Implementing Motivational Interviewing in West Virginia Behavioral Health Provider Organizations

Project Interest Meeting

Intensive TA Capacity Building Project

The primary purpose of this initiative is to provide training and technical assistance to Behavioral Health Provider Organizations in West Virginia in fully integrating Motivation Interviewing into administration, supervision and the provision of programs and services.

The goals of this capacity-building project are:

• The timely, appropriate and effective engagement individuals and families in the public behavioral health continuum: prevention, early intervention, treatment and recovery services and supports.
• Increased retention in programs and services indicated by decrease no-show rates and discontinuation rates.
• Increase in staff competencies in Evidenced-Based Practice of MI, operating in a supportive organizational environment that includes clinical supervision and skill-building.
• Increase in staff recruitment and retention as indicated by decreased turnover, vacancy rates and increased job satisfaction.
• Increase in the number of MINT trainers in West Virginia, thereby increasing the MI training capacity of the state.

Our approach is driven by:

• The impact of the current opioid epidemic in Region 3, particularly in WV;
• The knowledge that the majority of individuals with behavioral health disorders are not in treatment;
• The effectiveness of MI to increase engagement and retention of behavioral health professionals and the individuals and families they serve;
• The need to increase the implementation of evidence-based practices throughout the WV public health system. 

Motivational Interviewing is a clinical approach that helps people with mental health and substance use disorders and other chronic conditions such as diabetes, cardiovascular conditions, and asthma make positive behavioral changes to support better health. The approach upholds four principles— expressing empathy and avoiding arguing, developing discrepancy, rolling with resistance, and supporting self-efficacy (client’s belief s/he can successfully make a change). Equipping the BH workforce and BH provider organizations with an EBP adaptable and responsive to the changing trends in use and treatment needs is good for those in care as well as those the individual and organizations providing care.  

Building Organizational Capacity

Through recent training and technical assistance efforts, there are over 3000 individual WV practitioners trained in MI. A component of this project aims to work with WV provider organization change leaders to create an “MI spirit” within their organizational culture that supports the training, application and full integration of MI skills throughout the employment and service delivery structure, thereby supporting many of these previously trained practitioners. It offers the possibilities to improve not only organizational culture but also the possibilities of improving the organizational bottom line through increased show rates for the initial appointment, increased show rates for follow up, decreased termination of services prior to treatment plan completion, increase employee retention and job satisfaction as a protective factor against compassion fatigue. This project serves to sustain the WVPBHS MI capacity in the existing 3000+ clinicians, and to enhance that capacity through organization clinical supervision and support, virtual MI application real-time technical assistance sessions, and additional training of practitioners. 

The organizational capacity-building portion of the project will be achieved over a six- to nine-month period through face-to-face Implementation Facilitation and MI Basic and Advanced MI training, coupled with intensive technical assistance to implement and sustain the knowledge and skills. The Central East ATTC will also provide a training of trainers (TOT) to ensure organizational capacity is sustained over time.   Interested organizations will be invited to submit an application with senior leadership endorsement.  Up to five (5) organizations would be selected to participate in this process.