Journal of Substance Abuse Treatment 2018;87:56-63. [doi: 10.1016/j.jsat.2017.12.004]
Jennifer L. Smith, PhD, Paula Bertone, MA (Hunter College), Kenneth M. Carpenter, PhD, R. Morgan Wain, PhD, Mei-Chen Hu, PhD, Paul C. Amrhein, PhD, Edward V. Nunes, MD (all from Columbia University, GNY Node, except where noted).
Motivational interviewing (MI) is an evidence-based practice shown to be effective when working with people in treatment for substance use disorders. However, MI is a complex treatment modality optimized by training with feedback. Feedback, assessment, and monitoring of treatment fidelity require measurement, which is typically done using audiotaped sessions. The gold standard for such measurement of MI skill has been an audiotaped interview, scored by a rater with a detailed structured instrument such as the Motivational Interviewing Treatment Integrity 2.0 (MITI 20.0) Coding System. The Helpful Responses Questionnaire (HRQ) is a pen-and-paper test of empathy (a foundational MI skill) that does not require an audiotaped session.
A randomized trial of three different regimens for training counselors in MI (live supervision using teleconferencing, tape-based supervision, and workshop only) offered the opportunity to evaluate the performance of the HRQ as a measure of MI ability, compared to the several MITI 2.0 global scores and subscales. Participants were counselors (N=97) from 26 community-based substance use treatment programs affiliated with the Long Island and New York Nodes of the NIDA Clinical Trials Network, whose MI proficiency was measured at 4 time points: baseline (before an initial 2-day MI workshop), post-workshop, 8 weeks post-workshop (i.e., post-supervision), and 20 weeks post-workshop with both MITI 2.0 and HRQ
HRQ total scores correlated significantly with the Reflection to Question Ratio from the MITI 2.0 at post-workshop, week 8, and week 20, and with the Spirit and Empathy global scores at week 20. Correlations of HRQ with other MITI 2.0 subscales and time points after workshop were small and not significant. As predicted, HRQ scores differed between training conditions, with counselors assigned to live supervision achieving better HRQ scores than those in Workshop only.
Conclusions: The HRQ is a modestly accurate measure, mainly of the Reflection to Question ratio, considered a core marker of MI skill. It is sensitive to training effects and may help identify counselors needing more intensive supervision. Given its ease of administration and scoring, HRQ may be a useful marker of MI skill during training efforts. (Article (Peer-Reviewed), PDF, English, 2017)
Keywords: Clinical supervision | CTN platform/ancillary study | Fidelity of implementation | Helpful Responses Questionnaire (HRQ) | Motivational interviewing (MI) | Motivational Interviewing Treatment Integrity Instrument (MITI) | Training |Journal of General Internal Medicine (journal)
Document No: 1294, PMID: 29471927.
Submitted by CTN Dissemination Librarians, 12/20/2017.