The Mid-Atlantic ATTC

Motivational Interviewing for Supervisors

Introduction and Course Background Information

Welcome to Motivational Interviewing for Supervisors. This course is designed as part of dissemination efforts of the Mid-Atlantic ATTC to provide the field with advances in evidence based practices that are both affordable and accessible. A common concern we hear from providers and supervisors centers around the conflict between wanting the latest research outcomes with implementation directions, and at the same time, not feeling comfortable being away from work for several days to attend training. MI for Supervisors is designed to challenge and address supervisory skill building in a convenient on-line format.

If you have taken other Mid-Atlantic ATTC courses, you will find MI for Supervisors to be similar in format. However, MI for Supervisors is an advanced level course, more intensive and interactive than many of our courses. The course is designed for experienced supervisors with MI experience, to provide a challenging five week educational experience. Each week students will be asked to complete a module that may consist of readings, discussion board postings, and/or assignments which are e-mailed to the instructor. A CD demonstrating MI supervisory skills and supervisory sessions will be sent to each student to be used in assignments.

A. Brief History of Study and Blending Team

What We Know From Research

  • Treatment of addiction is as successful as treatment of other chronic conditions such as diabetes, hypertension and asthma (40%-60% success rates).
  • Good outcomes are contingent on people staying in treatment for an adequate length of time.
  • Many people leave treatment before it has a chance to work.
  • Whether or not a client stays in treatment depends on:
    • Motivation to change
    • Degree of support
    • External pressures (i.e, Criminal Justice System)

Motivational Interviewing (MI)

  • MI is especially useful for engaging and retaining people in treatment.
  • MI is well developed and researched.
  • Effects of MI are significant and durable.

In a Meta- analysis of 72 empirical MI studies by Hettema, J, Steele, J. & Miller, W. R. (2005) they report “robust and enduring effects when MI is added at the beginning of treatment.”

  • MI increases treatment retention
  • MI increases treatment adherence
  • MI increases staff-perceived motivation

Citation: Hettema, J, Steele, J. & Miller, W. R. (2005). A meta-analysis of research on MI treatment effectiveness (MARMITE), Annual Review of Clinical Psychology, Vol 1.

GOOD NEWS:

A substantial number of counselors in the US are being training in MI and report that they are using MI in their sessions.

 

BAD NEWS:
  • Research demonstrates that most counselors who say they are using MI really are not.
  • Unless counselors record sessions that can later be rated, it is not possible to know if they are really doing MI (or adhering to any type of practice).

The Study

The NIDA National Drug Abuse Treatment Clinical Trials Network - One Session Motivational Interviewing Protocol began in 2001 and completed in 2003. The purpose of the clinical trial was to test the effect of MI- based intake interview on client retention and substance abuse one month later. A secondary purpose was to ensure that people who are “doing MI” really are competently practicing MI.

 

MI Session Design

  • MI strategies and spirit were integrated into the clinics’ existing intake process.
  • MI Sandwich concept:
    • MI strategies during opening 20 mins.
    • Transition to intake assessment
    • MI strategies for closing 20 mins.
  • Used with diverse substance problems
  • Appropriate for “all comers.”

Who was involved?

  • 5 community treatment programs (CTPs)
    • 3 in Oregon
    • 1 in New York
    • 1 in Virginia
  • Clinicians, supervisors, administrators, directors were involved at each site
  • Researchers collaborated with program staff
  • National trainers provided training in Motivational Interviewing each the site as well as ongoing supervision on fidelity issues related to the protocol.

 

How does the study translate into a course on MI Supervision?

In 2002, NIDA, in cooperation with SAMHSA, formed Blending Teams consisting of CTN researchers and ATTC staff to collaborate on ways to expedite technology transfer to the service delivery field. The intent is to translate research findings from CTN studies into products that can be implemented in community programs. The MI BlendingTeam found that availability of MI training is fairly accessible; however, supervision of MI practicing clinicians is a key to fidelity. Therefore, the MI Blending Team designed a package that emphasizes MI clinical supervision and tools for supervisors, with a modified tape rating system that reflects the needs of community treatment programs.

B. Course Objectives

1. Participants will report understanding of the supervisory role in addictions technology transfer

2. Participants will utilize a modified tape rating system in their practice during the course.

3. Participants will be able to define components of supervisory teaching tools.

4. Participants will practice using supervisory tools with MI practicing supervisees.

5. Participants will demonstrate scenario of using feedback MI style (based on taped submissions)

6. Participants will identify opportunities and barriers for implementation in agency/practice.

C. Disclaimer

Prospective students should be aware that a certain skill level is required to take this course, which is why there are prerequisites (see below). Also, on-line learning does not afford all the advantages of face to face skills training. There is no MI supervisor certification or credential. If you want to get additional on-site training or are interested in becoming a Motivational Interviewing Trainer (member of the Motivational Interviewing Network of Trainers (MINT)), please visit www.motivationalinterview.org for more information.

D. Intended audience

Experienced supervisors who supervise MI clinicians

E. Prerequisites for course:

  • Certification (written documentation) of clinical skills training in face to face format on MI (at least 12 hours)
  • A willingness to audio-tape supervision session with a supervisee who uses MI. This is a tool that you will use for an assignment later in the course, and should be done prior to the beginning of the course.
  • Evidence of coursework in supervision
  • 2 years experience as a clinical supervisor