Training Clinicians in Motivational Interviewing (MITraining)
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|ClinicalTrials.gov Identifier: NCT01065480|
Recruitment Status : Completed
First Posted : February 9, 2010
Results First Posted : November 6, 2017
Last Update Posted : December 26, 2018
|Condition or disease||Intervention/treatment||Phase|
|Substance Abuse||Behavioral: Live teleconference supervision Behavioral: Taped Review Supervision||Not Applicable|
New evidence-based treatments have been slow to be adopted into the routine practice of addiction treatment, and traditional training methods are of limited effectiveness. In this study, the investigators propose to continue development of methods for training clinicians in Motivational Interviewing (MI), based on the principle of live supervision. Live supervision (supervisor and trainee seeing a patient together) is common in basic training, but rarely used in continuing education. In the initial funding period we developed Teleconference Supervision (TCS), which implements live supervision by an expert through teleconferencing technology, harnessing the principles of context-dependent learning, differential reinforcement with immediacy of feedback, and modeling. Clinicians interview standard patients at their home clinics, while Supervisors listen via telephone. The clinician wears an earpiece, through which the Supervisor provides immediate feedback and coaching designed to differentially reinforce and shape MI skills. In a randomized controlled trial with community clinicians (N= 100), TCS produced superior overall MI skill, compared to control conditions where clinicians received Workshop only training, or standard tape-based supervision. Findings were encouraging yet the proportion of clinicians achieving expert proficiency was limited, and there were trends toward loss of skill at follow-up, suggesting longer training is needed to maximize and sustain MI skill.
In the new funding period, the investigators propose to build and improve upon TCS by testing an extended model of Teleconference Supervision (TCS-Plus), which will preserve the elements of live supervision from an expert supervisor but will also provide 4 sessions of enhanced tape review supervision on a bi-weekly basis after the initial TCS training. Using telephone technology, enhanced taped review allows the Supervisor and Clinician to listen to the taped session together before discussing the session. Practice sessions will increase from 5 to 9 and be spread out from 8 to 16 weeks. Providing both TCS and enhanced tape review supervision maximizes supervision style advantages. While both offer context dependent learning, TCS provides for modeling and differential reinforcement with immediacy of feedback, and enhanced tape review provides ample time to role play and discuss technique. TCS-Plus will be compared to standard Tape Review supervision. The proposed project will be a StageI trial, intent on maximizing the gains already detected with the TCS model. The investiators will assess if TCS-Plus produces superior MI skill to standard Tape Review supervision in a randomized trial with 130 community based-clinicians. It is hoped that, if successful, TCS-Plus could be a model for remote training and supervision at community treatment programs, promoting adoption of a variety of evidence-based treatments for substance use disorders into routine practice.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||91 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Health Services Research|
|Official Title:||Training Motivational Interviewing Using Live Supervision|
|Actual Study Start Date :||March 1, 2010|
|Actual Primary Completion Date :||June 1, 2015|
|Actual Study Completion Date :||December 1, 2015|
Active Comparator: Live Teleconference Supervision
Clinicians from participating substance abuse treatment programs receive live supervision by MI trainer via teleconference while in session with client.
Behavioral: Live teleconference supervision
Participants receive live teleconference supervision during a session with a client on their use of Motivational Interviewing (MI) in the session. MI is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with nondirective counselling, it is more focused and goal-directed. The examination and resolution of ambivalence is its central purpose, and the counselor is intentionally directive in pursuing this goal.
Active Comparator: Taped Review Supervision
Clinicians from participating substance treatment programs audio record session with client and receive supervision after the session by MI trainer.
Behavioral: Taped Review Supervision
Participants audio record a session with a client and receive supervision after the session on their use of Motivational Interviewing during the session.
- Number of Participants With MI Skillfulness [ Time Frame: 1,8,16, 24 and 32 weeks ]MI skillfulness measured by the Motivational Interviewing Treatment Integrity Scale (MITI) on double coded audio recorded sessions and clinical interviews. The cumulative number of participants with MI Skillfulness at each time point assessed at 1, 8, 16, 24, and 32 weeks are reported.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01065480
|United States, New York|
|New York State Psychiatric Institute|
|New York, New York, United States, 10032|
|Principal Investigator:||Edward V Nunes, MD||New York State Psychiatric Institute/Columbia University|