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Motivational Interviewing Assessment: Evidence from Research

What is Motivational Interviewing
MI is a client-centered, yet directive, method for enhancing the patient’s intrinsic motivation to change by exploring and resolving ambivalence. A counselor using an MI style expresses empathy, develops discrepancy, rolls with resistance, and supports self-efficacy. MI is especially useful for engaging and retaining people in treatment, and is well developed and researched.

The Motivational Interviewing Assessment Protocol
The protocol was developed and tested in five community treatment programs across the country. The Motivational Interviewing Assessment study was designed as an intervention that all outpatient community treatment providers could undertake. Its use has been shown to increase:

• Client treatment attendance, and
• Retention of clients during the first month of treatment

The MIA intervention consists of adding a 20-minute MI enhancement to the beginning and end of an agency’s usual assessment interview. Because MI includes a complex assortment of skills, the MIA:STEP toolkit was developed for supervisors to use in mentoring and facilitating the development and maintenance of counselor MI skills.

MIA:STEP Toolkit for Clinical Supervision
Clinical supervision has often not included actual samples of clinical practice. Yet feedback and coaching are best based upon first-hand observation of the counselor engaged in working with a client or group of clients. The unique feature of this toolkit introduces an effective strategy for observation-based clinical supervision, the use of which has potential to improve counselor skills beyond MI. The teaching and refresher tools include both skill description handouts and assessment criteria sheets for fundamental MI concepts and skills; an interview rating guide; and a training curriculum that is aimed at developing clinical supervisor skills in using the MIA:STEP materials, especially for reviewing and evaluating recorded sessions of counselors using MI.

Research Findings

Why this Study is Important

• It showed that MI skills can be taught and used at a high level when using recorded sessions, interview coding, and clinical supervision.
• Clients who received one session of MI were more likely to be in treatment 4 weeks later and to have attended more sessions than clients who received regular assessments.
• Three-quarters of study participants followed up through 12 weeks; 77% at 1 month; and 75% at 3 months (range 66% - 84%).

By adding an MI component to a standard assessment, patient attendance and retention during the first moth of care increased significantly. MI has a well-documented capacity to engage and retain clients in treatment .now we have evidence that a single motivational style interview at the beginning of outpatient treatment helps clients remain in treatment during a time when drop-out risk is high.

Articles

• Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study, Carroll et al., Drug Alcohol Depend. 2006 February 28; 81(3): 301–312

For additional resources highlighting research related to buprenorphine treatment, please see the "Other Resources" section.