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"Do I need, am I able to … and do I even want to change?” Which potential does Motivational Interviewing offer for organizations?
Abstract
Organizational, team or individual change projects are highly dependent upon the motivation of the affected employees. Motivational Interviewing (MI) offers a promising method to initiate and accompany change management projects. Evidence from clinical psychology shows that MI stimulates change by evoking change talk and reducing sustain talk – two psycholinguistic constructs. In the following paper, we want to discuss – based on the existing research and an expert workshop – benefits and possible applications of MI for organizations. By means of three examples from interaction analysis,
we can show how coaches, facilitators and executives can implement principles of MI. Finally, we introduce two German versions of MI observations methods that help to objectively assess motivational interaction processes. Preliminary data shows that there is still a lack of motivational techniques within the observed interaction processes.
Supplementary resource (1)
... Whereas MI is usually taught to professionals in the helping professions (e.g. for therapist, nurses, or counselors), recent studies indicate that MI also seems suitable within business contexts, for example, for managers who work in change projects (Klonek et al., 2014), during appraisal interviews (Campbell, 2005), during facilitation of team meetings (Klonek et al., in press), or for career coachings (Passmore, 2007; Stoltz and Young, 2013). Besides theoretical arguments (e.g. Klonek and Kauffeld, 2012) that MI has added value outside the realm of helping professions, no study so far has evaluated its merit in higher education for the professional development of engineers. As engineering students are often insufficiently prepared for the workforce due to communication inadequacies (Katz, 1993), this study hopes to illustrate that MI has the potential to enhance communication skills of engineering students. ...
Purpose - Motivational Interviewing (MI) is a vocational communication skill from the helping professions. Verbal skills in MI are summarized under the acronyms OARS and EARS (Open-ended questions / Elaborating, Affirmations, Reflections and Summaries). We outline how MI provides important skills for engineers, and demonstrate skill assessment by using an observation-based scientific approach.
Methodology - Twenty-five engineering students took part in a skill-based MI training. Quality assurance of the training was assessed by using a repeated measurement design with multiple measures: systematic observations from recorded interactions and self-reported and standardized performance measures. Two external observers reliably coded the recorded conversations using the MI skill code.
Findings -Trainees showed a significant increase of verbal skills in MI. Directive confrontational behaviors decreased after training. Self-reported and performance measures indicated significant increases in MI post training. Conversational partners in the post-training condition showed significantly more motivation in comparison to partners before the training.
Research limitations – The main limitation of the study is the small sample size. However, training effect sizes showed large effects on verbal skills.
Practical implications - Communication skills in MI can be taught effectively for a technical population. This study suggests that MI is effective within the higher education of technical professions who have to deal with motivational issues. Observational measures can be used for quality assurance purposes, but also serve as a feedback instrument for work-based learning purposes.
Originality - This is the first study to evaluate training in MI for engineers using a multi-method approach with observational measures.
This contribution to the journal “Gruppe. Interaktion. Organisation. (GIO)” portraits Motivational Interviewing (MI) as a useful communication approach for evoking change readiness among employees. In today’s complex and dynamic business environment, organizations should be capable of adaptively responding to external demands. Such an organizational setup requires employees to constantly cope with change. However, eliciting change-supportive mindsets and behaviors is challenging. First, to better understand employees’ psychological responses when confronted with change, we review change-related attitudes, whereby we emphasize ambivalence as employees’ most common response when confronted with change. Next, we explain how the MI spirit, the MI process, and methods used by MI practitioners form the MI gestalt. Furthermore, to illustrate how MI extends existing inquiry approaches, we discuss how the focus of MI on the language of change may help to improve change agents’ communication skills and make MI an evidence-based communication approach. Moreover, we exemplify how MI can be applied at the individual, group, and organizational levels. For these practical applications, we note how MI can improve existing management practices such as appraisal interviews (individual level), team meetings (group level), and job crafting (organizational level). Finally, we outline the questions that further research needs to address to better understand how MI can be more effectively interwoven into organizational structures.
