However, MI comprises a complex set of skills that are not easy to master, so training requires valid measurement of fidelity and skill. The gold standard for MI fidelity assessment is 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.
Audiotaping interviews can be difficult in community practice settings where time constraints and limited staffing and access to technology can all be barriers. A simpler, yet still objective, means of assessing MI skill would be of significant benefit. To that end, this study evaluated the use of the Helpful Responses Questionnaire (HRQ), a pen-and-paper test of empathy (a foundational MI skill) that does not require an audiotaped session.
A randomized trial of 3 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 (now the Greater New York Node) of the NIDA Clinical Trials Network. Counselor 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.
Conclusions: These findings suggest that the HRQ may not be useful as a screening tool to identify counselors with higher vs. lower baseline proficiency in MI, but may provide a shorthand measure of reflective listening skill during training. Thus, the HRQ can be used as a quick assessment of progress in MI training. More work is needed to both develop vignettes relevant to substance use for the HRQ, and to create a more comprehensive pen-and-paper measure of MI skill that will be easy to collect and less time intensive than coding MITI assessments.
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Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.
Articles were written based on the following published research:
Citation: Smith JL, et al. Assessment of the Relationship Between a Written Measure of Empathy and an Independently Rated Interview of Motivational Interviewing. Journal of Substance Abuse Treatment 2017 (in press).