Motivational interviewing adherence tools: A scoping review investigating content validity

Area of Science:

• Behavioral Science
• Psychology
• Health Communication

Background:

• Motivational Interviewing (MI) is a collaborative counseling style.
• Assessing adherence to MI principles is crucial for effective practice.
• Existing measures may not fully capture the complexity of MI.

Purpose of the Study:

• To evaluate the content validity of Motivational Interviewing (MI) as a concept.
• To determine the relative emphasis of specific MI aspects within adherence measures.
• To assess how well current MI adherence measures align with research and best practices.

Main Methods:

• A scoping review following PRISMA guidelines.
• Identification and analysis of 28 MI adherence measures.
• Content analysis of 407 specific MI adherence codes.

Main Results:

• Fifteen MI themes emerged, with 13 focusing on clinician behaviors and 2 on client responses.
• Four themes (OARS, MI Spirit, evoking motivation, MI-inconsistent behaviors) comprised 72% of codes.
• Measures varied in assessed themes and number of questions, with most focusing solely on clinician behavior.

Conclusions:

• MI adherence measures reflect some core MI principles but lag behind current research and practice.
• Significant variance in assessing MI nuances raises questions about practical application and training.
• Most measures neglect the client's response, limiting a comprehensive understanding of MI effectiveness.