Acquisition of MI Competence Trough the Training Methods Used in the Swedish County Councils and Municipalities

The basis for a successful implementation of an evidence-based treatment in routine clinical care is quality assessment of all stages of delivery, implementation and evaluation. In the Swedish county councils and municipalities, Motivational Interviewing (MI) training with different forms and content is taking place as part of the implementation of the method.

Aims: To evaluate to what extent the practitioners acquire and retain MI skills through the different training methods used in the Swedish county councils and municipalities by comparing them with a format that in previous studies has shown to be required for the long-term acquisition of proficiency in MI; training including supervision consisting of feedback based on monitoring of practice.

Method: In 2013-2014, 175 practitioners that attend MI training in five different county councils and municipalities in Sweden will be randomized to one of the study's three groups: (a) "Regular training" (n= 66), b) "Regular training" followed by six individual supervision sessions at monthly intervals based on only the behavior counts component of the Motivational Interviewing Treatment Integrity (MITI) Code (n= 67), and (c) "Regular training" followed by supervision based on both the behavior counts and the five global dimensions of the MITI (n= 67). All practitioners will record three sessions: one before " regular training", one after "regular training" and one six month after training. The practitioners in group b and c will record five additional sessions in conjunction with the supervision. All supervision and recording sessions will be made over the phone with actors role-playing clients. The sessions will be assessed for proficiency in MI by MIC Lab at the Karolinska Institute according to the Swedish translation of MITI 3.1.

Time Frame: The specific time points at which the outcome measure (the Swedish version of the MITI, version 3.1.) will be assessed are:

• Before the county councils' workshop trainings (pre-workshop).
• Directly after the workshop trainings (post-workshop).
• Six months after the workshop trainings (follow-up). => Since the different county council workshop trainings differ in time (e.g. one to four month) the participants from the different county councils will be followed for a period in between seven month (one + six) to ten month (four + six).

The participants randomized to the two groups with additional supervision will also be assessed five times between the post-workshop and the follow-up assessment (e.g. every month).

Inclusion criteria

• Subjects are practitioners that attend MI-training in five different Swedish county councils 2013-2014.

Exclusion criteria

• Practitioners younger than 18 and older than 65