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Updated: Aug 24, 2026

Virtual Agent for Real-Time Motivational Interviewing by Integrating Adaptive Nonverbal Behavior and Language Models
Published on: December 23, 2025
Motivational interviewing training for community mental health providers: Findings and lessons learned from three
Arlene T Dalcin1,2, Tyler Fink1, Gerald J Jerome1,3
1Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, United States of America.
Purpose:
This study aimed to test innovative Motivational Interviewing (MI) training strategies: remote workshop and avatar conversation simulations among community mental health staff.
Innovation:
Researchers provided an engaging, interactive tool for learning and practicing MI to a variety of real-world practitioners and compared two methods for measuring skills: automated scoring from avatar simulations and coded interviews using the validated Motivational Interviewing Treatment Integrity (MITI) tool.
Methods:
Attitudes, beliefs, and MI skills of 127 practitioners implementing three distinct research projects were examined: ACHIEVE-D (weight loss); IMPACT (tobacco smoking cessation); and RHYTHM (CVD risk reduction).
Results:
95% of participants believed MI was important to learn; 88% completed the workshop; 64% used the avatar-based training. Practice improvements were modest and inconsistent over time across the three projects. While underutilized, 47 participants (75%) who tried the avatar training at least once felt that it helped develop their skills.
Conclusions:
Community mental health practitioners value learning MI. Their engagement with the asynchronous avatar training resources was insufficient and did not meaningfully improve their observed MI skills. Although a novel feature of the avatar-based training, the automated conversation scoring appeared to overestimate performance for all MI metrics relative to MITI scores at the same time points.
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