Testing Theory-Based Training in Motivational Interviewing

描述(由申请人提供)： 这个项目将测试在药物滥用治疗环境中实施动机访谈(ML)的两种方法中的一种对一线临床医生进行培训的策略。通过随机临床试验，我们将分配这些临床医生接受标准ML培训(MIT)或强调识别、强化和引发客户语言变化的能力的培训(MIT+)。最近的研究表明，以这种方式塑造客户语言与使用ML时在药物滥用治疗中的更好结果有关。虽然这种“改变的谈话”是一种假想的ML的有效成分，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两个版本的ML书籍中，而S缺乏关于临床医生应该如何在ML干预中实施这一组成部分的信息。因此，对ML的这一要素的培训和评估提供了双重优势，既加强了传播，又为未来的第三阶段临床试验提供了基础，以测试ML的因果机制。一旦培训完成，参与者-临床医生将提交他们自己以ML格式进行治疗的录音带，这些录音带将使用经验证的行为编码系统(动机访谈技能代码)进行评估。我们将比较这些培训期间客户语言的数量和强度，以表明在两种培训条件下改变的愿望、能力、理由、需求和承诺。我们的参与者将是140名在美国各地的公共药物滥用治疗环境中工作的临床医生-参与者将前往新墨西哥州接受威廉·米勒博士和P.I.的培训，之后被随机分配到两个培训条件之一，并提交其临床实践的基线熟练程度样本。参与者还会收到电话咨询和治疗过程的编码反馈，这两种情况在我们之前的研究中都已经显示出来，以加强新手临床医生的技能提高。与公共卫生的相关性：这项研究的目的是简化和提高药物滥用有效治疗的效率，动机访谈(ML)。临床医生将参加一个学习计划，以提高他们在特定的ML元素(在治疗期间改变客户语言)的治疗技能，我们将把这与常规的ML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.