Does Fidelity really matter?
Learning Motivational Interviewing to fidelity means becoming competent or proficient in the skill set. Once you’ve achieved competency or proficiency, the data shows you will notice the evidence based outcomes of Motivational Interviewing.
What does it mean to be competent or proficient in Motivational Interviewing?
According to Merriam Webster, competency is defined as, “Possession of sufficient knowledge or skill”
Proficiency is defined as, “Well advanced in art, occupation or branch of knowledge.”
Our goal is to help our participants of trainings to become as competent or proficient in Motivational Interviewing as they desire. Like all skills, to become competent in anything, whether it’s a sport, a hobby or a skill, it takes dedicated time and practice.
“It is unlikely that 75% of clinicians can achieve beginning proficiency in MI spirit after training unless competency is benchmarked and monitored and training is ongoing.” (Hall et al., 2016)
“Unless MI proficiency can be developed, measured and sustained, it will simply not be possible for organizations to achieve the types of improvements in patient-level outcomes demonstrated in MI clinical research trials.” (Butterworth& Andersen, 2011)
Why should I become competent or proficient in Motivational Interviewing?
Motivational Interviewing is an evidence based practice. There is research about how effective and efficient it is in resolving ambivalence and long term, sustained behavior change. If you want to access the research based outcomes of Motivational Interviewing, it takes becoming competent or proficient in that skill.
“Previous research indicates that motivational interviewing (MI) skills decline over time among participants in training workshops when post-workshop feedback and coaching are not provided.” (Schwalbe et al., 2014)
“Failure to establish treatment fidelity can result in unanticipated, non-significant findings that are erroneously attributed to problems with the intervention itself as opposed to its poor delivery (Resnicow et al., 2006).” (Robbins et al., 2012)
How will I know I’ve become competent or proficient?
By submitting audio tapes to get coded for fidelity. Many people use the MICA (Motivational Interviewing competency assessment) or the MITI (Motivational Interviewing Treatment Integrity) tools to code their conversations. These tools are used by trained professionals to help code how close your conversation was to Motivational Interviewing. With the MICA, once you receive your coded report back, you also receive a free coaching to get specific feedback for your current skill set and how to improve it.
“This indicated that trainees need more than a one-time workshop to improve skillfulness in this complex method. Two common learning aids seemed good candidates for improving training: progressive individual feedback on performance, and personal follow-up coaching.” (Miller & Rose, 2009)