Correspondence of Motivational Interviewing Adherence and Competence Ratings in Real and Role-Played Client Sessions

    loading  Checking for direct PDF access through Ovid

Abstract

Treatment integrity ratings (adherence and competence) are frequently used as outcome measures in clinician training studies, drawn from recorded real client or role-played client sessions. However, it is unknown whether clinician adherence and competence are similar in real client and role-played sessions or whether real and role-play clients provide similar opportunities for skill demonstration. In this study, we examined the correspondence of treatment adherence and competence ratings obtained in real client and role-played sessions for 91 clinicians trained in motivational interviewing (MI), using data from a multisite trial examining 3 methods of clinician training (Martino et al., 2011). Results indicated overall poor integrity rating correspondence across the 2 session types, as indicated by weak correlations (rs = .05–.27). Clinicians were rated significantly more MI adherent overall and specifically used more advanced MI strategies in role-played than real client sessions at several assessment time points (ds = 0.36, 0.42). Real clients, in comparison to the role-play actor, demonstrated greater motivation at the beginning of the session (d = 1.09), discussion of unrelated topics (d = 0.70), and alliance with the clinician (d = 0.72). These findings suggest that MI integrity rating data obtained from real client and role-played sessions may not be interchangeable. More research is needed to improve the procedures and psychometric strength of treatment integrity assessment based on role-played sessions.

Related Topics

    loading  Loading Related Articles