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Strengthening Motivational Interviewing skills following initial training

Strengthening Motivational Interviewing skills following initial training. Gerald Bennett Julie Moore Lindsey Rouse Jood Gibbins Dorset Health Care NHS Foundation Trust. The problem. Motivational Interviewing Professionals love to learn it But service users don’t get the benefit.

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Strengthening Motivational Interviewing skills following initial training

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  1. Strengthening Motivational Interviewing skills following initial training

  2. Gerald Bennett Julie Moore Lindsey Rouse Jood Gibbins Dorset Health Care NHS Foundation Trust

  3. The problem • Motivational Interviewing • Professionals love to learn it • But service users don’t get the benefit

  4. Brief workshop training helps them develop skills • But skills then decay

  5. over 10 years • Continual demand for training • 400+ staff trained • Few come to quarterly top-up training or take up offers of supervision

  6. A solution? • Skills development after initial training • Based in the workplace • Around usual clinical work • An hour a week • cheap

  7. A solution? In hour a week dedicated time • Receive and use weekly worksheet • Send off audiotapes for written feedback • 3 30-min telephone consultations

  8. THEME Twelve Hours Enhance Motivational Effectiveness

  9. Assess competence in MI Allocated to THEME MI Update day randomise Invite staff trained in MI Assess competence in MI Allocated to Control Assess competence in MI 16 weeks

  10. Participants 54 Staff who • had attended MI training • had managers’ written consent for time • Agreed to participate fully if offered THEME

  11. Assessment of competence in MI • Interviewed an actor • playing role of service user medium difficulty • Interview videotaped

  12. Videos assessed using rating scale (MITI) • Independently by two trained raters • Provides ….frequencies of types of behaviours …. Two overall ratings (spirit, empathy)

  13. Assessment method • Reliable • Valid • Sensitive to change

  14. Dependent variables • Categorise performance as ‘novice’, ‘beginner’, or ‘competent’. • Five specific indices from MITI eg % questions that were open questions

  15. Low level of participation • Worksheets: 9% did maximum • Audiotapes: 18% submitted maximum • Telephone supervision: 14% did maximum 45% none

  16. Partial support for value of THEME • Clinically significant measures of competence • Despite low compliance

  17. Why low compliance? • difficulty in finding clients who consent to have sessions taped • We hadn’t screened out staff with little clinical contact

  18. Brief workplace-based interventions have potential to provide patients with better quality treatment

  19. Categories of Competence in MI novice beginner competent Empathy <5 5-5.9 6+ Spirit <5 5-5.9 6+ Reflections: Questions <1 1-1.9 2+ % Questions Open <50 50-69 70+ % Reflections Complex <40 40-49 50+ % utterances MI consistent <90 90-99 100+

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