Resistance from coachees is a problem met by executive coaches in all fields. The continued interest in executive coaching by organisations has seen coaching beginning to be used more widely. An increasing number of low and average performing managers are following theirhigh performing peers into the executive coaching room. One particular challenge facing the coaching psychologist is how to engage individuals where motivation for change is low.
This paper draws on a five-stage model for behaviour change and an approach developed in the clinical setting which can usefully be applied to executive coaching to help the coaching psychologist address some of these behavioural challenges and add to their core coachingtechniques through combining Motivational Interviewing (MI) techniques with their existing repertoire of skills.
The paper starts with a review of the development of motivational interviewing, before moving to explore the evidence for MI as an intervention, which is largely within the health sector. The paper builds on this evidence by exploring how MI may be applied within non-clinical settings, as a tool to address poor performance resulting from low motivation to change.The paper also suggests other potential uses for MI such as in health coaching around stop smoking campaigns or obesity.
This study follows the idea that the key to understanding team meeting effectiveness lies in uncovering the microlevel interaction processes throughout the meeting. Ninety-two regular team meetings were videotaped. Interaction data were coded and evaluated with the act4teams coding scheme and INTERACT software. Team and organizational success variables were gathered via questionnaires and telephone interviews. The results support the central function of interaction processes as posited in the traditional input-process-output model. Teams that showed more functional interaction, such as problem-solving interaction and action planning, were significantly more satisfied with their meetings. Better meetings were associated with higher team productivity. Moreover, constructive meeting interaction processes were related to organizational success 2.5 years after the meeting. Dysfunctional communication, such as criticizing others or complaining, showed significant negative relationships with these outcomes. These negative effects were even more pronounced than the positive effects of functional team meeting interaction. The results suggest that team meeting processes shape both team and organizational outcomes. The critical meeting behaviors identified here provide hints for group researchers and practitioners alike who aim to improve meeting success.
Objective: The authors investigated the unique contribution motivational interviewing (MI) has on counseling outcomes and how MI compares with other interventions. Method: A total of 119 studies were subjected to a meta-analysis. Targeted outcomes included substance use (tobacco, alcohol, drugs, marijuana), health-related behaviors (diet, exercise, safe sex), gambling, and engagement in treatment variables. Results: Judged against weak comparison groups, MI produced statistically significant, durable results in the small effect range (average g = 0.28). Judged against specific treatments, MI produced nonsignificant results (average g = 0.09). MI was robust across many moderators, although feedback (Motivational Enhancement Therapy [MET]), delivery time, manualization, delivery mode (group vs. individual), and ethnicity moderated outcomes. Conclusions: MI contributes to counseling efforts, and results are influenced by participant and delivery factors.
This article offers a meta-analytic, qualitative, and process review of the empirical literature for adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors. AMIs are equivalent to other active treatments and yield moderate effects (from 0.35 to 0.56) compared to no-treatment/placebo for problems involving alcohol, drugs, and diet and exercise. Results do not support the efficacy of AMIs for smoking or HIV-risk behaviors. Conclusions regarding the mechanisms of action for AMIs are limited by methodological problems: confounding motivational interviewing with feedback, unclear definitions of the AMI interventions used, difficulties in therapist training, and limited use of treatment integrity rating scales. Extant research suggests that AMIs are equivalent in efficacy to and briefer than cognitive behavioral skills training (CBST) approaches. Since AMIs focus on readiness to change while CBST targets the change process, AMIs may be useful as preludes or additions to CBST.
Motivational interviewing (MI), an evidence-based counseling approach, has received much recognition from a wide variety of health care professionals. Because of the rising interest in MI, there is increasing demand for training in this counseling approach. The MI training community has answered this call and as a result placed much emphasis on studying the MI training process. The purpose of this article is to provide a systematic review of the published research on MI training. Our goal is to provide a consolidated account of MI trainings outlining the populations receiving training, methods used, and training outcomes. We also identify which aspects of the (W. R. Miller & T. B. Moyers, 2006) eight stages of learning MI each study addressed. Recommendations for advancing the MI training research are highlighted.
