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Published on: December 23, 2025
Training peer specialists with mental illness in motivational interviewing: A pilot study
Jack Tsai1, Anne Klee1, Nicole Shea1
1Veterans Affairs Connecticut Healthcare System.
Motivational interviewing (MI) training for peer specialists in the VA health system showed some practice changes, but ongoing support is crucial for sustained improvement. Further guidance on sharing lived experiences is recommended.
Area of Science:
- Healthcare research
- Behavioral science
- Peer support services
Background:
- Peer specialists play a vital role in the Veterans Affairs (VA) healthcare system.
- Motivational interviewing (MI) is a counseling approach that helps individuals explore and resolve ambivalence about behavior change.
- Evaluating the effectiveness of MI training for peer specialists is important for optimizing service delivery.
Purpose of the Study:
- To assess the impact of motivational interviewing (MI) training on peer specialists within the VA.
- To determine if MI training influences the fidelity of peer specialists' interactions with service recipients.
Main Methods:
- A 2-day MI workshop and booster sessions were provided to 14 VA peer specialists.
- 55 therapy sessions were audio-recorded and rated for MI fidelity over 3 months post-training.
- Analysis included scales for MI adherence, competence, and a novel item on sharing lived experiences.
Main Results:
- Peer specialists demonstrated a significant decrease in MI Inconsistent Adherence scores, including reduced unsolicited advice and emphasis on absolute abstinence.
- A significant decline was observed in the 'Sharing Lived Experiences' adherence item.
- No significant changes were noted in Fundamental or Advanced MI Adherence and Competence scales.
Conclusions:
- MI training is feasible for VA peer specialists and can lead to some practice modifications.
- Comprehensive training and continuous supervision are necessary for lasting changes in MI practice.
- Specific guidance on how peer specialists share lived experiences may enhance their effectiveness.
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