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The impact of motivational interviewing training on rehabilitation counselors: Assessing working alliance and client engagement. A randomized controlled trial (Torres et. al, 2019)

Review Guidelines

Absence of conflict of interest. 

Citation

Torres, A., Frain, M., & Tansey, T. N. (2019). The impact of motivational interviewing training on rehabilitation counselors: Assessing working alliance and client engagement. A randomized controlled trial. Rehabilitation Psychology, 64(3), 328-338.

Highlights

  • The study’s objective was to examine the impact of motivational interviewing (MI) training on self-perceptions of MI competence. 
  • The study was a randomized controlled trial that used survey data to compare perceived MI competence for counselors who participated in a MI training to those of counselors who did not have access to the training. 
  • The study suggested there was a positive relationship between the MI training and perceived MI competence. 
  • The quality of causal evidence presented in this report is low because a single provider implemented the intervention. This means we cannot be confident that the estimated effects are attributable to the MI training itself and not to characteristics of the provider. 

Intervention Examined

Motivational Interviewing (MI)

Features of the Intervention

Motivational Interviewing (MI) is a client-centered counseling approach designed to empower clients through directive yet nonconfrontational counseling to help clients resolve ambivalence and engage in change. MI has been used in many domains including career coaching and supporting employment for individuals with disabilities. 

In this study, the authors developed a four-hour MI training for counselors who work for the state of Florida’s vocational rehabilitation (VR) program. The training consisted of four one-hour modules delivered face-to-face by the lead study author to groups of eight to 12 counselors at a time. Modules incorporated information on theoretical foundations for MI, empirical data, and practical skills, and each included a video, discussion of a case study, and practicing examples or role playing. After the training, counselors could participate in optional one-on-one weekly coaching with the lead study author for up to four weeks.  

Features of the Study

The study was a randomized controlled trial. The authors recruited participants through an initial outreach email to counselors who worked for the state VR program in South Florida. Counselors who volunteered to participate were randomly assigned to the treatment group, which could participate in the MI training and optional follow-up coaching, or to the comparison group, which did not have access to the training and coaching until after the study ended. A total of 69 counselors were recruited; outcome data were available for 67 of these counselors, 32 in the treatment group and 35 in the comparison group. Over 80 percent of participating counselor were female, and all had at least a bachelor’s degree. About half of counselors were between ages 35 to 45 and slightly less than half identified as White/Caucasian.  

The Social Cognitive Motivational Interviewing Competence Scale (SCMICS) was used to measure counselors’ perceptions of their self-efficacy in motivational interviewing, the benefits of MI, barriers to change, and stages of change/action. The SCMICS was administered as a pretest before the MI training was scheduled and as a posttest once the training and coaching sessions were completed for the treatment group. The authors compared the change in scores from pretest to posttest for the treatment group versus the comparison group. 

Findings

Attitudes

  • The study suggested that the counselors in the treatment group increased their perceived MI competence more than those in the comparison group did when comparing pretest to posttest gains for the two groups. 

Considerations for Interpreting the Findings

The lead author was the only person who provided the MI training. This creates a confound because it is impossible to separate the effect of the training from the effect of the provider. 

Causal Evidence Rating

The quality of causal evidence presented in this report is low because a single provider implemented the intervention. This means we cannot be confident that the estimated effects are attributable to the MI training itself, and not to characteristics of the provider. 

Reviewed by CLEAR

September 2022