Observer agreement is often regarded as the sine qua non of observational research. Cohen's kappa is a widely used index and is appropriate when discrete entities-such as a turn-of-talk or a demarcated time interval-are presented to pairs of observers to code. kappa-like statistics and agreement matrices are also used for the timed-event sequential data produced when observers first segment and then code events detected in the stream of behavior, noting onset and offset times. Such kappas are of two kinds: time-based and event-based. Available for download is a computer program (OASTES; Observer Agreement for Simulated Timed Event Sequences) that simulates the coding of observers of a stated accuracy and then computes agreement statistics for two time-based kappas (with and without tolerance) and three event-based kappas (one implemented in The Observer, one in INTERACT, and one in GSEQ). On the basis of simulation results presented here, and due to the somewhat different information provided by each, the reporting of both a time-based and an event-based kappa is recommended.
This report presents reliability, validity and sensitivity indices for the Motivational Interviewing Treatment Integrity (MITI) scale. Factor analysis of MI treatment sessions coded with the Motivational Interviewing Skills Code (MISC) was used to derive 10 elements of MI practice, forming the MITI. Canonical correlation revealed that the MITI captured 59% of the variability in the MISC. Reliability estimates for the MITI were derived using three masked, independent coders. Intra-class coefficients ranged from .5 to .9 and were generally in the good to excellent range. Comparison of MITI scores before and after MI workshops indicate good sensitivity for detecting improvement in clinical practice as result of training. Implications for the use of this instrument in research and supervision are discussed.
Motivational Interviewing is a well-known, scientifically tested method of counselling clients developed by Miller and Rollnick and viewed as a useful intervention strategy in the treatment of lifestyle problems and disease.
To evaluate the effectiveness of motivational interviewing in different areas of disease and to identify factors shaping outcomes.
A systematic review and meta-analysis of randomised controlled trials using motivational interviewing as the intervention.
After selection criteria a systematic literature search in 16 databases produced 72 randomised controlled trials the first of which was published in 1991. A quality assessment was made with a validated scale. A meta-analysis was performed as a generic inverse variance meta-analysis.
Meta-analysis showed a significant effect (95% confidence interval) for motivational interviewing for combined effect estimates for body mass index, total blood cholesterol, systolic blood pressure, blood alcohol concentration and standard ethanol content, while combined effect estimates for cigarettes per day and for HbA(1c) were not significant. Motivational interviewing had a significant and clinically relevant effect in approximately three out of four studies, with an equal effect on physiological (72%) and psychological (75%) diseases. Psychologists and physicians obtained an effect in approximately 80% of the studies, while other healthcare providers obtained an effect in 46% of the studies. When using motivational interviewing in brief encounters of 15 minutes, 64% of the studies showed an effect. More than one encounter with the patient ensures the effectiveness of motivational interviewing.
Motivational interviewing in a scientific setting outperforms traditional advice giving in the treatment of a broad range of behavioural problems and diseases. Large-scale studies are now needed to prove that motivational interviewing can be implemented into daily clinical work in primary and secondary health care.
(1) To examine whether or not motivational interviewing (MI) is more efficacious than no intervention in reducing alcohol consumption; (2) to examine whether or not MI is as efficacious as other interventions.
A literature search followed by a meta-analytic review of randomized control trials of MI interventions. Aggregated between-group effect sizes and confidence intervals were calculated for each study.
Literature search revealed 22 relevant studies, of which nine compared brief MI with no treatment, and met methodological criteria for inclusion. In these, the aggregate effect size was 0.18 (95% C.I. 0.07, 0.29), but was greater 0.60 (95% C.I. 0.36, 0.83) when, in a post-hoc analysis, the follow-up period was three months or less. Its efficacy also increased when dependent drinkers were excluded. There were nine studies meeting methodological criteria for inclusion which compared brief MI with another treatment (one of a diverse set of interventions), yielding an aggregate effect size of 0.43(95% C.I. 0.17, 0.70). The literature review pointed to several factors which may influence MI's long-term efficacy effectiveness of MI.
