Training substance abuse clinicians in motivational interviewing using live supervision via teleconferencing.

Training through traditional workshops is relatively ineffective for changing counseling practices. Teleconferencing supervision (TCS) was developed to provide remote, live supervision for training motivational interviewing. In this CTN platform study, counselors from 26 substance abuse community treatment programs affiliated with the Long Island and New York Nodes (now the Greater New York Node) of the National Drug Abuse Treatment Clinical Trials Network (CTN) completed a 2-day MI workshop and were randomized to live supervision via teleconferencing (TCS; n=32), standard tape-based supervision (tape; n=32), or workshop alone (workshop; n=33). Supervision conditions received 5 weekly supervision sessions at their sites using actors as standard patients. Sessions with clients were rated for MI skill with the Motivational Interviewing Treatment Integrity (MITI) Coding System pre-workshop and 1, 8, and 20 weeks post-workshop. Results found that those receiving TCS scored better than the workshop group on the MITI for spirit and empathy. TCS was also superior to workshop in reducing MI non-adherence and was superior to workshop and tape in increasing reflection to question ratio. Tape was superior to TCS in increasing complex reflections. The percentage of counselors meeting proficiency differed significantly between training conditions for the most stringent threshold.

Conclusions: TCS shows promise for promoting new counseling behaviors following participation in workshop training. However, further work is needed to improve supervision methods to bring more clinicians to high levels of proficiency and facilitate dissemination of evidence-based practices. A longer duration of supervision, involving a combination of techniques embodied in both TCS and tape may bring a greater proportion of community-based counselors to high levels of proficiency, but more attention is also needed to modify methods to minimize costs and time burden, so that supervision can be brought to scale and sustained broadly across the treatment system.