Evaluating motivational enhancement therapy adherence and competence among Spanish-speaking therapists.

Despite the fact that the number of Hispanic individuals in need of treatment for substance use problems is increasing internationally, no studies have investigated the extent to which therapists can provide empirically supported treatments to Spanish-speaking clients with adequate fidelity. In this report, the authors provide data on the psychometric properties of a therapist adherence/competence rating system adapted from a previous English language multisite randomized clinical trial of motivational enhancement therapy (CTN-0004) and used in an independent Spanish version of the trial (CTN-0021). Both studies were conducted within the National Drug Abuse Treatment Clinical Trials Network. Identical in most ways (other than language and relevant cultural adaptations) to the protocol conducted in English, the Spanish MET protocol examined the effectiveness of a three-session adaptation of MET used in Project MATCH compared to counseling-as-usual (CAU) in five US-based community treatment programs. Independent ratings of 325 sessions indicated the adherence/competence rating system had good to excellent interrater reliability and indicated strong support for an a priori defined fundamental MET skill factor. Support for an advanced MET skill factor was relatively weaker. The rating scale indicated significant differences in therapists’ MET adherence and competence across conditions.

These findings indicate that the rating system has promise for assessing the performance of therapists who deliver MET in Spanish and suggest that bilingual Spanish-speaking therapists from the community can be trained to implement MET with adequate fidelity and skill using an intensive multisite training and supervision model.

Related protocols: CTN-0004, CTN-0021