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Levels of training

by admi on 1 September, 2008 - 21:59

Levels/Types of Training in Motivational Interviewing

Type Goals Length
1 Introduction to MI To experience the basics of MI and decide level of interest in learning more
To be familiar with the fundamental spirit and principles of MI
To be acquainted with relevant evidence of efficacy
To directly experience the MI approach and contrast it with others 		2 hours to 1 day
2 Application of MI To learn one or more specific applications of MI
To be acquainted with the fundamental spirit of MI
To learn practical guidelines for a specific application Ain the spirit of MI@
To have direct practice in and experience of this particular application
To decide level of interest in learning more 		1 hour to 1 day
3 Clinical Training To learn the basic clinical style of MI, and how to continue learning it in
practice
To understand the fundamental spirit and principles of MI
To strengthen empathic counseling skills (OARS)
To understand and practice the directive aspects of MI
To experience and practice an MI style for meeting resistance
To learn the fundamental client language cues (change talk and resistance), that
allow continued feedback and learning in practice 		2-3 days
Might be offered in
several 4-8 hour parts
4 Advanced Clinical Training To move from basic competence to more advanced clinical skillfulness in MI
To have intensive observed practice in advanced MI skills
To receive individual feedback regarding MI practice
To update knowledge of MI (recent research and developments) 		2-3 days
5 Supervisor Training To be prepared to guide an ongoing group in learning MI
To understand the sequence of skills for acquiring MI proficiency
To learn observational/analytic methods for evaluating MI
To learn methods for facilitating practice improvement over time
To be prepared to certify MI practitioners and maintain quality control 		2-3 days
6 Training for Trainers To learn a flexible range of skills and methods for helping others learn MI
To learn and practice an array of MI training methods
To enhance confidence in training and demonstrating MI
To assess the specific needs and context of trainees, and to design and adapt
training approaches accordingly
To update knowledge of MI and training (recent research/developments)
To participate in the international MI Network of Trainers 		3-4 days

A workshop alone is insufficient for learning MI. The above approximate times apply to an initial workshop only, and
training plans should provide for continuing coaching, feedback, and supervision.

What might you expect out of different lengths and types of training?

Introductory Training:
Individual Study and Self-Training. Perhaps the most common method by which clinicians explore MI is to study print materials {Miller, 2002 #15} and view training videotapes. Although this can provide some understanding of the basic approach, research by Miller and colleagues found that assigned self-training was not effective in improving clinical skillfulness in MI {Miller, 2004 #20}.

Introduction to Motivational Interviewing (1 hour to 1 day). Training of up to one day can acquaint the audience with basic concepts and methods of MI, but is unlikely to increase the clinical skillfulness of participants in the clinical method of MI. Depending on the audience, a trainer may provide some simple exercises that a practitioner can try with patients to get a "taste" of an MI style. Think of this level of training as helping participants to determine how interested they are in learning more about MI. The format may be primarily didactic, and may include live or videotaped demonstrations of MI.

Introductory Workshop (2-3 days). With 16-24 hours of training contact time, it is possible to provide participants with an understanding of the spirit and method of MI, and to offer some practical experience in trying out this counseling approach. Expect a mix of didactic presentation, demonstration, and practice exercises. We recommend limiting the number of participants per trainer at this level, in order to allow some opportunity for observation and feedback. Limitations will vary depending on the precise goals and nature of the training, but we recommend no more than 40 participants per trainer even in the best of circumstances. Our research and experience caution that practitioners may leave a one-time introductory workshop overconfident in their mastery of MI {Miller, 2001 #19}. If feasible, it is probably better to provide this practical training in blocks of 4 hours or so, with opportunity in between for participants to practice MI and come back with experience and problems (for example, 4/4/4: 4 sessions of 4 hours each spread over 4 months). Adding opportunities for personal performance feedback (e.g., from practice audiotapes) and/or individual coaching can significantly increase the effectiveness of training in helping participants to improve their clinical proficiency {Miller, 2004 #20}. A reasonable goal for this level of training is not clinical proficiency, but rather to "learn how to learn" MI from ongoing practice.

Intermediate and Advanced Training:

Intermediate/Advanced Clinical Training (2-3 days). Some practitioners who have learned the fundamentals of MI and have had an opportunity to practice it over time seek a more advanced level of clinical training in MI. At this level, the training should include analysis of practice audio or videotapes. Expect more demonstration and practice exercises, and less didactic material. Current focus in advanced clinical training is on differentiating change talk from commitment language, and learning how to elicit and shape the two. Prior proficiency and experience in the practice of MI are assumed.

Ongoing consultation and supervision (open-ended). Most MINT trainers share in the belief that ongoing on-site consultation and supervision is the best method to facilitate improvement in the practice of motivational interviewing and brief behavior consultations, and most MINT training is provided through private contracts of this nature. This allows for the most thorough adaptation of MI methods to specifics of the providers' situation.

Training for New Trainers (TNT, 3-4 days). The TNT is designed for people who will help others to learn MI, working with a range of populations and settings. Participants learn a broad and flexible set of training exercises that can be used to design training programs to meet the specific needs and levels of various trainee groups. Those who complete MINT-sponsored TNT events are eligible for membership in the international Motivational Interviewing Network of Trainers (MINT).

Other types of Training:

MI Supervisor Training (2-3 days). These workshops are designed for people who have responsibility for the ongoing training and supervision of clinicians providing MI. Their goal is to prepare an on-site expert supervisor who can continue to guide and shape the practice of clinicians in a program or system. Training includes expertise in systems for monitoring and coding session tapes for clinical practice. Prior proficiency and experience in the practice of MI are assumed.

MI Coder Training (2-3 days). These workshops focus on fidelity monitoring and process coding of MI as delivered in research protocols. Training may focus on one or more systems including the MITI, MISC, or SCOPE. Extensive opportunity for coding practice is necessary. Coders are not trained to actually deliver MI, but rather to code tapes reliably. Clinical expertise is not required.

Evaluation of training:
Although we have no means to formally evaluate workshops offered by MINT members at present, we remain interested in promoting quality training and welcome the feedback of any participants who have attended a training hosted by a MINT member. If you have comments on a training that you attended, please feel free to email Dr. Stephen Rollnick by clicking on this link

from http://motivationalinterview.org/
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