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
