MOVING MOTIVATIONAL INTERVIEWING INTO PRACTICE

将动机访谈付诸实践

• 批准号: 6174542
• 负责人: WILLIAM R. MILLER
• 金额: $ 33.08万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6174542
• 关键词: behavior therapy; behavioral /social science research tag; clinical research; clinical trials; drug abuse therapy; education evaluation /planning; health care personnel education; human subject; interview; motivation; patient care planning; training; workshop

Treatments with evidence of efficacy do not readily transfer into routine clinical practice. A particular challenge is changing established practice behaviors through continuing professional education. The average clinician practices for 30 years or more, during which time optimal practice is likely to undergo major changes. The usual continuing education format of a one-time workshop is unlikely to modify stable practice behavior substantially. The proposed study applies the basic design of a randomized clinical trial to test the efficacy of procedures for disseminating the clinical intervention style of motivational interviewing (MI). MI was selected because (1) there is strong evidence of its efficacy in addressing substance use disorders, (2) its procedures are well specified, (3) it is consonant with current trends in managed care, and (4) it has many of the attributes specified by Everett Rogers as promoting adoption of an innovation into established practice. A pilot study showed that a 2-day workshop alone was insufficient to change counselors' practice behavior enough to make a difference for clients. Two promising training enhancement procedures (individualized feedback to clinicians, and reinforced practice through individual consultations) will be evaluated via a design combining between-group and within-group effects with 140 substance abuse practitioners. Two well-developed systems for process coding of tapes will be used both to evaluate the efficacy of training, and to advance theory-relevant knowledge of active processes operating in motivational interviewing. A parallel substudy will implement and evaluate MI training of Spanish-speaking clinicians.

具有功效证据的治疗方法不容易转移到常规的临床实践中。 一个特殊的挑战是通过持续的专业教育改变既定的实践行为。 临床医生的平均实践已有30年或更长时间，在此期间最佳实践可能会发生重大变化。 一次研讨会的通常继续教育格式不太可能大大修改稳定的练习行为。 拟议的研究应用了一项随机临床试验的基本设计，以测试传播动机访谈临床干预风格（MI）的程序的功效。 之所以选择MI是因为（1）有强有力的证据表明其在解决药物使用障碍方面的功效，（2）它的程序已得到很好的指定，（3）它与当前的托管护理趋势相吻合，（4）它具有埃弗里特·罗杰斯（Everett Rogers）指定的许多属性，将其用于促进创新实践。 一项试点研究表明，仅一项为期2天的研讨会不足以改变辅导员的练习行为，足以使客户有所作为。 将通过设计组合组间和组内效应与140名滥用从业者的设计来评估两种有希望的培训增强程序（对临床医生的个性化反馈以及通过个人咨询的加强实践）将进行评估。 两个用于磁带的过程编码的完善的系统将既用于评估培训的功效，又要提高与理论相关的对动机访谈中运作的积极过程的了解。 平行的物质将实施和评估讲西班牙语临床医生的MI培训。