Brief MI is effective. Future studies should focus on possible predictors of efficacy such as gender, age, employment status, marital status, mental health, initial expectations, readiness to change, and whether the population is drawn from treatment-seeking or non-treatment-seeking populations. Also, the components of MI should be compared to determine which are most responsible for maintaining long-term changes.
Client language from a motivational interview (MI) and drug use outcome were investigated. Interview videotapes of 84 drug abusers were coded for frequency and strength of utterances expressing commitment, desire, ability, need, readiness, and reasons to change or maintain their habit. Cluster analysis of proportion days abstinent (PDA) revealed 3 groups: high PDA at intake and follow-up (3, 6, 9, 12 months; maintainers); low intake PDA/high follow-up PDA (changers); and low intake PDA/low to moderate follow-up PDA (stragglers). Distinct group patterns emerged for commitment strength (CS) during MI. Clients dishonest in checklist self-report exhibited CS similar to stragglers. CS for client evaluation of a change plan predicted outcome PDA. CS was predicted by strength of desire, ability, need, and reasons, but more strongly predicted outcome PDA, suggesting CS is a pathway for their influence on behavior.
Motivational interviewing (MI) is effective in the treatment of addictions. To evaluate MI adherence of therapists, the Motivational Interviewing Treatment Integrity Code (MITI) was developed. MI is used in German-speaking countries, but there is no equivalent to the MITI. Our aim was to adapt the MITI for use in German language settings (MITI-d). Twenty-eight session tapes of Alcoholism Specific Psychotherapy utilizing MI were rated by two student raters and the MITI-d instructor. To evaluate interrater reliability, intraclass correlation coefficients (ICCs) were computed. ICCs were good to excellent for relevant MI constructs, except for Complex Reflections, MI-nonadherent Behaviors, Empathy, and MI Spirit. The evaluation of test-retest reliability for the student raters showed good to excellent results. The MITI-d is a psychometrically sound instrument for evaluating basic MI competence in German language settings.
Behavioral scientists – including those in psychology, infant and child development, education, animal behavior, marketing, and usability studies – use many methods to measure behavior. Systematic observation is used to study relatively natural, spontaneous behavior as it unfolds sequentially in time. This book emphasizes digital means to record and code such behavior; while observational methods do not require them, they work better with them. Key topics include devising coding schemes, training observers, and assessing reliability, as well as recording, representing, and analyzing observational data. In clear and straightforward language, this book provides a thorough grounding in observational methods along with considerable practical advice. It describes standard conventions for sequential data and details how to perform sequential analysis with a computer program developed by the authors. The book is rich with examples of coding schemes and different approaches to sequential analysis, including both statistical and graphical means.
Objective To explore the effects of brief training in Motivational interviewing (MI) for medical students.
Design Video recordings of consultations between 113 final-year medical students and simulated patients were scored blind by two independent raters with the Motivational Interviewing Skill Code (MISC). Half of the students participated in a four-hour motivational interviewing workshop while the other half did not.
Results Differences between the two groups were statistically significant for five of six global MISC variables. All differences were in the expected direction, with higher scores in the group that had received MI training. There were also statistically significant group differences in the expected direction on several behavioural measures. The group that received MI training asked fewer closed questions and more open questions; they summarized, affirmed and emphasized patient control more often, and directed and confronted less often.
Conclusion Four hours of training has a measurable effect on medical students’ style and verbal behaviour in simulated patient consultations, but is not sufficient to become proficient in motivational interviewing.
A psycholinguistic account of motivational interviewing (MI) is proposed. Critical to this view is the assumption that therapists and clients are natural language users engaged in a constructive conversation that reveals and augments relevant information about the status of future change
in a client's substance abuse. The role of client speech acts—most notably, verbal commitments—during MI is highlighted. How commitments can be signaled in client speech or gestures is discussed. How these commitment signals can inform therapeutic process and subsequent behavioral
outcome is then put forth. Using natural language as a measure, a MI process model is presented that not only posits a mediational role for client commitment in relating underlying factors of desire, ability (self-efficacy), need, and reasons to behavior, but also a pivotal role as a need-satisfying
enabler of a social-cognitive mechanism for personal change.
