑造客户语言与使用MI时药物滥用治疗的更好结果相关。虽然这种“改变谈话”是MI的一种假设的活性成分，但关于咨询师应该如何引发和回应它的信息并没有包括在MI书的任何一个版本中，并且关于临床医生应该如何在MI干预中实施这一组成部分的信息也很少。因此，Ml的该元素的训练和评估提供了增强传播和为将来的III期临床试验提供基础以测试Ml的因果机制的双重优势。一旦培训完成，参与者-临床医生将提交他们自己在MI进行治疗的录音带，这些录音带将使用经验证的行为编码系统（动机性访谈技能代码）进行评估。我们将在这些课程中比较客户语言的数量和强度，表明两种培训条件之间的愿望，能力，原因，需求和承诺。我们的参与者将是140名在美国各地公共药物滥用治疗机构工作的临床医生。参与者将前往新墨西哥州接受威廉米勒博士和私人侦探的培训，在被随机分配到两种培训条件之一并提交其临床实践的基线熟练度样本之后。参与者还接受电话咨询和编码反馈他们的治疗会议，这两个都已在我们以前的研究中显示，以提高技能的提高新手临床医生。与公共卫生的相关性：本研究的目的是精简和提高效率的一个行之有效的治疗药物滥用，动机访谈（MI）。临床医生将参与学习计划，以提高他们在MI的特定元素中的治疗技能（在治疗期间改变客户语言），我们将将此与常规MI治疗进行比较。这项研究也将为今后研究药物滥用治疗的有效成分提供基础。

DESCRIPTION (provided by applicant): This project will test strategies for training front-line clinicians in one of two methods for implementing motivational interviewing (Ml) in substance abuse treatment settings. Using a randomized clinical trial, we will assign these clinicians to receive either standard Ml Training (MIT) or training that emphasizes the ability to recognize, reinforce and elicit client language toward change (MIT+). Recent research indicates that shaping client language in this manner is associated with better outcomes in substance abuse treatment when Ml is used. Although such "change talk" is a hypothesized active ingredient of Ml, information about how counselors should elicit and respond to it has not been included in either edition of Ml book, and there s a paucity of information about how clinicians should implement this component within an Ml intervention. Therefore, training and evaluation of this element of Ml offers the dual advantage of enhancing dissemination and providing a foundation for future Stage III clinical trials to test causal mechanisms for Ml. Once training is complete, participant-clinicians will submit audiotapes of themselves conducting treatment sessions in Ml and these will be evaluated using an empirically-validated behavioral coding system (the Motivational Interviewing Skills Code). We will compare the amount and intensity of client language during these sessions indicating desire, ability, reason, need and commitment to change between the two training conditions. Our participants will be 140 clinicians working in public substance abuse treatment settings around the U.S. Clinician-participants will travel to New Mexico to receive training from Dr. William Miller and the P.I., after being randomized to one of the two training conditions and submitting a baseline proficiency sample of their clinical practice. Participants also receive telephone consults and coded feedback of their treatment sessions, both of which have been shown in our previous research to enhance skill enhancement in novice clinicians. Relevance to Public Health: This research is intended to streamline and improve the efficiency of a proven treatment for substance abuse, motivational interviewing (Ml). Clinicians will participate in a learning program to improve their treatment skills in a particular element of Ml (changing client language during therapy) and we will compare this with regular Ml treatment. This research will also provide a foundation for future investigations of effective ingredients of substance abuse treatments.