Implementing Motivational interviewing in initial sessions with substance abusers
This study investigated the substance abuse (SU) counselors' adherence to motivational interviewing (MI), a well-known SU method in the Finnish outpatient setting. The data included the first encounters of 16 counselors and their 36 clients with an alcohol or SU problem. The interaction tapes were transcribed and coded with MITI (Motivational Interviewing Treatment Integrity), a method developed for evaluating MI treatment adherence. The reliability of the Finnish version of MITI was shown to be of good quality although MI-Non-Adherent and complex reflection -codes need further improvement. The MI results showed that the counselors' style of interaction adhered to the spirit of MI relatively well. However, the more specific MI methods were implemented more randomly, thus weakening MI treatment integrity in most of the sessions. The results highlight the need for instruments like MITI to ensure objective feedback and close monitoring in training and supervising MI for obtaining good MI treatment fidelity.