Presents a general descriptive theory of decision making under stress, which includes a typology of 5 distinctive patterns of coping behavior, including vigilance, hypervigilance, and defensive avoidance. The theory is illustrated with discussions of laboratory experiments, field studies, autobiographical and biographical material, and analyses of managerial and foreign policy decisions. Two analytical models, a schema for decision-making stages and a decisional "balance sheet," are also presented to clarify the theory. (28 p ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In diesem Beitrag wird eine empirisch zentrale, wissenschaftlich aber vernachlässigte Dimension von Führung behandelt.
Zunächst werden Aspekte der “Gewährung” von Geführteneinfluß diskutiert - vor allem über kooperativ-delegative Führungsstile. Es folgen empirisch häufig ermittelte Einflußstrategien von Geführten - auch vergleichend mit Formen der Vorgesetzten- und Kollegenbeeinflussung. Abschließend wird ein Strategieansatz zur Förderung einer “Führung von unten” entwickelt.
To investigate empirically the hypothesized relationship between counsellor motivational interviewing (MI) skills and patient change talk (CT) by analysing the articulation between counsellor behaviours and patient language during brief motivational interventions (BMI) addressing at-risk alcohol consumption.
Sequential analysis of psycholinguistic codes obtained by two independent raters using the Motivational Interviewing Skill Code (MISC), version 2.0.
Secondary analysis of data from a randomized controlled trial evaluating the effectiveness of BMI in an emergency department.
A total of 97 patients tape-recorded when receiving BMI.
MISC variables were categorized into three counsellor behaviours (MI-consistent, MI-inconsistent and 'other') and three kinds of patient language (CT, counter-CT (CCT) and utterances not linked with the alcohol topic). Observed transition frequencies, conditional probabilities and significance levels based on odds ratios were computed using sequential analysis software.
MI-consistent behaviours were the only counsellor behaviours that were significantly more likely to be followed by patient CT. Those behaviours were significantly more likely to be followed by patient change exploration (CT and CCT) while MI-inconsistent behaviours and 'other' counsellor behaviours were significantly more likely to be followed by utterances not linked with the alcohol topic and significantly less likely to be followed by CT. MI-consistent behaviours were more likely after change exploration, whereas 'other' counsellor behaviours were more likely only after utterances not linked with the alcohol topic.
Findings lend support to the hypothesized relationship between MI-consistent behaviours and CT, highlight the importance of patient influence on counsellor behaviour and emphasize the usefulness of MI techniques and spirit during brief interventions targeting change enhancement.
Motivational interviewing (MI) is a client-centered, directive therapeutic style to enhance readiness for change by helping clients explore and resolve ambivalence. An evolution of Rogers's person-centered counseling approach, MI elicits the client's own motivations for change. The rapidly growing evidence base for MI is summarized in a new meta-analysis of 72 clinical trials spanning a range of target problems. The average short-term between-group effect size of MI was 0.77, decreasing to 0.30 at follow-ups to one year. Observed effect sizes of MI were larger with ethnic minority populations, and when the practice of MI was not manual-guided. The highly variable effectiveness of MI across providers, populations, target problems, and settings suggests a need to understand and specify how MI exerts its effects. Progress toward a theory of MI is described, as is research on how clinicians develop proficiency in this method.
The purpose of this study was to examine the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. First year students (N=67) took part in a Brief Alcohol Screening and Intervention for College Students (BASICS) led by peer facilitators trained in MI and BASICS. Participants were assessed pre- and 2 weeks post-intervention on contemplation to change, as well as, pre- and 3 months post- intervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (MITI, Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Peer facilitators met beginning proficiency in MI on scores of empathy, the ratio of MI adherent behaviors to non-adherent behaviors and the ratio of open questions to total questions as defined by the MITI. Results indicated that a higher number of closed questions was related to less contemplation and a higher number of open questions was related to more contemplation post intervention. A higher number of simple reflections was associated with increased drinking at the 3 month assessment, however, complex reflections were found to attenuate the effect of simple reflections on changes in drinking. These findings highlight the importance of competent reflective listening skills and the need for continual training and supervision for peer facilitators.
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