Related Experiment Video
Updated: May 28, 2026

Virtual Agent for Real-Time Motivational Interviewing by Integrating Adaptive Nonverbal Behavior and Language Models
Published on: December 23, 2025
Implementing psychology-based empathetic refutational interview training to support vaccine confident conversations
Dawn Holford1, Emma C Anderson2, Virginia C Gould1
1School of Psychological Science, University of Bristol, Bristol, UK.
Objective:
It can be challenging for health workers to have conversations with the public about vaccination and address misinformation without evidence-based training. Our objective was to pilot and evaluate a programme to teach an evidence-based communication approach, the Empathetic Refutational Interview (ERI), developed to help health workers address vaccine misinformation while maintaining trust.
Study Design:
This mixed-methods study evaluated participants' skills and confidence in the ERI before and after training and explored the feasibility of participants training others to use the ERI.
Methods:
Ten in-person, two-day workshops were conducted for 106 trainees in London, UK between October 2023 and November 2024. Participants were supported to adapt training content and pass it on (e.g., onward ERI training). Participants completed assessment and feedback questionnaires before and after the workshop and were emailed follow-up questionnaires at one month and three months after the workshop.
Results:
We received 101 before-and-after questionnaire responses, and 42 and 35 responses to the follow-ups. Participants' confidence, preparedness, and skills in using the ERI for vaccine conversations improved significantly. In their feedback, participants cited better understanding of patients' psychological motivations and the structure provided by the ERI framework as useful elements for their practice. Eighteen participants reported passing on ERI knowledge to colleagues; most onward ERI training featured a shorter version of the content delivered during the workshop.
Conclusions:
The training successfully equipped health workers with skills and confidence to approach vaccine conversations. However, few trainees were able to give in-depth ERI training to others without further support.
Related Concept Videos
Empathy
Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing
This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The...
Therapeutic Communication
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal...
Modeling in Therapy
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in situations...
Rational Emotive Behavior Therapy
Humanistic Therapy