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Self-Report After Randomly Assigned Supervision Does Not Predict Ability to Practice Motivational Interviewing.

Journal of Substance Abuse Treatment 2015;57:96-101. [doi: 10.1016/j.jsat.2015.04.006]

R. Morgan Wain, PhD, Bryan A. Kutner, Jennifer L. Smith, PhD, Kenneth M. Carpenter, PhD, Mei-Chen Hu, PhD, Paul C. Amrhein, PhD, Edward V. Nunes, MD (all from Columbia University, GNY Node).

The objective of this study was to investigate the relation between self-report and objective assessment of Motivational Interviewing (MI) skills following training and supervision. After an MI workshop, 96 clinicians from 26 community programs participating in NIDA's National Drug Abuse Treatment Clinical Trials Network (CTN) were randomized to supervision (tele-conferencing or tape-based) or workshop-only. At four time points, trainees completed a self-report of MI skill, using items from the MI Understanding Questionnaire (MIU), and were objectively assessed by raters using the Motivational Interviewing Treatment Integrity (MITI) system. Correlations were calculated between MIU and MITI scores. A generalized linear mixed model was tested on MIU scores, with MITI scores, supervision condition and time as independent variables. MIU scores increased from pre-workshop (mean=4.74, SD=1.79) to post-workshop (mean=6.31, SD=1.03). With supervision, scores continued to increase, from post-workshop to week 8 (mean=7.07, SD=0.91, t=5.60, p<.0001) and from week 8 to week 20 (mean=7.28, SD=0.94, t=2.43, p=.02). However, MIU scores did not significantly correlate with MITI scores, with or without supervision. Self-reported ability increased with supervision, but self-report was not an indicator of objectively measured skill.

Conclusions: This study suggests that training does not increase correspondence between self-report and objective assessment, so community treatment programs should not rely on clinician self-report to assess the need for ongoing training and supervision and it may be necessary to train clinicians to accurately assess their own skill. This has important implications for community treatment, where time and resources may constrain the amount of MI training and supervision provided. Nevertheless, using self-report as a proxy for ability may have a serious negative impact on public health, as proficiency in MI is tied to client improvement, and clinician-perceived understanding of MI does not actually equate to proficiency in MI. (Article (Peer-Reviewed), PDF, English, 2015)

Keywords: Clinical supervision | CTN platform/ancillary study | Motivational interviewing (MI) | Training | Journal of Substance Abuse Treatment (journal)

Document No: 1141, PMID: 25963775, PMCID: PMC4560973.

Submitted by CTN Dissemination Librarians, 5/4/2015.

Amrhein, Paul C.
Carpenter, Kenneth M.
Hu, Mei-Chen
Kutner, Bryan A.  
Nunes, Edward V. search mail
Smith, Jennifer L. search
Wain, R. Morgan search

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
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