Community program therapist adherence and competence in a motivational interviewing assessment intake session

Teaching community program therapists to use motivational interviewing (MI) strategies for addictions treatment with sufficient frequency (i.e., adherence) and skill (i.e., competence) is a priority and challenge for the field. The development of psychometrically valid MI integrity measures that can be used for supervision and evaluation and be both sensitive and robust across clinical situations is needed.

This article examines the performance of the Independent Tape Rating Scale (ITRS) when used to evaluate the delivery of MI within a one-session assessment intake.

Audiotapes of 315 sessions of therapists in MI and counseling-as-usual conditions were rated according to the ITRS by raters blind to treatment condition.

Results indicate that community therapists were successfully trained and supervised to use MI within an assessment intake session, with MI adherence and competence that was discriminable from counseling-as-usual practices. Increased therapist MI adherence and competence was associated with increases in an index of client motivation for change, though unrelated to treatment outcome.

The ITRS appears to be a valid instrument for measuring therapist MI adherence and competence within an assessment intake.