What is seen through the looking glass: The impact of training on practitioner self-rating of motivational interviewing skills.

Training efforts for evidenced-based treatments require evaluation, yet the value of practitioner self-reports of skills acquisition has been questioned. Thus, a key issue concerns how accurately practitioners assess their own clinical skills. In this CTN platform study, 23 community practitioners that had previously participated in the National Drug Abuse Treatment Clinical Trials Network (CTN) took part in training of Motivational Interviewing (MI), completed standardized patient (SP) interviews before and after training, and provided self-ratings of MI elements after each interview. Interview recordings were later coded independently.

Results suggest training contributed to: 1) reasonable agreement between practitioner and independent ratings; and 2) more effective use of MI, despite a tendency for practitioners to underestimate training gains. This micro-analysis of training documents initials skill gains along with increased practitioner self-awareness. Further, it exemplifies how practitioner self-ratings and objective skill assessment methods may be used in tandem to more fully describe practitioner learning. And, in so doing, perhaps it provides a fuller picture of how the image in the looking glass changes as practitioners consider and explore, understand and appreciate, practice and self-evaluate, and adopt and adapt the spirit and techniques of this therapeutic approach.