Implementation of motivational interviewing in substance use disorder treatment: Research network participation and organizational compatibility.

Despite considerable empirical evidence that psycho-social interventions improve addiction treatment outcomes across populations, implementation remains problematic. A small body of research points to the importance of research network participation as a facilitator of implementation; however, studies examined limited numbers of evidence-based practices. To address this gap, the present study examined factors impacting implementation of motivational interviewing (MI). This study used data from a national sample of privately funded treatment programs (n=345) and programs participating in the NIDA Clinical Trials Network (CTN) (n=156). Data were collected via face-to-face interviews with program administrators and clinical directors (2007-2009). Analysis included bivariate t tests and chi-square tests to compare private and CTN programs, and multivariable logistic regression of MI implementation.

A majority (68%) of treatment programs reported use of MI. Treatment programs participating in the CTN (88.9%) were significantly more likely to report use of MI compared with non-CTN programs (58.5%; P<0.01). CTN programs (82.1%) also were more likely to use trainers from the Motivational Interviewing Network of Trainers as compared with private programs (56.1%; P<0.05). Multivariable logic regression models reveal that CTN-affiliated programs and programs with a psychiatrist on staff were more likely to use MI. Programs that used the Stages of Change Readiness and Treatment Eagerness Scale assessment tool were also more likely to use MI, whereas programs placing greater emphasis on confrontational group therapy were less likely to use MI.

Conclusions: These findings suggest the critical role of research network participation, access to psychiatrists, and organizational compatibility in the adoption and sustained use of MI for the treatment of substance use disorders. Results suggest that as treatment programs begin the implementation process, special attention should be paid to creating an organizational climate receptive to innovation, and also the critical infrastructure necessary to facilitate implementation of psychosocial EBPs such as MI.