Testing Theory-Based Training in Motivational Interviewing

点击翻译按钮获取中文摘要

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.